Postoperative pain after laparoscopic and vaginal hysterectomy for benign gynecologic disease: a randomized trial

Fabio Ghezzi; Stefano Uccella; Antonella Cromi; Gabriele Siesto; Maurizio Serati; Giorgio Bogani; Pierfrancesco Bolis

doi:10.1016/j.ajog.2010.04.026

Postoperative pain after laparoscopic and vaginal hysterectomy for benign gynecologic disease: a randomized trial

Fabio Ghezzi, Stefano Uccella, Antonella Cromi, Gabriele Siesto, Maurizio Serati, Giorgio Bogani, Pierfrancesco Bolis

American journal of obstetrics and gynecology · 2010 · vol. 203(2) , pp. 118.e1–118.e8 · doi:10.1016/j.ajog.2010.04.026 · PMID:20522410 · W2106484825

RCT OA: closed CC0 ⤵ 7 in-corpus citations

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This randomized trial compared postoperative pain levels in women undergoing laparoscopic versus vaginal hysterectomy for benign gynecologic disease.

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Abstract

OBJECTIVE: To compare postoperative pain after laparoscopic and vaginal hysterectomy for benign disease. STUDY DESIGN: A prospective randomized trial was designed to compare laparoscopic hysterectomy and vaginal hysterectomy in patients with uterine volume <or=14 weeks of gestation. Postoperative pain was measured using the visual analog scale (VAS) at 1, 3, 8, and 24 hours postoperatively. Intra- and postoperative outcomes were carefully recorded, including the need for postoperative rescue doses of analgesia. RESULTS: A total of 82 patients were enrolled. Patients who underwent vaginal hysterectomy complained of higher postoperative pain at each VAS evaluation (VAS-1 hour, P < .0001; VAS-3 hour, P < .0001; VAS-8 hour, P < .0001; VAS-24 hour, P = .0003) with a higher need for rescue analgesia (P < .0001) and a longer hospitalization (P = .001). The other perioperative characteristics were comparable between the 2 groups. CONCLUSION: Laparoscopic hysterectomy provides an advantage over vaginal hysterectomy in terms of postoperative pain, need for rescue analgesia and hospital stay, with similar perioperative outcomes.

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MeSH descriptors

Genital Diseases, Female Genital Diseases, Female Hysterectomy, Vaginal Hysteroscopy Postoperative Pain Adult Aged Age Factors Female Follow-Up Studies Genital Diseases, Female Humans Hysterectomy Hysterectomy Hysterectomy Hysterectomy, Vaginal Hysterectomy, Vaginal Hysteroscopy Hysteroscopy Incidence

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