Our Summary
This research paper is about a study that was conducted to examine how well surgery helped to treat pelvic pain in women who had previously had a hysterectomy (removal of the uterus) but had kept their ovaries. This was done in a university hospital’s gynecology department and involved 99 patients who were treated between 2008 and 2016.
The operation performed on all patients was a laparoscopic oophorectomy, which is a procedure where the ovaries are removed through small incisions in the abdomen. The average age of the patients was around 49 years and they had, on average, three previous abdominal surgeries.
The results of the study showed that after six weeks, around 60% of the patients said their symptoms were gone, about 29% said their symptoms were better but not completely gone, and roughly 11% said their symptoms were still there. Younger patients and those who had a history of gastrointestinal disease were more likely to still have pain after the surgery.
There were some complications during and after the surgery, and the risk of these complications was higher in patients who were overweight, had a lot of previous surgeries, or had severe internal scar tissue.
In conclusion, removing the ovaries to treat pelvic pain after a hysterectomy is a possible solution, but it’s not easy and it does have risks. Even though there were complications and some patients still had symptoms, most of the patients had their symptoms resolve or improve after the surgery. The study suggests that more research is needed to understand the long-term outcomes of this surgery. Also, it’s very important to carefully choose and counsel patients before deciding to go ahead with this procedure.
FAQs
- What is the success rate of laparoscopic oophorectomy in relieving pelvic pain after an ovary-sparing hysterectomy?
- What factors may increase the risk of complications during laparoscopic oophorectomy?
- What percentage of patients reported persistent symptoms after undergoing laparoscopic oophorectomy for pelvic pain following ovary-sparing hysterectomy?
Doctor’s Tip
A helpful tip a doctor might tell a patient about laparoscopic hysterectomy is to carefully follow post-operative instructions provided by the healthcare team. This may include taking prescribed medications, getting plenty of rest, avoiding heavy lifting, and attending follow-up appointments. Following these recommendations can help ensure a smooth recovery and optimal outcome after surgery.
Suitable For
Patients who are typically recommended for laparoscopic hysterectomy include those experiencing pelvic pain following ovary-sparing hysterectomy. In this study, patients who underwent laparoscopic oophorectomy for pelvic pain had a mean age of 48.9 years and a mean body mass index (BMI) of 28.1. They had a history of multiple previous abdominal surgeries, with 60% reporting a previous abdominal hysterectomy, 21% reporting a previous laparoscopic hysterectomy, and 19% reporting a previous vaginal hysterectomy.
Patients who are younger and those with a previous history of gastrointestinal disease were more likely to report persistent pain at follow-up. Complications occurred in 13% of patients, with a 2% rate of conversion to laparotomy. Patients at greater risk of complications were those with a higher BMI, a greater number of previous open abdominal surgeries, or severe adhesions noted at the time of the procedure.
Overall, laparoscopic oophorectomy was found to be a feasible procedure for treating pelvic pain following ovary-sparing hysterectomy, with most patients experiencing symptom resolution or improvement. However, careful patient selection and counseling are important before proceeding with this surgery. Further studies are needed to assess long-term outcomes.
Timeline
Timeline of patient experiences before and after laparoscopic hysterectomy:
Before surgery:
- Patient experiences pelvic pain following ovary-sparing hysterectomy
- Consults with gynecologist for evaluation and treatment options
- Decision is made to undergo laparoscopic oophorectomy for pain relief
- Pre-operative tests and evaluations are conducted
- Patient receives counseling on the procedure and potential risks and benefits
After surgery:
- Patient undergoes laparoscopic oophorectomy for pelvic pain
- At 6-week follow-up, 59.5% of patients report resolution of symptoms, 10.7% report persistent symptoms, and 29.8% report improved but not resolved symptoms
- Younger patients and those with a history of gastrointestinal disease are more likely to report persistent pain
- 13% of patients experience intraoperative or postoperative complications
- 2% of patients require conversion to laparotomy
- Patients with higher BMI or a greater number of previous abdominal surgeries are at greater risk of complications
- Further studies are needed to assess long-term outcomes of laparoscopic oophorectomy for pelvic pain
What to Ask Your Doctor
- What are the potential benefits of undergoing a laparoscopic oophorectomy for pelvic pain following ovary-sparing hysterectomy?
- What are the potential risks and complications associated with this procedure?
- How long is the recovery period after a laparoscopic oophorectomy?
- How likely is it that my symptoms will be resolved or improved after the surgery?
- Are there any alternative treatment options for pelvic pain that I should consider before proceeding with surgery?
- How many of these procedures have you performed, and what is your success rate?
- Will I need to take any medications or follow any specific post-operative care instructions after the surgery?
- Are there any long-term effects or considerations I should be aware of after undergoing a laparoscopic oophorectomy?
- How soon after the surgery can I expect to return to normal activities and work?
- What should I do if I experience any unusual symptoms or complications after the surgery?
Reference
Authors: Richards L, Healey M, Cheng C, Dior U. Journal: J Minim Invasive Gynecol. 2019 Sep-Oct;26(6):1044-1049. doi: 10.1016/j.jmig.2018.10.005. Epub 2018 Oct 9. PMID: 30308307