Hysterectomy in obese women: a comparison of abdominal and vaginal routes.

Abstract:

OBJECTIVE:To compare perioperative outcome measures of abdominal and vaginal hysterectomies in obese women. METHODS:We reviewed the charts of all obese women (body mass index more than 30 kg/m(2)) who underwent abdominal or vaginal hysterectomy for benign gynecologic conditions in our institution between 1997 and 2002. Laparoscopically assisted vaginal hysterectomies and hysterectomies with concomitant major pelvic or abdominal surgery were excluded. The rate of operative and postoperative complications, length of hospitalization, operative time, and perioperative change of hemoglobin concentration were analyzed for abdominal hysterectomy and vaginal hysterectomy. RESULTS:The study group consisted of 369 obese women, of whom 189 (51.2%) underwent abdominal, and 180 (48.8%), vaginal hysterectomy. Patient characteristics were statistically comparable between the groups except for uterine weight, which was higher in the abdominal group, and parity, which was greater for women who underwent vaginal hysterectomy (P <.05). After controlling for all the significantly different variables, vaginal hysterectomy resulted in lower incidence of postoperative fever (odds ratio [OR] 0.22, 95% confidence interval [CI] 0.12-0.39), ileus (OR 0.21, 95% CI 0.06-0.75), urinary tract infection (OR 0.21, 95% CI 0.06-0.75), shorter operative time (126.8 +/- 58.7 minutes compared with 109.7 +/- 68.5 minutes) and length of hospital stay (3.5 +/- 1.9 days compared with 1.9 +/- 1.1 days). Seven women (3.7%) who underwent abdominal hysterectomy developed wound infections during their hospital stay compared with none in the vaginal hysterectomy group. CONCLUSION:For obese women, vaginal hysterectomy is superior due to its lower incidence of postoperative fever, ileus, and urinary tract infection and shorter operative time and hospital stay. LEVEL OF EVIDENCE:II-2

journal_name

Obstet Gynecol

authors

Isik-Akbay EF,Harmanli OH,Panganamamula UR,Akbay M,Gaughan J,Chatwani AJ

doi

10.1097/01.AOG.0000140685.30899.24

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

710-4

issue

4

eissn

0029-7844

issn

1873-233X

pii

104/4/710

journal_volume

104

pub_type

杂志文章
  • Endometrial carcinoma after endometrial resection for dysfunctional uterine bleeding.

    abstract:BACKGROUND:Endometrial destruction is an accepted conservative surgical approach for women with dysfunctional uterine bleeding. However, this procedure cannot guarantee complete removal of the entire endometrium. The possibility exists that endometrial carcinoma may develop even years after such procedure. CASE:We rep...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000160484.20261.fd

    authors: Sagiv R,Ben-Shem E,Condrea A,Glezerman M,Golan A

    更新日期:2005-11-01 00:00:00

  • Hormone therapy prescribing patterns in the United States.

    abstract:OBJECTIVE:We sought to examine prescribing patterns (prevalence and rates of initiation and discontinuation) for estrogen plus progestin (hormone therapy [HT] and estrogen alone [ET]) in the United States in the 2 years before the published results of Women's Health Initiative's (WHI) HT trial's early termination and f...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000143826.38439.af

    authors: Buist DS,Newton KM,Miglioretti DL,Beverly K,Connelly MT,Andrade S,Hartsfield CL,Wei F,Chan KA,Kessler L

    更新日期:2004-11-01 00:00:00

  • A three-year prospective assessment of rectocele repair using porcine xenograft.

    abstract:OBJECTIVE:To prospectively evaluate clinical outcome of rectocele repair using xenograft 3 years after surgery. METHODS:Twenty-three patients who completed evaluation preoperatively and 1 year after surgery were assessed at a 3-year follow-up. Clinical examination was performed preoperatively, and at the 1- and 3-year...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000192547.58102.ab

    authors: Altman D,Zetterström J,Mellgren A,Gustafsson C,Anzén B,López A

    更新日期:2006-01-01 00:00:00

  • Outpatient treatment of acute pyelonephritis in pregnancy after 24 weeks.

    abstract:OBJECTIVE:To compare outpatient to inpatient management of acute pyelonephritis in pregnancy beyond 24 weeks' gestation. METHODS:Ninety-two gravidas past 24 weeks' gestation, randomized to outpatient or inpatient therapy, received two 1-g doses of intramuscular ceftriaxone at 24-hour intervals while hospitalized, then...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1016/s0029-7844(99)00386-5

    authors: Wing DA,Hendershott CM,Debuque L,Millar LK

    更新日期:1999-11-01 00:00:00

  • Can prenatal vitamin K1 (phylloquinone) supplementation replace prophylaxis at birth?

    abstract:OBJECTIVE:To assess the effect of prenatal vitamin K1 on the coagulation status of newborns. METHODS:We measured noncarboxylated prothrombin and performed the Normotest in two groups of 5-day-old infants whose mothers were given oral vitamin K1, 10 mg/day for 2 weeks at least 10 days before delivery, or were untreated...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Anai T,Hirota Y,Yoshimatsu J,Oga M,Miyakawa I

    更新日期:1993-02-01 00:00:00

  • Improved prediction of preeclampsia by two-stage screening of uterine arteries using the early diastolic notch and color Doppler imaging.

    abstract:OBJECTIVE:To assess the value of the early diastolic notch and color Doppler imaging of the uterine arteries at 24 weeks' gestation in a two-stage Doppler screening test for preeclampsia. METHODS:Two thousand fifty-eight unselected women had an initial screening study with continuous-wave Doppler at 18-22 weeks' gesta...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Bower S,Bewley S,Campbell S

    更新日期:1993-07-01 00:00:00

  • Thumbtack use for control of presacral bleeding, with description of an instrument for thumbtack application.

    abstract::There is well-known difficulty in controlling hemorrhage from presacral vessels. There are reports on the use of thumbtacks to secure hemostasis in the face of presacral hemorrhage. This communication reports the successful use of thumbtacks to establish presacral hemostasis and describes a simple instrument designed ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Timmons MC,Kohler MF,Addison WA

    更新日期:1991-08-01 00:00:00

  • Differences in cervical cancer mortality among black and white women.

    abstract:OBJECTIVE:To determine whether stage of disease and treatment patterns account for mortality differences between black and white women with cervical cancer. METHODS:Using data obtained from the Surveillance, Epidemiology, and End Results (SEER) Program for 1988-1994, we determined the associations between race and sta...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(99)00334-8

    authors: Howell EA,Chen YT,Concato J

    更新日期:1999-10-01 00:00:00

  • Social support in improving perinatal outcome: the Resource Mothers Program.

    abstract::This report studies the Resource Mothers Program, an organization that improves perinatal outcome through social support. Resource Mothers are nonprofessional women who combine warmth, parenting experience, and knowledge of their local community services to reduce the hazards associated with rural adolescent pregnancy...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Heins HC Jr,Nance NW,Ferguson JE

    更新日期:1987-08-01 00:00:00

  • Antecedent history as a predictor of surgical cure of urgency symptoms in mixed incontinence.

    abstract:OBJECTIVE:To determine the cure rate of urge incontinence after Burch colposuspension in patients with mixed incontinence diagnosed urodynamically, to determine if cure rates were different when the onset of urge symptoms antedated or postdated the symptoms of stress incontinence, and to propose appropriate preoperativ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(97)00550-4

    authors: Scotti RJ,Angell G,Flora R,Greston WM

    更新日期:1998-01-01 00:00:00

  • Changes in the indications for scheduled births to reduce nonmedically indicated deliveries occurring before 39 weeks of gestation.

    abstract:OBJECTIVE:To estimate the change in indications for scheduled deliveries during the Ohio Perinatal Quality Collaborative's initiative to decrease scheduled deliveries for nonmedical indications before 39 weeks of gestation. METHODS:Documented indications for scheduled deliveries between 36 0/7 and 38 6/7 weeks were ca...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e318260d9b2

    authors: Bailit JL,Iams J,Silber A,Krew M,McKenna D,Marcotte M,Donovan E,Ohio Perinatal Quality Collaborative.

    更新日期:2012-08-01 00:00:00

  • A comparative trial of cefazolin and moxalactam as prophylaxis for preventing infection after abdominal hysterectomy.

    abstract::In a randomized, double-blind clinical trial, 208 women who underwent abdominal hysterectomy received either cefazolin (N = 108) or moxalactam (N = 100) as perioperative antimicrobial prophylaxis. There were no differences between the two groups in rates of serious infection, minor wound infection, standard febrile mo...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Tuomala RE,Fischer SG,Muñoz A,Souney PF,Steele L,Polk BF

    更新日期:1985-09-01 00:00:00

  • Fetal blood flow velocity waveforms as predictors of growth retardation.

    abstract::Seventy-five high-risk pregnancies were studied in order to define the clinical value of the analysis of fetal blood flow velocity waveforms in early screening for growth retardation. Recordings were obtained at 26-28 weeks' gestation, in the absence of ultrasonographic signs of growth retardation, using a pulsed dupl...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Arduini D,Rizzo G,Romanini C,Mancuso S

    更新日期:1987-07-01 00:00:00

  • Cervical adenosquamous carcinoma: tumor implantation in an episiotomy scar.

    abstract:BACKGROUND:We report a rare case of a cervical adenosquamous carcinoma, initially diagnosed during delivery, with subsequent implantation in the episiotomy scar 5 weeks postpartum. CASE:A 35-year-old woman with cervical adenosquamous carcinoma diagnosed during delivery was treated with radical abdominal hysterectomy w...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000275260.45730.ea

    authors: Neumann G,Rasmussen KL,Petersen LK

    更新日期:2007-08-01 00:00:00

  • Predicting painful or difficult intrauterine device insertion in nulligravid women.

    abstract:OBJECTIVE:To assess the relationship of preinsertion vaginal ultrasound assessment and menstrual and gynecologic history as predictors of difficult or painful intrauterine device insertion in nulligravid women. METHODS:Nulligravid women seeking contraception were invited to participate in this nonrandomized study and ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000000362

    authors: Kaislasuo J,Heikinheimo O,Lähteenmäki P,Suhonen S

    更新日期:2014-08-01 00:00:00

  • Misoprostol compared with laminaria before early second-trimester surgical abortion: a randomized trial.

    abstract:OBJECTIVE:To compare the efficacy and acceptability of same-day misoprostol and overnight laminaria for cervical ripening before early second-trimester surgical abortion. METHODS:We performed a randomized, double-blinded, controlled trial comparing 400 microg of vaginal misoprostol, given 3-4 hours preoperatively, wit...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/01.AOG.0000168629.17326.00

    authors: Goldberg AB,Drey EA,Whitaker AK,Kang MS,Meckstroth KR,Darney PD

    更新日期:2005-08-01 00:00:00

  • Decreased preterm births in an inner-city public hospital.

    abstract:OBJECTIVE:To examine preterm births among African-American and Hispanic women who delivered at an inner-city public hospital in the context of contemporaneously increasing rates in the United States. METHODS:The rates of preterm birth, defined as birth before 37 weeks of gestation, for singleton neonates with birth we...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e318195e257

    authors: Leveno KJ,McIntire DD,Bloom SL,Sibley MR,Anderson RJ

    更新日期:2009-03-01 00:00:00

  • Induction of labor using high-dose or low-dose prostaglandin vaginal pessaries.

    abstract::Two hundred women were studied in a randomized controlled trial of induction of labor using high-dose (3 mg) or low-dose (0.5 mg) prostaglandin E2 vaginal pessaries. Induction using 3-mg pessaries was more successful, with a shorter overall induction-delivery interval and less requirement for analgesia, although uteri...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章

    doi:

    authors: Hunter IW,Cato E,Ritchie JW

    更新日期:1984-03-01 00:00:00

  • Committee opinion no. 507: human trafficking.

    abstract::Human trafficking is a widespread problem with estimates ranging from 14,000 to 50,000 individuals trafficked into the United States annually. This hidden population involves the commercial sex industry, agriculture, factories, hotel and restaurant businesses, domestic workers, marriage brokers, and some adoption firm...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e3182310d06

    authors:

    更新日期:2011-09-01 00:00:00

  • Biparietal diameter/femur length ratio, cephalic index, and femur length measurements: not reliable screening techniques for Down syndrome.

    abstract::Previous published reports have shown that fetuses affected with Down syndrome have normal biparietal diameter (BPD), high BPD-to-femur length ratio, and shorter femur length and occipitofrontal diameter. A retrospective comparison of the BPD, occipitofrontal diameter, cephalic index, femur length, and BPD/femur lengt...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Shah YG,Eckl CJ,Stinson SK,Woods JR Jr

    更新日期:1990-02-01 00:00:00

  • Screening and follow-up of the patient at high risk for breast cancer.

    abstract::Accurately defining a patient's risk of developing breast cancer is a challenging endeavor. Many factors have been implicated in the causation of breast cancer and quantifying them is difficult. Risk stratification is performed using population models, such as the Gail model, as well as the patient's personal and fami...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/01.AOG.0000295638.83285.97

    authors: Willey SC,Cocilovo C

    更新日期:2007-12-01 00:00:00

  • The impact of National Health Service Corps physicians in the lowering perinatal mortality rate in Dade County, Florida.

    abstract::In some parts of Dade County, Florida, perinatal mortality rates have revealed serious problems in the delivery of health care to poor pregnant women. From 1982-1985, the reported perinatal mortality rates varied from 32-36 per 1000 live births, more than double the national average. Under the leadership of the Primar...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,收录出版

    doi:

    authors: Nguyen HN,O'Sullivan MJ,Fournier AM

    更新日期:1991-09-01 00:00:00

  • Documenting the current definitions of chronic pelvic pain: implications for research.

    abstract:OBJECTIVE:We examined chronic pelvic pain definitions used in published research, because the definition has direct implications for investigating causation and evaluating treatment. DATA SOURCES:MEDLINE was searched for published articles in an Abridged Index Medicus journal from 1966 to 2001, restricted to humans, f...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/01.AOG.0000115513.92318.b7

    authors: Williams RE,Hartmann KE,Steege JF

    更新日期:2004-04-01 00:00:00

  • Primary sarcoma of the adult vagina: a clinicopathologic study.

    abstract::Combination chemotherapy has dramatically improved the results of treatment for embryonal rhabdomyosarcoma of the vagina in children, but little attention has been directed toward vaginal sarcomas in adults. This report of 17 cases of primary sarcoma of the adult vagina includes ten leiomyosarcomas, four mixed mesoder...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Peters WA 3rd,Kumar NB,Andersen WA,Morley GW

    更新日期:1985-05-01 00:00:00

  • Urethral closure pressure and leak-point pressure in incontinent women.

    abstract:OBJECTIVE:To examine the association between maximum urethral closure pressure and Valsalva leak-point pressure in women with genuine stress incontinence (GSI). METHODS:Fifty-six women with GSI were evaluated in a urodynamics laboratory. Maximum urethral closure pressure and vesical leak-point pressure were measured w...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0029-7844(95)00263-Q

    authors: Sultana CJ

    更新日期:1995-11-01 00:00:00

  • Diagnosis and resection of an oral contraceptive-suppressible Sertoli-Leydig cell tumor with preservation of fertility and a 7-year follow-up.

    abstract::A 21-year-old white woman presented with virilization, hirsutism, and acne of 1.5 years' duration. Endocrine testing demonstrated complete suppression of serum testosterone, from 5.3 to 0.6 ng/mL, and serum androstenedione, from 4.7 to 1.7 ng/mL, after oral administration of 50 micrograms of mestranol and 1 mg of nore...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:

    authors: Haning RV Jr,Loughlin J,Shapiro SS

    更新日期:1989-05-01 00:00:00

  • Uterine sarcoidosis potentially associated with interferon-alpha use for chronic hepatitis C infection.

    abstract:BACKGROUND:A regimen including interferon-alpha has become the standard of care in the treatment of chronic hepatitis C over the last decade. One rare adverse effect associated with the use of interferon-alpha is a granulomatous pulmonary reaction. CASE:A unique case of uterine sarcoidosis associated with the use of i...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000157764.44292.aa

    authors: Tsiodras S,Drimala P,Stavreas N,Dachlythras M,Alamani AM,Naoum G

    更新日期:2005-05-01 00:00:00

  • Urinary conduits in gynecologic oncology.

    abstract::Over an 11-year period (1971 to 1981), 212 urinary conduit surgeries were performed by the Department of Gynecology at the University of Texas, M. D. Anderson Hospital and Tumor Institute at Houston. The urinary diversions were performed as part of the pelvic exenteration operation in 154 patients, for radiation injur...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/00006250-198605000-00015

    authors: Hancock KC,Copeland LJ,Gershenson DM,Saul PB,Wharton JT,Rutledge FN

    更新日期:1986-05-01 00:00:00

  • Human immunodeficiency virus type 1-related nucleic acids and papillomavirus DNA in cervicovaginal secretions of immunodeficiency virus-infected women.

    abstract:OBJECTIVE:To evaluate simultaneous human immunodeficiency virus (HIV)-related nucleic acids and human papillomavirus (HPV)-DNA in cervicovaginal secretions of HIV-seropositive women. METHODS:We collected 47 paired blood and cervicovaginal lavage samples from 124 known HIV-1-seropositive women. Proviral HIV-1 DNA, cell...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(01)01130-9

    authors: Spinillo A,Debiaggi M,Zara F,De Santolo A,Polatti F,Filice G

    更新日期:2001-06-01 00:00:00

  • Pregnancy complications in Sioux Indians.

    abstract::The poor health status of Sioux Indians residing on reservations in South Dakota has been recognized for many years. The present report documents evidence of a high incidence of socioeconomic health-related disorders and pregnancy-related complications by comparing 342 pregnant white women and 405 pregnant Sioux India...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Petersen LP,Leonardson G,Wingert RI,Stanage W,Gergen J,Gilmore HT

    更新日期:1984-10-01 00:00:00