The hysterectomy lottery

Davies, Anthony; Magos, Adam

doi:10.1080/01443610020026119

Cited by 16 publications

(3 citation statements)

References 23 publications

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“…However, a small percentage of women with benign conditions undergo laparoscopic hysterectomy, which was introduced in the 1980s. 3 The choice of approach and the rate of complications depend on the surgeon’s expertise, the indication for surgery, the nature of the disease, patient characteristics and patient choice. Several studies have examined the risk of morbidity after vaginal or abdominal hysterectomy for benign conditions.…”

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confidence: 99%

Hysterectomy for benign conditions in a university hospital in Saudi Arabia

Sait

Alkhattabi

Boker

et al. 2008

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVEHysterectomy is a common surgical procedure among women with a lifetime prevalence of 10%. The indications and complications of this procedure have not been previously reported from a teaching institution in Saudi Arabia. We examined the indications for hysterectomy and the surgical morbidity for women undergoing hysterectomy at a university hospital in Saudi Arabia.PATIENTS AND METHODSWe reviewed the records of women who underwent hysterectomies for benign gynecological conditions between January 1990 and December 2002, at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, comparing patient characteristics, indications for hysterectomy and the rate of complications in women undergoing abdominal hysterectomy (AH) versus vaginal hysterectomy (VH).RESULTSOf 251 women, 199 (79%) underwent AH and 52 (21%) underwent VH. An estimated blood loss of ≥500 mL occurred in 104 patients (52.3%) in the AH group and in 20 patients (38.5%) in the VH group (difference not statistically significant). The most common indications for hysterectomy were uterine fibroids (n=107, 41.6%) and dysfunctional uterine bleeding (n=68, 27.1%). The most common indication for VH was uterine prolapse (n=45, 86.5%). The overall complication rates were 33.5%, 15.4% and 30.4% in women who underwent AH, VH and both, respectively. Intraoperative and postoperative complications occurred in 24 (9.7%) patients in the AH group and in 51 patients in the VH group (20.3%). Postoperative infection occurred in 42/199 (21.6%) in the AH group and 5/52 (9.6%) in the VH group (difference not statistically significant).CONCLUSIONSWe describe a large series of hysterectomies, which provides information for surgeons on the expected rate of complications following hysterectomy for benign conditions. We found that the rate of complications was not significantly higher than other centers internationally.

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confidence: 99%

Hysterectomy for benign conditions in a university hospital in Saudi Arabia

Sait

Alkhattabi

Boker

et al. 2008

Annals of Saudi Medicine

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“…This is in agreement with a 2001 postal survey conducted in England among consultant gynaecologists that demonstrated that gynaecologists who performed many LHs had the highest VH rates, and predicted that VH would be further emphasised in years to come. [22] It may be that LAVH could serve as the vehicle for performing more VHs in the future.…”

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confidence: 99%

Preferred and actual methods of hysterectomy: A survey of current practices among members of the South African Society of Obstetricians and Gynaecologists

Chrysostomou

Djokovic

2020

S Afr J OG

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“…1 The large variations in practice indicate that the route of surgery is more dependent on the surgeon's preference than on the medical condition. 2 However, practices are changing and the vaginal route has increasingly become the method of choice for hysterectomy. 3,4 The most common factors limiting the use of vaginal hysterectomy have been a lack of uterine prolapse, nulliparity, history of pelvic surgery, excessive uterine size, and the need for prophylactic oophorectomy.…”

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Factors Influencing the Operative Time and Complications of Vaginal Hysterectomy of a Nonprolapsed Uterus

Silva-Filho¹,

Reis²,

Noviello³

et al. 2004

Journal of Pelvic Medicine and Surgery

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Objective: This study was undertaken to evaluate factors influencing the operative time and early complications of vaginal hysterectomy of a nonprolapsed uterus.Methods: This was a prospective, observational study, including 128 patients (mean age, 45.7 years) undergoing vaginal hysterectomy for benign conditions, except uterine prolapse. Main outcome measures were operative time, intraoperative complications (bleeding or lacerations), and conversion to laparotomy.Results: The median operative time was 60 minutes (range, 25-180 minutes) and the mean hospital stay was 36 hours (range, 24 -240 hours). A multivariate logistic regression showed that the operative time was significantly influenced by uterine weight (P <0.001) and adnexectomy (P ‫؍‬ 0.045). There were 10 (6.3%) intraoperative complications, of which 6 (4.7%) were with excessive bleeding, 3 (2.3%) bladder lacerations, and 1 (0.8%) rectal laceration. Two patients underwent conversion to laparotomy for nonfeasibility of the vaginal route and both had a uterine weight higher than 400 g. After multivariate analysis, only uterine weight influenced the occurrence of intraoperative complications (P ‫؍‬ 0.002).Conclusion: The uterine weight is an independent predictor of operative time and perioperative complications of vaginal hysterectomy for benign conditions in patients with a nonprolapsed uterus.

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The hysterectomy lottery

Cited by 16 publications

References 23 publications

Hysterectomy for benign conditions in a university hospital in Saudi Arabia

Hysterectomy for benign conditions in a university hospital in Saudi Arabia

Preferred and actual methods of hysterectomy: A survey of current practices among members of the South African Society of Obstetricians and Gynaecologists

Factors Influencing the Operative Time and Complications of Vaginal Hysterectomy of a Nonprolapsed Uterus

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