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.
Ghezzi
Fabio
F
Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy. fabio.ghezzi@uninsubria.it
Uccella
Stefano
S
Cromi
Antonella
A
Siesto
Gabriele
G
Serati
Maurizio
M
Bogani
Giorgio
G
Bolis
Pierfrancesco
P
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