Postoperative Pain after Laparoscopic, Vaginal and Abdominal Hysterectomy for Benign Pathology: A Nationwide population-based Comparison

Hysterectomy is a commonly performed gynecological procedure. Although laparoscopic hysterectomy takes longer time, its proponents have emphasized several advantages over abdominal hysterectomy in terms of intraoperative blood loss, less postoperative morbidity, rapid recovery time, shorter hospital stay, fewer febrile episodes and early return to normal activities. In the past decade, only few randomized trials have compared these different approaches focusing on postoperative pain as the primary outcome. In the current study, we identified patients undergoing laparoscopic hysterectomy, vaginal hysterectomy and abdominal hysterectomy in 2002-2008 by sampling Taiwan's National Health Insurance (NHI) database. Among 9,659 hysterectomies, 19.6% were laparoscopic, 58.8% abdominal, and 21.7% vaginal. Univariate and multiple logistic regressions were used to analyze the association between postoperative pain, hysterectomy types and pathological diagnoses. Our study demonstrated that laparoscopic hysterectomy resulted in less postoperative pain and a shorter hospital stay, in comparison with abdominal and vaginal hysterectomy.