The Pfannenstiel incision as a source of chronic pain.
OBJECTIVE
To estimate prevalence, risk factors, and etiology of post-Pfannenstiel pain syndromes.


METHODS
All women (n=866) with a Pfannenstiel incision for cesarean delivery or abdominal hysterectomy performed between January 2003 and December 2004 received a questionnaire evaluating pain located in the Pfannenstiel region. A multivariate logistic regression analysis was done to determine predictors for chronic pain development. Patients with moderate or severe pain were interviewed and underwent a physical examination.


RESULTS
The response rate was 80% (690 of 866 patients). Subsequent to a follow-up after 2 years, one third (223 of 690) experienced chronic pain at the incision site. Moderate or severe pain was reported by 7%, and in 8.9% of respondents, pain impaired daily activities. Numbness, recurrent Pfannenstiel surgery, and emergency caesarean delivery were significant predictors of chronic pain. Nerve entrapment was present in over half the examined patients with moderate-to-severe pain (17 of 32).


CONCLUSIONS
Chronic pain occurs commonly after a Pfannenstiel incision. Nerve entrapment was found to be a frequent cause of moderate-to-severe pain.
Loos
Maarten J
MJ
Department of General Surgery and Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, the Netherlands. loosmaarten@hotmail.com
Scheltinga
Marc R
MR
Mulders
Leon G
LG
Roumen
Rudi M
RM
D000328:Adult; D000368:Aged; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000453:epidemiology; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology*; D010808:Physical Examination; D012307:Risk Factors; D011795:Surveys and Questionnaires