Improved Postoperative Pain Control by Addition of Oral Phenazopyridine before Total Laparoscopic Hysterectomy

Abstract

ment). Mean age was 47 years old and mean body mass index was 30.7 kg/m 2 . Overall total laparoscopic hysterectomy (40.0%, n = 355) was the most common route of hysterectomy performed followed by total vaginal hysterectomy (32.3%, n = 288) and total abdominal hysterectomy (11.5%, n = 102). Supracervical, laparoscopic-assisted vaginal, and roboticassisted routes were infrequently performed. No statistically significant difference was noted in the pre-operative work-up between the two groups when considering number of pelvic ultrasounds, CTs, MRIs, or endometrial biopsies performed. An increase in pre-operative MRIs obtained in the post-FDA statement group was noted, 6.4% versus 3.4%, but not statistically significant (p = .12). Post-FDA statement total abdominal hysterectomies were more frequently performed, 6.0% versus 14.0%. The frequency of laparoscopic supracervical hysterectomies decreased, 17.2% versus 3.5%. Postoperatively more patients in the post-FDA statement group underwent re-operation than pre-FDA statement, 1.5% versus 0% (p = .04). Rate of other post-operative complications was comparable between the two groups. Conclusions: After the FDA statement on power morcellation, surgical route of hysterectomies performed for benign indications shifted with an increased frequency of abdominal hysterectomies and a decline in laparoscopic supracervical hysterectomies observed. Preoperative work-up was comparable between the groups. Postoperative reoperation rates however were higher among the post-FDA group than the pre-FDA group.