Postoperative pain after laparoscopic and vaginal hysterectomy for benign gynecologic disease: a randomized trial.
OBJECTIVE
To compare postoperative pain after laparoscopic and vaginal hysterectomy for benign disease.


METHODS
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.


CONCLUSIONS
Laparoscopic hysterectomy provides an advantage over vaginal hysterectomy in terms of postoperative pain, need for rescue analgesia and hospital stay, with similar perioperative outcomes.
Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy. fabio.ghezzi@uninsubria.it
Fabio
F
Ghezzi
Stefano
S
Uccella
Antonella
A
Cromi
Gabriele
G
Siesto
Maurizio
M
Serati
Giorgio
G
Bogani
Pierfrancesco
P
Bolis
D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005831:Genital Diseases, Female / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods*; D015907:Hysteroscopy / Q000009:adverse effects / Q000379:methods*; D015994:Incidence; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000453:epidemiology; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016896:Treatment Outcome