03 Size of genital hiatus and short-term surgical success following native tissue apical suspension in patients with concomitant posterior repair compared to those without

Abstract

surgical pathology were abstracted from the electronic medical record. Multivariate logistic regression was used to identify independent predictors of persistent pelvic pain 6 months following hysterectomy, defined as <50% improvement in pelvic pain severity. RESULTS: Among 176 participants with pelvic pain prior to hysterectomy, 126 (71.6%) were retained at 6-months, and 15 (11.9%) reported persistent pelvic pain. There was no difference in age (P ¼ 0.59), race (P ¼ 0.23), average pain severity (P ¼ 0.59) or pain duration (P ¼ 0.80) in those with and without persistent pelvic pain. While intraoperative findings of endometriosis (P ¼ 0.045) and uterine fibroids (P ¼ 0.03) were associated with a higher incidence of persistent pain, surgical route (P ¼ 0.46), pelvic adhesions (0.51), uterine weight (P ¼ 0.66), and adenomyosis on histopathology (P ¼ 0.27), were not related to risk of persistent pain. Higher preoperative centralized pain scores (P ¼ 0.01), but not depression (P ¼ 0.13) or anxiety (P ¼ 0.28) were more common in women with persistent pelvic pain. Multivariate logistic regression controlling for age, preoperative pain severity, anxiety, depression, and operative findings of endometriosis and fibroids indicated that every 1-point increase in centralized pain prior to hysterectomy was associated with a 27% increase in odds of persistent pelvic pain (OR ¼ 1.27, 95% CI ¼ 1.03, 1.57) 6-months after surgery. CONCLUSION: While the majority of women with CPP report considerable improvement in pain following hysterectomy, higher degrees of centralized pain prior to hysterectomy is a robust predictor of persistent pelvic pain, even among women whose score falls below the diagnostic criteria for fibromyalgia.