• Scand J Pain · Apr 2016

    Characterization of persistent pain after hysterectomy based on gynaecological and sensory examination.

    • Satu M Pokkinen, Kari Nieminen, Arvi Yli-Hankala, and Maija-Liisa Kalliomäki.
    • Department of Anaesthesia, Tampere University Hospital, PO Box 2000, FI-33521 Tampere, Finland. Electronic address: Pokkinen.Satu.M.@student.uta.fi.
    • Scand J Pain. 2016 Apr 1; 11: 42-48.

    Background And AimsPrevious studies have shown that pelvic pain is common after hysterectomy. It is stated that only a minor part of that pain can be defined as persistent postsurgical pain. Our primary aim was to find out if the pelvic pain after hysterectomy may be classified as postsurgical. Secondary aims were to characterize the nature of the pain and its consequences on the health related quality of life.MethodsWe contacted the 56 women, who had reported having persistent pelvic pain six months after hysterectomy in a previously sent questionnaire. Sixteen women participated. Clinical examinations included gynaecological examination and clinical sensory testing. Patients also filled in quality of life (SF-36) and pain questionnaires.ResultsTen out of sixteen patients still had pain at the time of examination. In nine patients, pain was regarded as persistent postsurgical pain and assessed probable neuropathic for five patients. There were declines in all scales of the SF-36 compared with the Finnish female population cohort.ConclusionsIn this study persistent pelvic pain after vaginal or laparoscopic hysterectomy could be defined as persistent postsurgical pain in most cases and it was neuropathic in five out of nine patients. Pain had consequences on the health related quality of life.ImplicationsBecause persistent postsurgical pain seems to be the main cause of pelvic pain after hysterectomy, the decision of surgery has to be considered carefully. The management of posthysterectomy pain should be based on the nature of pain and the possibility of neuropathic pain should be taken into account at an early postoperative stage.Copyright © 2015 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

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