![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
Abstract
Objective
To investigate the outcome of total laparoscopic hysterectomy (TLH) and postoperative pain characteristics and compare the pain severity after TLH for adenomyosis or uterine fibroids.
Methods
This prospective observational study collected 101 patients received TLH for adenomyosis (AD group) including 41 patients were injected goserelin (3.6 mg) 28 days before TLH, while other adenomyosis patients received TLH without preoperative treatment, and 113 patients received TLH for uterine fibroids (UF group). Pain scores were evaluated at different time sites from operation day to postoperative 72 h using the numeric rating scale. Clinical data were collected from clinical record.
Results
Operative time and anaesthetic time were longer in the AD group than those in the UF group (66.88 ± 8.65 vs. 64.46 ± 7.21, p = 0.04; 83.95 ± 10.05 vs. 79.77 ± 6.88, p < 0.01), severe endometriosis was quite more common in AD group (23.76% vs. 2.65%, p < 0.01). Postoperative usage of Flurbiprofen in AD group were more than that of UF group (15.48 ± 38.00 vs. 4.79 ± 18.16, p = 0.02). Total pains and abdominal visceral pains of AD group were more severe compared with UF group in motion and rest pattern at several time sites, while incision pain and shoulder pain were similar. The total postoperative pains after goserelin preoperative treatment in AD group were less than that without goserelin preoperative treatment (p < 0.05). The levels of serum NPY, PGE2 and NGF after laparoscopic hysterectomy of adenomyosis reduced with GnRH agonist pretreatment.
Conclusions
Acute postoperative pain for adenomyosis and uterine fibroids showed considerably different severity, postoperative total pain and abdominal visceral pains of TLH for adenomyosis were more severe compared with uterine fibroids. While patients received goserelin before laparoscopic hysterectomy of adenomyosis suffered from less severity of postoperative total pain than that without goserelin preoperative treatment.
Key messages
Acute postoperative pain for adenomyosis and uterine fibroids showed considerably different severity, postoperative total pain and abdominal visceral pains of TLH for adenomyosis were more severe compared with uterine fibroids.
Patients received goserelin before laparoscopic hysterectomy of adenomyosis suffered from less severity of postoperative total pain than that without goserelin preoperative treatment.
Acknowledgements
We are grateful to everyone involved in carrying out the study, analysing the data, and producing the manuscript.
Contribution to authorship
Qing Wu, Yun Zhou and Huafeng Shou conceived the study and participated in its design, drafting and writing the manuscript as well as supervising the study and critically revising the manuscript. Qing Wu, Shanshan Cao and Saijun Sun collected the clinical data. Qing Wu, Yun Zhou, and Hui Li was responsible for drafting and writing the manuscript and statistical analysis. All authors substantially contributed to the revision of the manuscript.
Ethics approval and consent to participate
The studies involving human participants were reviewed and approved by the Institutional Ethics Committee of Zhejiang Provincial People’s Hospital, China. The patients/participants provided their written informed consent to participate in this study.
Consent for publication
Not applicable.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Availability of data and material
The data of study are not publicly available due to ethical and legal restrictions. However, upon request, data may be available from the corresponding author on reasonable request.