Impact of hysterectomy on opioid use in patients with adenomyosis: A nationwide register study.
<h4>Introduction</h4>Dysmenorrhea and heavy menstrual bleeding are the most common symptoms in adenomyosis, in addition to infertility and chronic pelvic pain. Hysterectomy is a common treatment for adenomyosis symptoms with curative effect on heavy menstrual bleeding but with less studi...
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2025-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0317135 |
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| author | Malin Brunes Gudny Jonsdottir Marion Ek Helena Kopp Kallner Klara Hasselrot |
| author_facet | Malin Brunes Gudny Jonsdottir Marion Ek Helena Kopp Kallner Klara Hasselrot |
| author_sort | Malin Brunes |
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| description | <h4>Introduction</h4>Dysmenorrhea and heavy menstrual bleeding are the most common symptoms in adenomyosis, in addition to infertility and chronic pelvic pain. Hysterectomy is a common treatment for adenomyosis symptoms with curative effect on heavy menstrual bleeding but with less studied effects on pain reduction.<h4>Material and methods</h4>This is a nationwide retrospective register-based cohort study including all hysterectomized patients with pathology-verified adenomyosis between 1 January 2012 and 31 December 2015 with a long-term follow-up three years pre- and three years postoperatively. Two national registers were linked in order to describe the primary outcome of proportion with use of opioids among hysterectomized patients with and without adenomyosis pre- and postoperatively. Logistic and multinomial regression models were used.<h4>Results</h4>A total of 2,228 (15%) patients had pathology-verified adenomyosis. Overall opioid use was 18.6% and 21.1% three years before and three years after surgery, respectively. Results showed a significantly increased risk of opioid use three years after hysterectomy in patients with preoperative use of opioids and antidepressants (adjusted Odds Ratio (aOR) 5.7, 95% Confidence Interval (CI) 4.5-7.2 and aOR 1.4, 95% CI 1.1-1.8). The risk of needing long-term opioids was higher among patients with smaller uteri (<300g, aOR 2.8, 95% CI 1.7-4.7) compared to women with uterine sizes ≥600g.<h4>Conclusions</h4>Hysterectomy does not reduce opioid use among adenomyosis patients in long-term follow-up, although the subjective reduction of pain was not investigated in this study. Women with preoperative use of opioids/antidepressants and uterine size <300g are at increased risk for chronic opioid use. |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-c2c4f9bda3584766aff39b69ac4a43aa2025-08-20T02:12:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01201e031713510.1371/journal.pone.0317135Impact of hysterectomy on opioid use in patients with adenomyosis: A nationwide register study.Malin BrunesGudny JonsdottirMarion EkHelena Kopp KallnerKlara Hasselrot<h4>Introduction</h4>Dysmenorrhea and heavy menstrual bleeding are the most common symptoms in adenomyosis, in addition to infertility and chronic pelvic pain. Hysterectomy is a common treatment for adenomyosis symptoms with curative effect on heavy menstrual bleeding but with less studied effects on pain reduction.<h4>Material and methods</h4>This is a nationwide retrospective register-based cohort study including all hysterectomized patients with pathology-verified adenomyosis between 1 January 2012 and 31 December 2015 with a long-term follow-up three years pre- and three years postoperatively. Two national registers were linked in order to describe the primary outcome of proportion with use of opioids among hysterectomized patients with and without adenomyosis pre- and postoperatively. Logistic and multinomial regression models were used.<h4>Results</h4>A total of 2,228 (15%) patients had pathology-verified adenomyosis. Overall opioid use was 18.6% and 21.1% three years before and three years after surgery, respectively. Results showed a significantly increased risk of opioid use three years after hysterectomy in patients with preoperative use of opioids and antidepressants (adjusted Odds Ratio (aOR) 5.7, 95% Confidence Interval (CI) 4.5-7.2 and aOR 1.4, 95% CI 1.1-1.8). The risk of needing long-term opioids was higher among patients with smaller uteri (<300g, aOR 2.8, 95% CI 1.7-4.7) compared to women with uterine sizes ≥600g.<h4>Conclusions</h4>Hysterectomy does not reduce opioid use among adenomyosis patients in long-term follow-up, although the subjective reduction of pain was not investigated in this study. Women with preoperative use of opioids/antidepressants and uterine size <300g are at increased risk for chronic opioid use.https://doi.org/10.1371/journal.pone.0317135 |
| spellingShingle | Malin Brunes Gudny Jonsdottir Marion Ek Helena Kopp Kallner Klara Hasselrot Impact of hysterectomy on opioid use in patients with adenomyosis: A nationwide register study. PLoS ONE |
| title | Impact of hysterectomy on opioid use in patients with adenomyosis: A nationwide register study. |
| title_full | Impact of hysterectomy on opioid use in patients with adenomyosis: A nationwide register study. |
| title_fullStr | Impact of hysterectomy on opioid use in patients with adenomyosis: A nationwide register study. |
| title_full_unstemmed | Impact of hysterectomy on opioid use in patients with adenomyosis: A nationwide register study. |
| title_short | Impact of hysterectomy on opioid use in patients with adenomyosis: A nationwide register study. |
| title_sort | impact of hysterectomy on opioid use in patients with adenomyosis a nationwide register study |
| url | https://doi.org/10.1371/journal.pone.0317135 |
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