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

Conover, Mitchell M.; Howell, Jennifer O.; Wu, Jennifer M.; Kinlaw, Alan C.; Dasgupta, Nabarun; Funk, Michele Jonsson

doi:10.1002/pds.3766

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

Published Date:

Mar 31 2015

Publisher's site:

http://dx.doi.org/10.1002/pds.3766

Source:

Pharmacoepidemiol Drug Saf. 24(8):875-884.

[PDF-1.36 MB]

Details:

Alternative Title:

Pharmacoepidemiol Drug Saf

Personal Author:

Conover, Mitchell M. ; Howell, Jennifer O. ; Wu, Jennifer M. ; Kinlaw, Alan C. ; Dasgupta, Nabarun ; ... More ▼

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.

Subject:

[+]

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 ; ... More ▼

Collection(s):

CDC Public Access

Main Document Checksum:

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Supporting Files:

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