Effect of hysterectomy on pain in women with endometriosis: a population‐based registry study

Sandström A, A Sandström, M Bixo, Marie Bixo, M Johansson, Johansson M, Mattias Johansson, Bäckström T, T Bäckström, Torbjörn Bäckström, Şahruh Türkmen, S Turkmen, Turkmen S
BJOG: An International Journal of Obstetrics & Gynaecology · 2020 · vol. 127(13) , pp. 1628–1635 · doi:10.1111/1471-0528.16328 · PMID:32437082 · W3026284036
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This registry study found that hysterectomy significantly reduced pelvic or lower abdominal pain, with a substantial decrease in severe pain, for women with endometriosis.

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Abstract

Objective To assess pain symptoms before and after hysterectomy in women with endometriosis. Design A population‐based registry study. Setting Sweden. Population Women aged 18–45 years who underwent hysterectomy for endometriosis between 2010 and 2015. Methods Pain symptoms before hysterectomy and 12 months after surgery were collected from the Swedish National Quality Register for Gynaecological Surgery (GynOp). Pain symptoms were also assessed by follow‐up surveys after a median follow‐up period of 63 months. Main outcome measures Pelvic or lower abdominal pain after hysterectomy. Results The study included 137 women. The proportion of women experiencing pain of any severity decreased by 28% after hysterectomy ( P < 0.001). The proportion of women with severe pain symptoms decreased by 76% after hysterectomy ( P < 0.001). The majority of women (84%) were satisfied with the surgical result. Presence of severe pain symptoms after the hysterectomy was associated with less satisfaction ( P < 0.001). Pain symptoms after surgery, patient satisfaction and the patient's perceived improvement were not significantly different between women whose ovarian tissue was preserved and women who underwent bilateral oophorectomy. Conclusions We observed a significant, long‐lasting reduction in pain symptoms after hysterectomy among women with endometriosis. Hysterectomy, with the possibility of ovarian preservation, may be a valuable option for women with endometriosis who suffer from severe pain symptoms. Tweetable abstract Hysterectomy is a valuable option for women with endometriosis and severe pain symptoms.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Endometriosis Hysterectomy Pelvic Pain Pelvic Pain Uterine Diseases Uterine Diseases Adolescent Adult Endometriosis Female Humans Middle Aged Pelvic Pain Prospective Studies Registries Severity of Illness Index Sweden Uterine Diseases Young Adult

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