Comparison of postoperative pain rates with different hysterectomy techniques: A retrospective study

This study aimed to compare different hysterectomy techniques regarding postsurgical pain. Women who underwent hysterectomy for nonmalignant etiologies between January 2019 and March 2023 were included in this retrospective study. The participants were divided into 4 groups based on the surgical techniques performed: abdominal hysterectomy (AH), laparoscopic hysterectomy, vaginal hysterectomy, and vaginal natural orifice transluminal endoscopic surgery (vNOTES). Pain scores and analgesic consumption were used for pain assessment. Parameters before the surgery and 24 hours, 1 week, 1, 3, and 6 months after the operation were retrospectively evaluated. Additionally, possible factors associated with pain, such as age, previous pelvic pain, previous abdominal surgery, indications for surgery duration of the surgery, volume of hysterectomy material, mean postoperative hospital stay, and blood transfusion were analyzed. A total of 264 patients were enrolled in this study. Thirty (11.3%) patients reported postsurgical chronic pain (PSCP). The mean number of days with postoperative pain was highest in the AH group and lowest in the vNOTES group. AH patients had the highest pain scores at the 24th hour and 1 week after surgery, and vNOTES cases had the lowest pain frequency in the 3rd- and 6th-month records. The preoperative presence of pain and higher pain intensity in the early postoperative period were other factors associated with PSCP. There was no significant difference in perioperative complications. The results of this study suggest that vNOTES is superior to other hysterectomy techniques in terms of postoperative chronic pain control without increased perioperative complication rates. Effective pain control during the early postoperative period may decrease the frequency of PSCP.