Hysterectomy for chronic pelvic pain

Hysterectomy is indicated as a treatment of chronic pelvic pain only when a documented disease or surgically correctable condition of the pelvic organs is present. When hysterectomy is performed solely for relief of pelvic pain, the results may be disappointing-pain may not improve after the surgery.

Hysterectomy is used as surgical treatment for chronic pelvic pain when:

• Symptoms of chronic pelvic pain are decreasing the quality of life.
• The function of abdominal organs, such as the bladder or bowels, is impaired because of scar tissue (adhesions).
• An ovarian cyst or severe endometriosis is present.
• Treatment with medication has failed to relieve pelvic pain or other symptoms.
• The severity of the chronic pain syndrome outweighs the risks of surgery.

The size, location, and involvement of other abdominal organs determines which hysterectomy procedure is most appropriate.

Removal of the ovaries (oophorectomy) is commonly required because the ovaries are often involved in chronic pelvic pain.

How effective is it?

When hysterectomy is performed solely for pelvic pain, the results may be disappointing. Hysterectomy is indicated as a treatment for chronic pelvic pain only when a documented disease or surgically correctable condition of the pelvic organs is present.

Women who have significant relief of pelvic pain after a 2-month trial of a gonadotropin-releasing hormone agonist (GnRH-A) drug (which "shuts down" the ovaries) may be more likely to have relief of pelvic pain following hysterectomy and oophorectomy.

What else should I know?

An accurate diagnosis is essential to the successful outcome of a hysterectomy. If your symptoms are not accurately diagnosed, a hysterectomy may not relieve your pain.

The symptoms of chronic pelvic pain may stop when menopause occurs. Hysterectomy has no long-term advantage over waiting for natural menopause to occur. If you are considering this surgery, weigh the value of eliminating your pain against the risks and costs of a hysterectomy.