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