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Incidence of opioid-managed pelvic pain after hysteroscopic sterilization versus laparoscopic sterilization, U.S. 2005-2012
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Mar 31 2015
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Source: Pharmacoepidemiol Drug Saf. 24(8):875-884.
[PDF-1.36 MB]
Details:
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Alternative Title:Pharmacoepidemiol Drug Saf
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Personal Author:
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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.
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Pubmed ID:25832014
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Pubmed Central ID:PMC4527877
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Volume:24
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Issue:8
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