• Maarten J Loos, Marc R Scheltinga, Leon G Mulders, and Rudi M Roumen.
• Department of General Surgery and Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, the Netherlands. loosmaarten@hotmail.com
• Obstet Gynecol. 2008 Apr 1;111(4):839-46.

ObjectiveTo estimate prevalence, risk factors, and etiology of post-Pfannenstiel pain syndromes.MethodsAll women (n=866) with a Pfannenstiel incision for cesarean delivery or abdominal hysterectomy performed between January 2003 and December 2004 received a questionnaire evaluating pain located in the Pfannenstiel region. A multivariate logistic regression analysis was done to determine predictors for chronic pain development. Patients with moderate or severe pain were interviewed and underwent a physical examination.ResultsThe response rate was 80% (690 of 866 patients). Subsequent to a follow-up after 2 years, one third (223 of 690) experienced chronic pain at the incision site. Moderate or severe pain was reported by 7%, and in 8.9% of respondents, pain impaired daily activities. Numbness, recurrent Pfannenstiel surgery, and emergency caesarean delivery were significant predictors of chronic pain. Nerve entrapment was present in over half the examined patients with moderate-to-severe pain (17 of 32).ConclusionChronic pain occurs commonly after a Pfannenstiel incision. Nerve entrapment was found to be a frequent cause of moderate-to-severe pain.

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