Clinical opinion: guidelines for hysterectomy

American Journal of Obstetrics and Gynecology
S Robert Kovac

Abstract

Abdominal hysterectomy remains the predominant method of uterine removal in the United States, despite evidence that vaginal hysterectomy offers advantages in regard to operative time, complication rates, return to normal activities, and overall cost of treatment. The predominance of the abdominal approach may be based on factors other than clinical considerations that include resident training, use of obsolete or limited guidelines, a perception rather than a confirmation that pathologic conditions exist that may suggest contraindications to the vaginal approach, misconceptions regarding the cost and safety of vaginal hysterectomy, and increased third-party reimbursement for the abdominal procedure. Evidence-based practice guidelines that were developed by the Society of Pelvic Reconstructive Surgeons and were adopted by the National Guidelines Clearinghouse have demonstrated that, in a number of studies that span several years, a dramatic shift toward the vaginal approach occurred when the guidelines were applied prospectively. The guidelines demonstrate that transvaginal hysterectomy is both feasible and optimal for many patients who long have been considered inappropriate candidates for vaginal hysterectomy. This clinical o...Continue Reading

References

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Citations

Apr 23, 2013·Best Practice & Research. Clinical Obstetrics & Gynaecology·Bhaskar D Goolab
Feb 10, 2010·Clinical Obstetrics and Gynecology·Mamta Muralidhar Kulkarni, Rebecca Glenn Rogers
Jun 24, 2009·Obstetrics and Gynecology·Frank F TuTrent E J Gordon
Jan 15, 2014·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Kavi FataniaWai Yoong
Aug 1, 2006·International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services·Keng Boon Harold Tan
Aug 13, 2013·Journal of Minimally Invasive Gynecology·Tyler M Muffly, Nathan S Kow
Jun 23, 2009·Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN·Kimberly H Kim, Kathryn A Lee
Jan 5, 2016·Best Practice & Research. Clinical Obstetrics & Gynaecology·Guylaine G Lefebvre, Eliane M Shore
Apr 2, 2016·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Jenna GaleSukhbir S Singh
Mar 10, 2009·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Andreas MuellerFalk Thiel
Feb 29, 2008·Fertility and Sterility·Andreas HackethalKarsten Münstedt
Mar 7, 2008·European Journal of Obstetrics, Gynecology, and Reproductive Biology·D De VitaE Piccione
Jun 1, 2011·Acta Obstetricia Et Gynecologica Scandinavica·Sidsel Lykke NielsenUNKNOWN Steering Committee of Danish Hysterectomy Database
Jun 21, 2014·Acta Obstetricia Et Gynecologica Scandinavica·Lei YuanLiangqing Yao
Nov 9, 2010·American Journal of Obstetrics and Gynecology·Catherine A MatthewsStephen Cohen
Jul 30, 2014·American Journal of Obstetrics and Gynecology·Sangeeta SenapatiJavier F Magrina
Dec 13, 2005·Journal of Minimally Invasive Gynecology·Barbara S LevyLaura L Emery
Oct 22, 2011·Obstetrics and Gynecology·Jamie Kroft, Amanda Selk
Apr 2, 2008·Obstetrics and Gynecology·Arnaud Le TohicPatrick Madelenat
Mar 5, 2021·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Andreas ChrysostomouBruno J van Herendael

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