Hysterectomy for Chronic Pelvic Pain

Richard Cockrum; Frank Tu

doi:10.1016/j.ogc.2022.02.008

Hysterectomy for Chronic Pelvic Pain

Obstet Gynecol Clin North Am. 2022 Jun;49(2):257-271. doi: 10.1016/j.ogc.2022.02.008.

Authors

Richard Cockrum¹, Frank Tu²

Affiliations

¹ Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Walgreen's Bldg 1507, 2650 Ridge Avenue, Evanston, IL 60201, USA; Department of Obstetrics and Gynecology, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA.
² Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Walgreen's Bldg 1507, 2650 Ridge Avenue, Evanston, IL 60201, USA; Department of Obstetrics and Gynecology, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA. Electronic address: ftu@northshore.org.

PMID: 35636807
DOI: 10.1016/j.ogc.2022.02.008

Abstract

For well selected patients with chronic pelvic pain (CPP), 74% to 95% of women will report complete or significant improvement in pain after hysterectomy. A thoughtful history, examination, and review of imaging can improve success by linking pain complaints to discrete pathology, menstrual activity, or uterine tenderness. All patients with CPP should be evaluated for chronic overlapping pain conditions (COPCs) (eg, irritable bowel syndrome (IBS), fibromyalgia) and risk factors for persistent pain or chronic postsurgical pain (eg, depression, pain catastrophizing, central sensitization), and offered treatment as indicated. There are special considerations for preoperative planning and enhanced recovery for patients with chronic pain.

Keywords: Chronic pelvic pain; Hysterectomy; Perioperative management; Surgical treatment.

Publication types

Review

MeSH terms

Chronic Disease
Chronic Pain* / complications
Female
Humans
Hysterectomy / adverse effects
Irritable Bowel Syndrome* / complications
Pelvic Pain / etiology
Pelvic Pain / surgery