Variation in Vaginal Hysterectomy Rates in an Integrated Healthcare System

Is an enlarged fibroid uterus a contraindication for Non-Descent Vaginal Hysterectomy (NDVH)? Retrospective comparison between cohort whose uterine size ≥ 12 weeks and cohort whose uterine size less than 12 weeks underwent NDVH.

“…Our success in VH with larger fibroid uteri than 12 weeks has been reported in literatures as single searched item either as a case report (62) or as a prospective cohort (45,46,63,65) in different countries across the globe, or as prospective both randomized and unrandomized or retrospective both simple or propensity score-based comparisons with either TAH, TLH, RALH exploring different perioperative both clinical and financial consequences . Studies compare women underwent NDVH those with preoperative uterine size up to 12 weeks and postoperative histopathological uterine weight up to 280 grams against women with size more than 12 weeks and weight greater than 280 grams-displays similar results like we found regarding both safety and efficacy of NDVH in women with fibroids uteri larger than 12 weeks and 280 grams including Pogoda et al (1) , Shah et al (3) , Dubuisson et al (4) , Schmitt et al (36) , Wasson et al (37) , Buono et al (40) , Zaritsky et al (41) , Kammerer-Doak et al (43) , Unger et al (44) , Newbold et al (49) , Elzaher et al (51) , Deval et al (55) , Nazah et al (56) , Paparella et al (59) , Sirota et al (63) , Sahin et al (64) . According to our findings, VH for uteri larger than 12 weeks is deemed safe, despite significantly longer OR time, higher OBL, longer LOHS, longer time needed to return to usual activity and more decline in postoperative HB.…”

“…The size of the uterus can affect the ease of removal, and it is unclear whether an enlarged uterus is a contraindication for NDVH (1,4) . The large sized uterus more than 12 week was considered a traditional contraindication by most acting gynecologists who were surveyed for their opinion regrades routs for hysterectomy for benign gynecological diseases as stated in SGS's systematic review attributable to uncertainties about increased technical difficulty and risk of complications (31,33,34) , despite that a lot of pioneered gynecologists worldwide including American (2,3,(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) , Canadian (45) , English (46)(47)(48)(49) , Indian (23,50,51) , Chinese (52) , Malaysian (53) ,south Africans (8,9,45,54) , French (4,(55)(56)(57) , polish (1,58) , Italian (59)(60)(61) , Greece (62) , Turkan (63)(64)(65) had been challenged the alleged uterine size as a contraindication for NDVH and they had succeeded in that task with great safety. Therefore, the goal of this retrospective research is to determine...…”

Regional practice variation in hysterectomy and the implementation of less invasive surgical procedures: A register‐based study in the Netherlands

“…A plausible explanation for the decreasing use of vaginal hysterectomy among women with idiopathic bleeding disorders could be the greater use of alternatives such as endometrial ablation in everyday clinical practice. Literature also shows that the choice of hysterectomy approach depends on the provider, indicating that the decreasing trend in vaginal hysterectomies could reflect surgeon preference for the laparoscopic approach 28 . A recent survey among Irish residents uncovered a low sense of proficiency with abdominal and vaginal hysterectomy.…”

“…Literature also shows that the choice of hysterectomy approach depends on the provider, indicating that the decreasing trend in vaginal hysterectomies could reflect surgeon preference for the laparoscopic approach. 28 A recent survey among Irish residents uncovered a low sense of proficiency with abdominal and vaginal hysterectomy. This trend may also partially contribute to the decline in vaginal hysterectomies compared with the laparoscopic approach.…”

Гормональна Терапія Проліферативних Процесів Ендо-Міометрію Як Предиктор Метаболічних Порушень У Віддаленому Післяопераційному Періоді

“…Згідно літературних даних, гістеректомія (ГЕ) є однією із найбільш частих гінекологічних операцій, що виконуються у світі [8,11,33]. Основними показами до даного втручання є доброякісні захворювання мат ки, при цьому міома матки у пацієнток старше 30 років зустрічається у 15-17 %, де у 75 % випадків клінічна ситуація вимагає оперативного оздоровлення [8,27].…”