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Incidence of opioid‐managed pelvic pain after hysteroscopic sterilization versus laparoscopic sterilization, US 2005‐2012
Author(s) -
Conover Mitchell M.,
Howell Jennifer O.,
Wu Jennifer M.,
Kinlaw Alan C.,
Dasgupta Nabarun,
Jonsson Funk Michele
Publication year - 2015
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.3766
Subject(s) - medicine , pelvic pain , propensity score matching , sterilization (economics) , hysteroscopy , hazard ratio , obstetrics , laparoscopy , incidence (geometry) , surgery , confidence interval , physics , optics , monetary economics , economics , foreign exchange market , foreign exchange
Objective Compare incidence of opioid‐managed pelvic pain within 12 months after hysteroscopic and laparoscopic sterilization. Methods Using administrative claims, we identified women aged 18–49 years without recent history of childbirth who underwent hysteroscopic or laparoscopic sterilization between 2005 and 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. Copyright © 2015 John Wiley & Sons, Ltd.