Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Vaginal Hysterectomy & Perceived Contraindications

Female Pelvic Med Reconstr Surg; ePub 2017 Sep 13; Schmitt, et al

Vaginal hysterectomy can be safely performed with favorable outcomes, even in women with perceived contraindications, a recent study found. The retrospective cohort of benign hysterectomies took place between 2009 and 2013. Outcomes includes uterine debulking, transfusion, intraoperative complications, length of stay (LOS), and Accordion grade 2+ postoperative complications. Researchers found:

  • Among 692 vaginal hysterectomies, 11% had a uterine weight >280 g, 11.3% had no vaginal parity, 14.9% had a history of cesarean delivery, and 37.7% had a body mass index (BMI) of 30 kg/m2 or greater; 15.9% had ≥2 contraindications.
  • After adjustments, uterine weight >280 g and prior cesarean delivery were significantly associated with an increased likelihood of uterine debulking, which occurred in 146 (21.1%) women.
  • None of the contraindications were significantly associated with the need for a blood transfusion, presence of an intraoperative complication, LOS >2 days, or presence of an Accordion grade 2+ postoperative complication.


Schmitt JJ, Occhino JA, Weaver AL, McGee ME, Gebhart JB. Outcomes of vaginal hysterectomy with and without perceived contraindications to vaginal surgery. [Published online ahead of print September 13, 2017]. Female Pelvic Med Reconstr Surg. doi:10.1097/SPV.0000000000000469.

This Week's Must Reads

Unintended Pregnancy & Interpregnancy Interval, Contraception; ePub 2018 Mar 1; Ahrens, et al

Do Meds Reduce Bleeding During Surgical Abortions?, Contraception; ePub 2018 Feb 25; Whitehouse, et al

Assessing Rate of POP Surgery in the US, Obstet Gynecol; 2018 Mar; Sammarco, et al

Opioid Administration After Pelvic Surgery, Female Pelvic Med Reconstr Surg; ePub 2018 Feb 27; Willis-Gray, et al

Is Group Prenatal Care a Viable Option?, Obstet Gynecol; ePub 2018 Mar; McCue, Borders, et al

Must Reads in Gynecology

Trends in Utilization of Hysterectomy in US, Am J Obstet Gynecol; ePub 2017 Dec 26; Morgan, et al

USPSTF Guidelines for HT in Postmenopausal Women, JAMA; 2017 Dec 12; US Preventive Services Task Force

ACOG Issues Tubal Ectopic Pregnancy Guidelines, Obstet Gynecol; ePub 2017 Dec 6; ACOG

HPV Immunization Among Young Adult Women, Am J Obstet Gynecol; ePub 2017 Dec 6; Oliveira, et al

Opioid Prescription & Use After Gynecologic Surgery, J Minim Invasive Gynecol; ePub 2017 Nov 14; Griffith, et al