Clinical indications for hysterectomy route: patient characteristics or physician preference?

Article Abstract:

Patient characteristics and surgeon's preference may greatly influence the type of hysterectomy performed. Researchers analyzed the hospital records of 502 women who had elective hysterectomy at one hospital to determine why some women received total abdominal hysterectomies, and others either total vaginal hysterectomies or internal instrument-guided vaginal hysterectomies. Patients who were older, heavier, and black were more likely to receive total abdominal hysterectomies than laparoscopically-guided vaginal hysterectomies. More women (213) had total abdominal hysterectomies than either laparoscopically-assisted (174) or total vaginal hysterectomies (115). A majority of surgeons may be more comfortable with performing abdominal hysterectomies.

Beliefs, opinions and attitudes, Surgeons

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Costs and charges associated with three alternative techniques of hysterectomy

Article Abstract:

Laparoscopy done in conjunction with vaginal hysterectomy may be more expensive than vaginal hysterectomy alone or abdominal hysterectomy. This was the conclusion of researchers who studied 1,049 women who had a hysterectomy at one hospital. Although laparoscopic vaginal hysterectomy reduced the hospital stay by an average of 1 day, it cost substantially more than the other two operative procedures. The operation also took longer because the combined approach required different sets of instruments and longer operating time. Vaginal hysterectomy alone was the least expensive procedure.

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Use of alternative techniques of hysterectomy in Ohio, 1988-1994

Article Abstract:

Vaginal hysterectomy that is done in conjunction with laparoscopy may be more expensive than two other commonly used surgical procedures. Researchers analyzed all of the hysterectomies done at 180 Ohio hospitals between 1988 and 1994. The annual hysterectomy rate in Ohio fell 10% during this time. Laparoscopic vaginal hysterectomy accounted for 7.5% of all hysterectomies in 1994, compared to 1% in 1988. It was also the most expensive of three operative techniques, which included vaginal hysterectomy and abdominal hysterectomy.

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