E-Posters-Evaluation of Patients Undergoing Total Vaginal Hysterectomy Who Have Perceived Clinical Contraindications

Evaluation of Patients Undergoing Total Vaginal Hysterectomy Who Have Perceived Clinical Contraindications - Kristen Buono, MD

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A study evaluated patients who underwent total vaginal hysterectomy (TVH) despite having perceived clinical contraindications. The study found that 34% of patients who had TVH had at least one perceived clinical contraindication. However, these patients had shorter surgeries with less blood loss on average compared to those who met the algorithm criteria for TVH. There were no significant differences in perioperative complications between patients who did and did not meet the algorithm criteria. Surgeons who performed TVH on patients with perceived clinical contraindications were more likely to be general gynecologists and have been in practice for a longer duration. The study concluded that TVH can safely be performed in patients with clinical contraindications. <br /><br />The study was a secondary analysis of a retrospective cohort study of patients who underwent hysterectomy for benign indications within a large health maintenance organization over a 2.5-year period. Patients were identified by CPT coding and their medical records were reviewed for accuracy. The TVH Clinical Algorithm was used to determine which patients met the criteria for TVH. The study found differences in demographic characteristics and perioperative outcomes between patients who met or did not meet the algorithm criteria.<br /><br />Overall, the study contributes to the growing body of literature challenging perceived contraindications to TVH. The study suggests that clinical algorithms may not always be necessary for decision-making regarding the route of hysterectomy and that TVH can be safely performed in patients with clinical contraindications. The study was supported by funding from the Southern California Permanente Medical Group Clinician Investigator Program.

Keywords

total vaginal hysterectomy

clinical contraindications

surgery

blood loss

algorithm criteria

perioperative complications

surgeons

general gynecologists

retrospective cohort study

hysterectomy