3 years ago

Occurrence of Chronic Pelvic Pain, Abnormal Uterine Bleeding, and Hysterectomy Post Procedure among Women Who Have Undergone Female Sterilization Procedures−a Retrospective Claims Analysis of Commercially Insured Women in the US

To evaluate the frequency of chronic pelvic pain (CPP), abnormal uterine bleeding (AUB), and hysterectomy following hysteroscopic (HS) and laparoscopic (LS) sterilization in the US Design Retrospective cohort study (Canadian Task Force II-2) Setting Commercially-insured women Patients Women (18-49) with claims for HS or LS (1/1/2010-12/31/2012) were identified from the MarketScan Commercial database. Women were required to have 6 months of continuous coverage prior to (baseline) and 24 months after (follow-up) the procedure date. Women with ≥1 diagnosis for a pain condition (pain in pelvis/lower abdomen, low back pain, chronic headache, fibromyalgia) and/or AUB (excessive/frequent menstruation, irregular menstrual cycle, metorrhagia) during baseline were identified with ICD-9-CM codes. Interventions HS/LS Measurements and Main Results Outcome measurements: proportions of women with CPP, AUB, and hysterectomy during follow-up. Among the study population, 10,224 underwent HS; 8,051 underwent LS. During baseline, 23.3% and 26.9% of women with HS and LS, respectively, had a pre-existing pain diagnosis. Among both HS and LS study cohorts, greater proportions of women with a pre-existing pain condition versus those without had CPP in the 24 months afterward (HS-cohort: 19.8% vs. 9.3%, p<0.001; LS-cohort: 23.8% vs. 11.4%, p<0.001). During baseline, 11.7% and 6.4% of women with HS and LS, respectively, had pre-existing AUB. Among cohorts, greater proportions of women with pre-existing AUB versus those without had AUB in the 24 months afterward (HS-cohort: 21.2% vs. 7.3%, p<0.001; LS-cohort: 15.9% vs. 6.4%, p<0.001). Among women who underwent HS and LS, pre-existing pain and AUB were associated with higher rates of hysterectomy post procedure. Multivariable regression results showed similar direction of findings. Conclusions Among women who underwent HS and LS, pre-existing pain conditions and AUB were associated with higher rates of CPP and AUB post procedure, respectively, and both pre-existing conditions were associated with a greater frequency of subsequent hysterectomy.

Publisher URL: www.sciencedirect.com/science

DOI: S1553465017312657

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