Preoperative pain as a risk factor for neuropathic post-surgical pain–six month follow-up after radical prostatectomy

Introduction: Neuropathic post-surgical pain (NPSP) is a debilitating condition that can occur following surgical procedures, including radical prostatectomy. Preoperative pain has emerged as a potential risk factor for the development of NPSP, suggesting that early identification and management of preoperative pain may play a crucial role in preventing NPSP. This study aimed to investigate the association between preoperative pain and NPSP following radical prostatectomy, providing valuable insights into the pathophysiology and prevention of NPSP. Material and Methods: Following surgery, participants were followed up for a period of six months to assess the development of NPSP. Postoperative pain assessments were conducted at regular intervals, including one week, one month, three months, and six months after surgery. Pain intensity was evaluated using the NRS, and pain characteristics were assessed using validated neuropathic pain assessment tools, such as the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) and the Douleur Neuropathique ۴ Questions (DN۴) questionnaire. Results: Functional impairment and quality of life were also significantly affected in patients with NPSP. The BPI interference scores, which measure the impact of pain on daily activities, were significantly higher in the NPSP group compared to the non-NPSP group at all follow-up time points (p < ۰.۰۰۱). Similarly, the EuroQol-۵D questionnaire, which assesses health-related quality of life, revealed lower scores in the NPSP group, indicating poorer overall well-being (p < ۰.۰۰۱). Conclusion: this study highlights the significance of preoperative pain as a risk factor for the development of NPSP following radical prostatectomy. Patients with preoperative pain are at a significantly higher risk of experiencing NPSP, which is associated with higher pain intensity, functional impairment, and decreased quality of life. Efforts should be made to implement preoperative pain assessment protocols and optimize pain management strategies to minimize the risk of NPSP and improve postoperative outcomes.

Keywords:

Neuropathic , post-surgical pain , radical prostatectomy