SEARCH · PubMed Health

Results for “Hysterectomy”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

PubMed1979

A prospective trail comparing hysterectomy, hysterectomy plus vaginal radium, and uterine radium plus hysterectomy in stage I endometrial carcinoma.

From 1958 to 1967, a prospective randomized trial was conducted in 189 women with stage I, group I endometrial adenocarcinoma, comparing treatment by hysterectomy alone, preoperative uterine radium followed by hysterectomy, and hysterectomy and postoperative vaginal radium. All women have been followed for a minimum of 10 years. The actual survival rate at 5 years for all patients was 94.5% and at 10 years, 92.6%, with no statistical significance among the 3 treatment groups. Ther was also no statistical significance in survival rate in relation to size of uterine or myometrial invasion. There was a statistically significant difference in survival between grade I and grade III lesions (P less than 0.01) and between grade II and grade III lesions (P less than 0.05).

Adenocarcinoma↗

PubMed2026

Vaginal Hysterectomy Versus Vaginal Assisted Natural Orifice Transluminal Endoscopic Surgery Hysterectomy; Results of a Randomised Controlled Trial.

OBJECTIVE: To compare Vaginal Hysterectomy (VH) with Vaginal Assisted Natural Orifice Transluminal Endoscopic Surgery (NOTES) hysterectomy (VANH) as a day-care procedure. DESIGN: Single-blind, multicentre randomised controlled trial. SETTING: Two Dutch non-academic teaching hospitals. POPULATION: Women aged ≥ 18 years undergoing hysterectomy for benign indications. METHODS: Women were randomised 1:2 (VH or VANH). Primary outcome was SDD. Secondary outcomes included operative time, rate of elective salpingectomies, intraoperative blood loss, complications (Clavien-Dindo), pain scores (NRS) and analgesic use, post-operative recovery (RI-10), and quality of life (EQ-5D-5L). Analyses were performed on an intention-to-treat basis. RESULTS: A total of 113 patients were included in the analyses (n = 42 VH, and n = 71 VANH). SDD occurred significantly more frequently in the VANH group (87.3%) than VH group (71.4%; OR 2.76, 95% CI 1.04-7.25; p = 0.04). VANH was associated with a significantly shorter operative time (median 55 min versus 65 min; p = 0.005), less blood loss (median 50 mL vs. 150 mL; p < 0.001) and more often elective opportunistic salpingectomy compared to VH (100% vs. 77.4%; p = 0.008). NRS were significantly lower in the VANH group the first hour post-operative (3 vs. 1, p < 0.001). Post-operative complications (VH 9.5% vs. VANH 15.5%; p = 0.34), readmission (VH 4.8% vs. VANH 8.5%; p = 0.47), analgesic use, recovery, and quality of life were not statistically significant. CONCLUSIONS: VANH is a safe and effective alternative to VH, offering a higher likelihood of SDD, shorter operative time, reduced blood loss, and more often an elective salpingectomy, without increased complications or differences in pain, recovery, or quality of life.

Humans↗

PubMed2026

International trends in concurrent hysterectomy at risk-reducing surgery in BRCA1/2 pathogenic variant carriers: a mixed-methods study.

BACKGROUND: BRCA1/2 pathogenic variant carriers are advised to undergo a risk-reducing salpingo-oophorectomy between the ages of 35 and 45 due to their increased risk of tubo-ovarian cancer. A concurrent hysterectomy may be performed at the time of risk-reducing salpingo-oophorectomy. Currently, the international execution of hysterectomy during risk-reducing surgery and the factors guiding related decision-making are unknown. OBJECTIVE: We aimed to evaluate the international execution of concurrent hysterectomy during risk-reducing surgery for tubo-ovarian cancer and factors guiding providers' decision-making about this. STUDY DESIGN: We conducted a mixed-methods study. First, we executed a quantitative analysis with data from the Women choosIng Surgical Prevention (WISP) and TUBectomy with delayed oophorectomy as Alternative for risk-reducing salpingo-oophorectomy in high-risk Women to assess the Safety of Prevention (TUBA-WISP II) study, both prospective preferential trials assessing surgical strategies for tubo-ovarian cancer prevention. Data were collected via electronic case report forms. Concurrent hysterectomy during risk-reducing salpingo-oophorectomy was compared between Europe, North- and South America, and Australia using Kruskal-Wallis tests. We used univariable logistic regression models to estimate the association of personal and prevention-related characteristics with the execution of hysterectomy at risk-reducing salpingo-oophorectomy in women from North- and South America. Subsequently, we conducted focus group interviews with gynecologic providers from 12 countries who provide preventive care for individuals at increased risk of tubo-ovarian cancer to identify indications, barriers, and facilitators for the execution of hysterectomy with risk-reducing salpingo-oophorectomy. RESULTS: In the quantitative analysis, we included 2181 participants, of whom 1647 (75.5%) were from Europe, 498 (22.8%) from North- and South America, and 36 (1.7%) from Australia. Execution of hysterectomy at risk-reducing salpingo-oophorectomy differed substantially between continents, with an execution of 48.8% in North- and South America, 14.2% in Australia, and 2.8% in Europe (P<.001). Execution of concurrent hysterectomy at risk-reducing salpingectomy in women from North- and South America occurred more often in women with a BRCA1 pathogenic variant compared to a BRCA2 pathogenic variant (adjusted odds ratio 0.4 [95% confidence interval, 0.2-0.7]). In the qualitative analysis, we interviewed 23 healthcare providers and identified 31 barriers and 32 facilitators regarding hysterectomy execution during risk-reducing salpingo-oophorectomy. A total of 8 different indications were mentioned, but opinions varied on the validity and weight given to each indication. Providers indicated that important barriers or facilitators for concurrent hysterectomy included a lack of clear guidelines, cultural variation between countries, (lack of) consensus within departments, and different interpretation of the endometrial cancer risk. CONCLUSION: Internationally, there is a large variation in execution of hysterectomy during risk-reducing surgery with frequent utilization in North- and South America, and rare utilization in Europe. This could be explained by the interpretation of indications for hysterectomy by providers, which might be explained by cultural variation, the absence of clear guidelines, and limited scientific evidence.

Humans↗

PubMed1979

Prophylaxis of minor febrile and major infectious morbidity following hysterectomy.

A retrospective analysis was conducted of 668 consecutive cases using T-tube suction drainage and/or prophylactic antibiotics as infection prophylaxis for hysterectomy. The data are analyzed for the incidence of minor febrile morbidity (temperature greater than 100.4 for 2 days) and for major infection (hospital stay more than 14 days, reoperation or readmission for the management of pelvic abscess or pelvic thrombophlebitis). The study also compares a minor febrile and major infection group with a noninfected group by measuring parameters of patient discomfort, medical staff effort, and financial costs. It is concluded that 1) minor febrile morbidity frequently follows abdominal (20--30%) and vaginal (30--50%) hysterectomy; 2) minor febrile morbidity has temporary but significant consequences in the form of increased patient discomfort, medical staff effort, and financial costs; 3) major infections are rare following abdominal hysterectomy (less than 0.5%) and uncommon following vaginal hysterectomy (1--4%); 4) suction drainage used alone, prophylactic antibiotics used alone, or a combination of suction drainage and antibiotic prophylaxis is each associated with a statistically significant reduction in the incidence of minor febrile morbidity following both abdominal and vaginal hysterectomy (P = less than 0.01); and 5) such infection prophylaxis may also reduce the incidence of major infection following vaginal hysterectomy.

Abscess↗

PubMed1979

The results of treatment of microinvasive carcinoma (stage iA) of the uterine cervix by means of simple and extended hysterectomy.

At the Department of Obstetrics and Gynecology of Tohoku University, radical hysterectomy with pelvic lymphadenectomy had been performed on patients with microinvasive carcinoma of the uterine cervix before 1966. Investigation of lymph nodes of 90 patients treated in this manner has shown no lymph node metastasis of tumor cells in any of them. Since 1967, microinvasive carcinoma has been treated as a matter of principle by extended hysterectomy without lymphadenectomy. From that time until 1974, 119 cases of microinvasive carcinoma have been treated by extended hysterectomy and 69 such cases by simple hysterectomy. The 5-year relative survival rate was 0.989 for extended hysterectomy patients and 1.008 for simple hysterectomy patients. Together, a 5-year relative survival rate of 0.992 was obtained.

Adult↗

PubMed1978

Low-dose carbenicillin prophylaxis for vaginal and abdominal hysterectomy.

A double-blind prospective study of 99 patients undergoing vaginal and abdominal hysterectomy was performed at North Carolina Baptist Hospital of the Bowman Gray School of Medicine at Wake Forest University. The study indicated that low-dose intravenous carbenicillin begun preoperatively and continued for 24 hours resulted in decreased febrile morbidity, postoperative infection rate, and shortened hospital stay in patients undergoing both vaginal and abdominal hysterectomy. The indications for operation, clinical characteristics of patients, and operative and postoperative management were similar for the control and study groups. For the vaginal hysterectomy group, febrile morbidity was reduced from 34.6% in the control group to 7.7% in the group receiving carbenicillin. For patients undergoing abdominal hysterectomy, febrile morbidity was reduced from 54.1% in the control group to 4.0% in the group receiving prophylactic carbenicillin. Similar reductions for the carbenicillin study group in fever index and average total hospital stay were also noted. Urinary tract infections were determined to be present more commonly in the group of patients with febrile morbidity receiving no prophylactic antibiotics. The incidence of pelvic infections were reduced in both carbenicillin-treated groups. This investigation suggests that low-dose carbenicillin prophylaxis is beneficial in reduction of morbidity following both vaginal and abdominal hysterectomy.

Adult↗

PubMed1975

The acute effect of hysterectomy on ovarian function.

The acute effect of abdominal and vaginal hysterectomy on the ovarian production of estradiol-17-beta (E2) and progesterone (P) was studied in a group of patients undergoing hysterectomy for various gynecologic indications. Plasma levels of steroids as well as gonadotropins (FSH and LH) were measured by RIA. There was a significant but transient drop of plasma E2 during the follicular phase and of plasma E2 and P during the luteal phase, following hysterectomy. No significant variations in the steroid plasma levels were found in a control group of patients undergoing laparoscopy for diagnostic purposes. No changes were noted in either group in the plasma levels of gonadotropins. The changes seen appear to be related to the surgical manipulation in the ovarian region rather than to the type of hysterectomy performed or the stress of surgery.

Adult↗

PubMedDate not supplied

Post-hysterectomy morbidity after previous punch cervical biopsy plus diagnostic curettage.

The post-operative morbidity of 70 patients who underwent total abdominal hysterectomy five to thirteen days after punch-biopsy of the cervix uteri and diagnostic curettage was compared of that of a control group of patients, with hysterectomy alone. It was observed that the sequence punch-biopsy hysterectomy presented a significantly higher post-operative morbidity. This increase was mainly due to higher parametritis, excessive vaginal discharge and wound infections rates. The interval between the two operations was also found to influence the post-hysterectomy morbidity, which seems to decrease with longer intervals.

Biopsy, Needle↗

PubMed1979

A study of hysterectomy in a family practice.

This paper reports on a study of women in a family practice who have undergone hysterectomy as compared with a group of matched controls. Significant differences were found in the greater number of major surgical procedures (other than hysterectomy) and the reporting of chronic and recurrent symptoms for the study group. Study group women were also found to have a greater number of identified intrapersonal and family problems. There was no significant difference, however, in the number of identified chronic organic problems. Differences which did not reach statistical significance suggest that women in the study group may be more likely to be living without a male partner, to be using long-term medication, and to be smokers. A most important finding was that the group of women who had undergone hysterectomy had also had 2.6 times the number of major surgical operations than the controls, excluding the hysterectomy. There were no differences between the two groups with respect to a number of other factors studied, eg, education, religion, history of psychiatric admission, obesity.

Adult↗

PubMed1977

[Indications for hysterectomy in placental tumors].

Indications for hysterectomy in placental tumours are now most often to carry out hysterectomy as a second attack designed to deal with residual lesions of choriocarcinoma that prove resistant to chemotherapy. Of 80 patients treated, 24 were first seen for chemotherapy after hysterectomy and this is too great a number. On the remaining 56 patients we carried out hysterectomy in 8 cases of whom 7 were secondary to chemotherapy. Seven times we found a residual lesion. These patients are now apparently cured.

Adult↗

PubMed1979

Ten-year review of hysterectomies: trends, indications, and risks.

This report concerns the indications, morbidity, and death associated with 6,435 consecutive abdominal and vaginal hysterectomies at Hutzel Hospital during a 10 year period. There was an extraordinary number of high-risk patients included in this group. Morbidity and postoperative bleeding were more common following vaginal rather than abdominal hysterectomy. These complications were also more common when the operation was performed during the proliferative phase of the menstrual cycle. There were 17 deaths. Thromboembolic complications were the major cause of death. Selective use of prophylactic antibiotics and low-dose heparin and reduction in the number of blood transfusions by preoperative endocrine and hematinic therapy may reduce the postoperative morbidity and mortality rates. Probably few operations will ever contribute as much to improving the quality of life of women as do indicated hysterectomies. However, the added risk do not seem to justify utilizing this operation for the sole purpose of sterilization in preference to simpler and safer procedures.

Adult↗

PubMedDate not supplied

Hysterectomy following sterilization.

In a review of 108 cases of consecutively selected women undergoing hysterectomy for nonmalignant disease, it was found that one third of the patients or their husbands had previously been sterilized. In many instances, the gynecologic problem necessitating hysterectomy antedated the sterilizing procedure. It is postulated that, when couples request sterilization, two operations might be avoided if routine consideration were given to any condition that might lead to hysterectomy.

Adult↗

PubMed1977

Elective hysterectomy.

Hysterectomy is the most frequently performed major operation. Its frequency is increasing due to greater use of elective indications such as uterine cancer prophylaxis, contraception, and menopausal problems. The effects of elective simple hysterectomy are evaluated in terms of morbidity and mortality rates and costs. Among 35-year-old women operated upon, the average over-all gain in life expectancy is only 0.2 years. This is due to the saving of 1.3 per cent of women who would have died from cancer of the cervix or endometrium; they gained 14.3 years of life. In addition, 3 per cent of women are spared the development of and treatment for these two conditions. All women operated upon would be relieved of some undesirable aspects of the menopausal years such as irregular uterine bleeding. There are also economic gains. However, the operation has adverse health effects which could offset any gains from cancer prevention. In addition, each year of life saved would cost about $12,800 and most of the added years would be lived in old age. Delaying the operation to age 45 and including oophorectomy would result in a lower cost per year of life saved-about $9,800-but the risk of adverse health effects probably would be increased very much. Cancer prophylaxis cannot justify elective hysterectomy; we cannot assess whether quality-of-life considerations do.

Adult↗

PubMed1979

Surgical treatment of stages IB and IIA invasive carcinoma of the cervix by radical abdominal hysterectomy.

From 1963 to 1977, 349 radical abdominal hysterectomies with bilateral pelvic lymphadenectomy were performed for Stage IB (331 patients) and Stage IIA (18 patients) cervical cancer at the New York Medical College, with no operative deaths. Definitive diagnosis was obtained from the biopsy specimen in 281 patients. Twenty-nine patients were pregnant when the diagnosis was established. The average operating time was 4 hours and 48 minutes with an average blood loss of 900 ml. Eleven fistulas were noted: ureterovaginal, 7; vesicovaginal, 3; rectovaginal, 1. Since 1972, there have been no fistulas in 130 radical hysterectomies. Metastatic carcinoma of the regional lymph nodes was discovered in 27 patients for an incidence of 7.7%. Postoperative total pelvic external irradiation was utilized in 40 patients (27 with positive nodes, 10 with microscopic carcinoma in vascular channels, and an additional three patients with an inadequate vaginal extirpation margin). A total of 62% of those patients with poor prognostic criteria receiving postoperative irradiation are alive and well. Two hundred nineteen patients have been followed up for at least 5 years and the survival rate was 90%. Our data support the view that radical abdominal hysterectomy with bilateral pelvic lymphadenectomy is the treatment of choice for patients with Stages IB and IIA cervical cancer in the nonpregnant state, unless there are major medical contraindications.

Adenocarcinoma↗

PubMed1979

The value of intravenous urography prior to abdominal hysterectomy for gynecologic disease.

Negligence and failure to "test timely" are the two most common charges in obstetric and gynecologic malpractice suits. Both charges are often made in cases involving urinary tract injury during gynecologic surgery. These injuries occur most commonly during abdominal hysterectomy. This report is a 6 year study of 170 consecutive abdominal hysterectomies to ascertain the value of routine preoperative urography in preventing urinary tract injuries. As a control, 260 consecutive abdominal hysterectomies were performed without preoperative urography. There was one ureteral transection in the control group, but unrecognized urinary tract injuries did not occur in either the study or control group. The risks, costs, and benefits of urography are analyzed.

Adult↗

PubMedDate not supplied

Characteristics of posthospitalization recovery following hysterectomy.

A study to determine the characteristics of posthospitalization recovery after hysterectomy was designed and implemented. Explicit consideration was given to women's feelings of sexuality and the fears and myths which precede and follow the surgery. Retrospective and current self-report data on four major areas were obtained: a) physical changes, b) emotional changes, c) changes in sexuality, and d) fears or beliefs. The results identify some common posthysterectomy physical and emotional experiences. The data challenge the belief that hysterectomy is usually a blow to a woman's concept of self and indicate that most women do not harbor unrealistic fears of physical, emotional, and sexual sequelae. The study findings have implications for nursing care of hysterectomy patients.

Adaptation, Physiological↗

PubMed1979

The pathology of hysterectomy specimens.

Six hundred and twenty-one hysterectomies were performed at National Women's Hospital, Auckland, during 1975. Abnormal vaginal bleeding was the clinical indication in 50.72% of the cases. Fibroids, pelvic mass, prolapse, stress incontinence and cervical neoplasia were the indication for 45.88% of the cases. Total hysterectomy was performed in 618 (99.5%) patients whilst sub-total hysterectomy was done in only three cases. Histopathological studies revealed that 567 (91.30%) specimens were pathological and there was multiple pathology in 55.87% of the specimens. Leiomyomas were present in 278 cases (44.76%); microleiomyomatosis in 178 specimens (22.66%); endometrial hyperplasia in 139 specimens (22.33%) adenomyosis in 87 cases (14.00%); malignant diseases in 76 cases (12.23%); and endometriosis in 40 specimens (6.44%). There were no histological abnormalities in 54 specimens, 8.69% of this series.

Adult↗

PubMed1979

Cesarean hysterectomy: a twenty-five-year review.

This article analyzes cesarean hysterectomies performed at Louisville General Hospital on clinic patients for the 25 year period 1953 through 1977. During this time there were 63,259 deliveries, of which 2417 were cesarean sections and 149 were cesarean hysterectomies. Twenty-six of the latter were classified as emergency operations done for urgent medical indications; in the remaining 123 patients the indications were elective to some degree. Operative and postoperative complications and morbidity are discussed, and changing trends regarding the place of cesarean hysterectomy in obstetrics over the years are evaluated.

Adolescent↗