Effect of Operative Time on Risk of Venous Thromboembolism After Benign Hysterectomy or Myomectomy [3]

Abstract

INTRODUCTION:The transgender and gender-nonconforming community long has been marginalized in society. As transgender individuals become more visible, obstetrician-gynecologists should direct educational initiatives to enhancing clinical templates that ensure inclusive, competent, and sensitive health services for this population, incorporating partner, culture, and community implications. Gender-unbiased health services are necessary to eliminate real and perceived barriers to care. METHODS: A review of literature on transgender medicine on PubMed over the past 5 years was conducted.RESULTS: There is scant research on transgender patients in obstetric and gynecologic health care settings, especially outside of hormonal and surgical transition. There are few studies on barriers to quality transgender health care, fewer quantitative studies on transgender patients' experiences in health care settings, and still fewer studies dealing with cultural and interpersonal practices that can help improve experiences for the patient and health care team. One non-peer-reviewed survey reports that 24% of transgender respondents were denied equal treatment in doctor's offices or hospitals, 19% were refused treatment owing to their gender identity, 28% were verbally harassed and 2% physically attacked in a medical setting, and 28% postponed or avoided necessary medical care owing to discrimination. A "gender-equal" gynecologic template of care will be presented. CONCLUSION/IMPLICATIONS: More quantitative and qualitative studies should be performed assessing the needs of the transgender and gender-nonconforming community in obstetric and gynecologic practice. Existing statistics indicate that unacceptable bias and discrimination are occurring, making transgender patients less likely to seek care. Care templates on gender-equal patient encounters should be implemented to better address global and specific health needs in this population in a nonbiased manner.INTRODUCTION: Increased operative time has been shown to increase the risk of postoperative venous thromboembolism (VTE) in women undergoing hysterectomy for malignancy. The purpose of this study is to determine whether increased operative time increases the risk of VTE after hysterectomy or myomectomy performed for benign indications. METHODS: Electronic medical records were reviewed for women who underwent hysterectomy or myomectomy for benign indications at the University of Illinois hospital between January 1, 2009, and December 31, 2013. The case group was comprised of women diagnosed with VTE within 42 days of surgery. Women who underwent the same procedures during the same time period but did not develop VTE made up the control group. Student t-tests and odds ratios with 95% confidence intervals were calculated to determine the risk of VTE based on operative time.RESULTS: There were 16 women in the case group and 64 in the control group. All women had received intraoperative mechanical thromboprophylaxis. The mean age of those in the case and control groups was 41.4 ye...

Uterine Fibroids and Pregnancy: A Review of the Challenges

“…Extensive abdominal myomectomy is associated with prolonged anesthesia and surgery times, increased risk of hemorrhage, sepsis, thromboembolism, uterine synechia, intraperitoneal adhesions and intestinal obstruction [3,[18][19][20]. Large uterine fibroids are a known cause of deep venous thrombosis from their pressure effect and the potential risks need to be managed.…”