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Endometriosis, surgical approach impact risk of bowel injury in hysterectomy

Key clinical point: Use of the abdominal surgical approach and endometriosis were significant risk factors for bowel injury in women undergoing hysterectomy.

Major finding: Women with endometriosis had the most frequent incidence of bowel injury (0.59%), and in hysterectomies where the abdominal approach was used, there was an over tenfold risk of bowel injury compared with when a vaginal approach was used (odds ratio, 10.80; 95% confidence interval, 7.31-15.95).

Study details: A retrospective cohort study of the incidence of bowel injury in 155,557 women who underwent hysterectomy between 2012 and 2016.

Disclosures: Dr. Zhu and three coauthors reported no relevant financial disclosures. One coauthor received support from the University of Ottawa Clinical Research Chair in Reproductive Population Health and Health Services, the Canadian Institutes for Health Research, and Physicians’ Services Incorporated Foundation to conduct this research. Two other coauthors reported financial relationships with various pharmaceutical and medical technology companies.


Zhu CR et al. Obstet Gynecol. 2020 Oct. doi: 10.1097/AOG.0000000000004007.