Incidence of opioid-managed pelvic pain after hysteroscopic sterilization versus laparoscopic sterilization, U.S. 2005-2012

Details

• Alternative Title:
  Pharmacoepidemiol Drug Saf
• Personal Author:
  Conover, Mitchell M. ; Howell, Jennifer O. ; Wu, Jennifer M. ; Kinlaw, Alan C. ; Dasgupta, Nabarun ; Funk, Michele Jonsson
• Description:
  Objective
  
  Compare incidence of opioid-managed pelvic pain within 12-months after hysteroscopic and laparoscopic sterilization.
  
  Methods
  
  Using administrative claims, we identified women age 18-49 without recent history of childbirth who underwent hysteroscopic or laparoscopic sterilization between 2005-2012. We defined the outcome as ≥2 diagnoses for pelvic pain and ≥2 prescription fills for opioids. We calculated adjusted hazard ratios (HR) using Cox models and propensity score methods (matching and inverse-probability-of-treatment-weighting [IPTW]).
  
  Results
  
  We identified 71,875 eligible women (hysteroscopic n=26,927 [37.5%], laparoscopic n=44,948 [62.5%]). Of those, 236 (0.88%) hysteroscopic patients and 420 (0.93%) laparoscopic patients experienced the outcome (crude HR=0.97, [95%CI: 0.83, 1.14]). Adjusted analyses also yielded near-null results (matched HR=1.08 [95%CI: 0.90, 1.31]; IPTW HR=0.97 [95%CI: 0.80, 1.18]). While most sensitivity analyses generated results close to the null, hazard ratios estimated using propensity score matching ranged from 0.65 to 1.53.
  
  Conclusions
  
  Among women without recent history of childbirth, we did not find compelling evidence of a clinically meaningful increase in the incidence of pelvic pain requiring opioids during the year after hysteroscopic sterilization. However, effects observed in sensitivity analyses may merit further investigation.
  
  
• Subjects:
  Adolescent Adult Analgesics, Opioid Databases, Factual Female Humans Hysteroscopy Incidence Laparoscopy Middle Aged Pain, Postoperative Pain Measurement Pelvic Pain Pharmacoepidemiology Propensity Score Proportional Hazards Models Severity Of Illness Index Sterilization, Tubal Time Factors Treatment Outcome Young Adult

  More +
• Source:
  Pharmacoepidemiol Drug Saf. 24(8):875-884.
• Pubmed ID:
  25832014
• Pubmed Central ID:
  PMC4527877
• Document Type:
  Journal Article
• Funding:
  1UL1RR025747/RR/NCRR NIH HHS/United States ; 1UL1TR001111/TR/NCATS NIH HHS/United States ; 2R49CE002479/CE/NCIPC CDC HHS/United States ; K02 HS017950/HS/AHRQ HHS/United States ; K23 HD068404/HD/NICHD NIH HHS/United States ; K23HD0068404/HD/NICHD NIH HHS/United States ; R01 AG023178/AG/NIA NIH HHS/United States ; R01 HL118255/HL/NHLBI NIH HHS/United States ; UL1 RR025747/RR/NCRR NIH HHS/United States ; UL1 TR001111/TR/NCATS NIH HHS/United States
• Place as Subject:
  United States
• Volume:
  24
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8dca6702a2207f412b9ac80c37e86d21c431f3bfeec1af9e66a4987177671b59
• Download URL:
  https://stacks.cdc.gov/view/cdc/34915/cdc_34915_DS1.pdf
• File Type:
  [PDF - 1.36 MB ]