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 New Site Icon

Source:

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

[PDF-1.36 MB]

Details:

Personal Authors:

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

Keywords:

[+]

Pubmed ID:

25832014

Pubmed Central ID:

PMC4527877

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.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Funding:

Supporting Files:

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