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Hysterectomy

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181. Barriers to Evidence-Based Transgender Care: Knowledge Gaps in Gender-Affirming Hysterectomy and Oophorectomy. (Abstract)

Barriers to Evidence-Based Transgender Care: Knowledge Gaps in Gender-Affirming Hysterectomy and Oophorectomy. Reversal of gender-discriminatory insurance coverage policies has led to a substantial increase in access to gender-affirming surgical care in the United States over the past 20 years. Although the evidence supports the safety, feasibility, and medical necessity of gender-affirming hysterectomy and oophorectomy, there are currently no evidence-based guidelines to define optimal care (...) surrounding many aspects of these surgeries. This commentary reviews the evidence supporting the safety, feasibility, and route of hysterectomy and oophorectomy for transgender men, the benefits and risks of oophorectomy in cisgender women and their extrapolation to transgender men, and the effects of testosterone supplementation in transgender men with and without ovaries. In addition, this article highlights the data gaps surrounding whether oophorectomy should be performed at the time of hysterectomy

2019 Obstetrics and Gynecology

182. Effects of Shared Decision Making on Opioid Prescribing After Hysterectomy. (Abstract)

Effects of Shared Decision Making on Opioid Prescribing After Hysterectomy. To evaluate the effects of shared decision making using a simple decision aid for opioid prescribing after hysterectomy.We conducted a prospective quality initiative study including all patients undergoing hysterectomy for benign, nonobstetric indications between March 1, 2018, and July 31, 2018, at our academic institution. Using a visual decision aid, patients received uniform education regarding postoperative pain (...) implementation of the decision aid. Secondary outcomes included opioid consumption, patient satisfaction, and refill requests after intervention implementation.Of 170 eligible patients, 159 (93.5%) used the decision aid (one patient who used the decision aid was subsequently excluded from the analysis owing to significant perioperative complications), including 110 (69.6%) laparoscopic, 40 (25.3%) vaginal, and eight (5.3%) abdominal hysterectomies. Telephone surveys were completed for 89.2% (n=141

2019 Obstetrics and Gynecology

183. Patterns of hysterectomy in India: a national and state-level analysis of the Fourth National Family Health Survey (2015-2016). (Full text)

Patterns of hysterectomy in India: a national and state-level analysis of the Fourth National Family Health Survey (2015-2016). The National Family Health Survey-4 in India provided the first nationally representative estimates of hysterectomy among women aged 15-49. This paper aims to examine the national and state-level age-specific prevalence of hysterectomy, individual and household level factors associated with the procedure, and state-level indicators that may explain variation across (...) states.Cross-sectional, nationally representative household survey.National Family Health Survey was conducted across all Indian states and union territories between 2015 and 2016.The survey covered 699 686 women between the ages of 15 and 49 years.Descriptive analyses and multivariate logistic regression.Women who reported ever having a hysterectomy and age at hysterectomy.Age-specific prevalence of hysterectomy was 0.36% (0.33,0.39) among women aged 15-29; 3.59% (3.45,3.74) among women aged 30-39

2019 BJOG PubMed abstract

184. The effect of anemia severity on postoperative morbidity among patients undergoing laparoscopic hysterectomy for benign indications. (Abstract)

The effect of anemia severity on postoperative morbidity among patients undergoing laparoscopic hysterectomy for benign indications. One-third of non-pregnant women worldwide are anemic.1 Anemia is a known independent risk factor for postoperative morbidity.2 Given that the vast majority of hysterectomies are not performed in the emergency setting, we designed this study to evaluate the effect of preoperative anemia on postoperative morbidity following laparoscopic hysterectomy performed (...) for benign indications. Our main goal is to encourage surgeons to use anemia-corrective measures before surgery when feasible.Retrospective cohort study of 98 813 patients who underwent a laparoscopic hysterectomy between 2005 and 2016 for benign indications identified through the American College of Surgeons National Surgical Quality Improvement Program. Anemia was examined as a function of hematocrit and was analyzed as an ordinal variable stratified by anemia severity as mild, moderate or severe

2019 Acta Obstetricia et Gynecologica Scandinavica

185. Women undergoing peripartum hysterectomy due to obstetric hemorrhage: A prospective population-based study. (Abstract)

Women undergoing peripartum hysterectomy due to obstetric hemorrhage: A prospective population-based study. Peripartum hysterectomy is usually undertaken in cases of life-threatening obstetric hemorrhage to prevent the death of the mother. Near-miss events are still under-researched and inappropriate care continues to be a critical issue, even in countries with advanced obstetric surveillance systems. The aim of the present study was to estimate the prevalence, associated factors, management (...) and intraoperative and postoperative complications of peripartum hysterectomy due to obstetric hemorrhage.A prospective population-based study has been conducted in six Italian regions covering 49% of births in Italy. The study population comprised all women aged 11-59 years undergoing peripartum hysterectomy, from September 2014 to August 2016, due to obstetric hemorrhage within 7 days of delivery. In each maternity unit a trained reference person reported incident cases using electronic data collection forms

2019 Acta Obstetricia et Gynecologica Scandinavica

186. Perioperative Duloxetine for Pain Management After Laparoscopic Hysterectomy: A Randomized Placebo-Controlled Trial. (Abstract)

Perioperative Duloxetine for Pain Management After Laparoscopic Hysterectomy: A Randomized Placebo-Controlled Trial. To evaluate the effect of perioperative duloxetine on pain management in patients recovering from laparoscopic hysterectomy.A randomized placebo-controlled trial.A university hospital.Of 100 patients enrolled, 80 were randomized 1:1 to receive perioperative duloxetine (n = 40) or placebo (n = 40).Patients undergoing laparoscopic hysterectomy for benign conditions from November

2019 Journal of minimally invasive gynecology Controlled trial quality: uncertain

187. Comparison of the efficacy and safety of two advanced vessel sealing technologies in total laparoscopic hysterectomy. (Abstract)

Comparison of the efficacy and safety of two advanced vessel sealing technologies in total laparoscopic hysterectomy. Adequately powered, randomized controlled studies evaluating efficacy and safety of advanced bipolar energy devices in gynecologic laparoscopic surgery are very few. We aimed to compare the two most commonly used devices in total laparoscopic hysterectomy.This randomized controlled trial was carried out in the department of obstetrics and gynecology in an education and research (...) hospital. One hundred thirty-two women who underwent total laparoscopic hysterectomy for benign indications were included. Women with age younger than 18 years, suspected malignancy, stage 3-4 endometriosis and cervical/intraligamentary leiomyoma were excluded. Patients were randomized preoperatively to LigaSure or Articulating Enseal. One experienced surgeon performed all operations.LigaSure was used in 67 patients and Enseal was used in 65 patients. Primary outcomes of the study were operative time

2019 The journal of obstetrics and gynaecology research Controlled trial quality: uncertain

188. [Postoperative low-dose sufentanil combined with transversus abdominis plane block promotes recovery following laparoscopic hysterectomy]. (Abstract)

[Postoperative low-dose sufentanil combined with transversus abdominis plane block promotes recovery following laparoscopic hysterectomy]. To compare the efficacy and safety of postoperative analgesia with low-dose sufentanil combined with transversus abdominis plane (TAP) block and with sufentanil alone in promoting patients'recovery following laparoscopic hysterectomy.Sixty patients undergoing laparoscopic hysterectomy in our hospital between September, 2016 and August, 2017 were randomly (...) (including 4 with mild and 2 with moderate PONV).Lowdose sufentanil combined with TAP block is effective for postoperative analgesia after laparoscopic hysterectomy and helps to reduce the incidence of PONV and shorten the first off-bed time and postoperative hospital stay to promote the recovery of the patients.

2019 Nan fang yi ke da xue xue bao = Journal of Southern Medical University Controlled trial quality: uncertain

189. Comparison of Fentanyl and Dexmedetomidine as Intrathecal Adjuvants to Spinal Anaesthesia for Abdominal Hysterectomy. (Abstract)

Comparison of Fentanyl and Dexmedetomidine as Intrathecal Adjuvants to Spinal Anaesthesia for Abdominal Hysterectomy. Spinal anaesthesia, although advantageous for conducting abdominal hysterectomy, is not the first choice amongst surgeons for fear of intra-operative visceral pain. Intrathecal adjuvants may improve quality of spinal anaesthesia. This study aims to compare efficacy of intrathecal Fentanyl and Dexmedetomidine to reduce visceral pain during abdominal hysterectomy performed under (...) spinal anaesthesia.Sixty women undergoing abdominal hysterectomy for benign indications were randomly assigned to two equal groups in a double-blind fashion. Fentanyl 25 micrograms in group A or Dexmedetomidine 10 micrograms in group B was co-administered with hyperbaric Bupivacaine 15 milligrams for spinal anesthesia. Surgery through Pfannenstiel incision proceeded once sensory block reached eighth thoracic dermatome. The intra-operative visceral pain was assessed using a five-point scale: none

2019 JNMA; journal of the Nepal Medical Association Controlled trial quality: uncertain

190. Comparison of Topical and Subcutaneous Bupivacaine Infiltration with Subcutaneous Ketamine on Postoperative Pain in Total Abdominal Hysterectomy. (Full text)

Comparison of Topical and Subcutaneous Bupivacaine Infiltration with Subcutaneous Ketamine on Postoperative Pain in Total Abdominal Hysterectomy. Hysterectomy is one of the most common surgical procedures. Problems such as severe pelvic pain, irregular or heavy bleeding and uterine cancer from those that may be used to treat them no choice but to remove the uterus by surgery. Abdominal pain after abdominal hysterectomy, the most common complaints of patients undergoing this type of surgery (...) is considered.This study aimed to compare the effects of bupivacaine into the subcutaneous tissue and skin ketamine for pain control after surgery in patients undergoing abdominal hysterectomy was performed under general anesthesia.This study is a randomized, double-blind clinical trial involving 99 women scheduled for TAH referred to tertiary centers was performed. Group A: 5 mL of 0.25% bupivacaine into the subcutaneous tissue and, Group II: 100 mg ketamine skin and subcutaneous tissue with cc5 volume

2019 Medical archives (Sarajevo, Bosnia and Herzegovina) Controlled trial quality: uncertain PubMed abstract

191. Regarding "Paracervical Block as a Strategy to Reduce Postoperative Pain After Laparoscopic Hysterectomy: A Randomized Controlled Trial". (Abstract)

Regarding "Paracervical Block as a Strategy to Reduce Postoperative Pain After Laparoscopic Hysterectomy: A Randomized Controlled Trial". 30872183 2019 09 01 1553-4669 26 6 2019 Sep - Oct Journal of minimally invasive gynecology J Minim Invasive Gynecol Regarding "Paracervical Block as a Strategy to Reduce Postoperative Pain After Laparoscopic Hysterectomy: A Randomized Controlled Trial". 1203 S1553-4650(19)30120-7 10.1016/j.jmig.2019.02.018 Lovett-Carter Danielle D Providence, RI. eng Letter

2019 Journal of minimally invasive gynecology Controlled trial quality: predicted high

192. Therapy of B-ultrasound-guided puncture for incision infection after total abdominal hysterectomy. (Abstract)

Therapy of B-ultrasound-guided puncture for incision infection after total abdominal hysterectomy. This paper aims to investigate the clinical efficacy of B-ultrasound-guided puncture in the treatment of incision infection after total abdominal hysterectomy (TAH) and to provide references for the clinical treatment.116 patients with uterine incision infection after TAH were selected and randomly divided into the observation group and the control group, with 58 cases in each group. The patients

2019 European review for medical and pharmacological sciences Controlled trial quality: uncertain

193. Minilaparoscopic Total Hysterectomy in Current Practice Feasibility and benefits: A Unicentric, Randomized Controlled Trial. (Abstract)

Minilaparoscopic Total Hysterectomy in Current Practice Feasibility and benefits: A Unicentric, Randomized Controlled Trial. To investigate whether mini-instrumentation may be used for hysterectomy (HT) by all surgeons (assistants and seniors) without increasing the operative time or altering surgeon working conditions.A unicenter, randomized controlled, single blind, parallel, noninferiority trial comparing 2 surgical techniques.A tertiary referral center.Thirty-two patients undergoing HT

2019 Journal of minimally invasive gynecology Controlled trial quality: uncertain

194. Retraction notice to "Treatment of postoperative emetic symptoms with granisetron in women undergoing abdominal hysterectomy: A randomized, double-blind, placebo-controlled, dose-ranging study": [CTR 65/4 (2004) 321-329]. (Full text)

Retraction notice to "Treatment of postoperative emetic symptoms with granisetron in women undergoing abdominal hysterectomy: A randomized, double-blind, placebo-controlled, dose-ranging study": [CTR 65/4 (2004) 321-329]. [This retracts the article DOI: 10.1016/j.curtheres.2004.06.002.].

2019 Current therapeutic research, clinical and experimental Controlled trial quality: uncertain PubMed abstract

195. Comparison of laparoscopic and abdominal radical hysterectomy in early stage cervical cancer patients without adjuvant treatment: Ancillary analysis of a Korean Gynecologic Oncology Group Study (KGOG 1028). (Abstract)

Comparison of laparoscopic and abdominal radical hysterectomy in early stage cervical cancer patients without adjuvant treatment: Ancillary analysis of a Korean Gynecologic Oncology Group Study (KGOG 1028). We compared two groups of early stage cervical cancer patients treated with different surgical methods without adjuvant treatment using retrospective multicenter data previously collected for Korean Gynecologic Oncology Group (KGOG) study designed for developing prognostic models.We (...) initially assessed data from the multi-institutional cohort with early stage (IB-IIA) cervical cancer patients treated with radical hysterectomy without adjuvant treatment between 2000 and 2008. Propensity score matching was performed to compare disease-free survival (DFS) and overall survival (OS) of patients with laparoscopic to abdominal radical hysterectomy. Additionally, survival comparison was performed in patients with tumor size <2 cm.After matching, 119 patients with laparoscopic radical

2019 Gynecologic Oncology

196. Impact of laparoscopic radical hysterectomy on survival outcome in patients with FIGO stage IB cervical cancer: A matching study of two institutional hospitals in Korea. (Abstract)

Impact of laparoscopic radical hysterectomy on survival outcome in patients with FIGO stage IB cervical cancer: A matching study of two institutional hospitals in Korea. To compare survival outcomes of primary laparoscopic radical hysterectomy (LRH) and open radical hysterectomy (ORH) in patients with FIGO stage IB cervical cancer.We retrospectively identified stage IB1-IB2 cervical cancer patients who received either LRH (n = 343) or ORH (n = 222) at two tertiary institutional hospitals

2019 Gynecologic Oncology

197. Opioid use after minimally invasive hysterectomy in gynecologic oncology patients. (Abstract)

Opioid use after minimally invasive hysterectomy in gynecologic oncology patients. To quantify, and identify predictors of, post-discharge opioid use in gynecologic oncology patients undergoing minimally invasive hysterectomy (MIH).For this prospective cohort study, gynecologic oncology patients planning to undergo MIH were recruited at a single institution. Post-operative opioid usage was evaluated via chart review and surveys at 1-2-week and 4-6-week post-operative visits. Opioids

2019 Gynecologic Oncology

198. Endometrial cancer does not increase the 30-day risk of venous thromboembolism following hysterectomy compared to benign disease. A Danish National Cohort Study. (Abstract)

Endometrial cancer does not increase the 30-day risk of venous thromboembolism following hysterectomy compared to benign disease. A Danish National Cohort Study. We aimed to clarify if endometrial cancer patients are at higher risk of venous thromboembolism (VTE) following hysterectomy, compared to patients undergoing hysterectomy for benign gynecological disease.In a nationwide registry-based cohort study, patients undergoing hysterectomy for endometrial cancer or benign disease were followed (...) 30 days after surgery. The Danish Gynecological Cancer Database (DGCD) and the Danish National Patient Register (DNPR) were linked with four other administrative registries to describe the population and retrieve data on venous thromboembolism and mortality. Multivariable logistic regression models were used to estimate odds ratios (ORs) for 30-day postoperative VTE.We identified 5513 patients with endometrial cancer, and 45,825 patients with benign disease undergoing hysterectomy in the period 2005

2019 Gynecologic Oncology

199. Superior Hypogastric Plexus Blocks for Postoperative Pain Management in Abdominal Hysterectomies. (Abstract)

Superior Hypogastric Plexus Blocks for Postoperative Pain Management in Abdominal Hysterectomies. To evaluate the efficacy of intraoperative superior hypogastric plexus (SHP) blocks on postoperative pain management in abdominal hysterectomies.A total of 78 female ASA I-II patients who underwent elective total abdominal hysterectomy for benign reasons were assessed for eligibility. After exclusion of patients who did not fulfil the inclusion criteria, 60 patients were evaluated in 2 groups (...) times were found to be significantly longer in the SHP group (627±352.9▒min) (P<0.05). All VAS score assessments were found to be statistically significantly low in the SHP group (P<0.05). No complications related to the SHP blocks were observed.Intraoperative superior hypogastric plexus blocks in abdominal hysterectomies are promising methods for acute postoperative pain management as part of a multimodal analgesia regimen. Although single superior hypogastric plexus blocks provide adequate pain

2019 Clinical Journal of Pain

200. Intraoperative methadone for postoperative pain after laparoscopic hysterectomy: Protocol for a randomised, double-blind trial. (Abstract)

Intraoperative methadone for postoperative pain after laparoscopic hysterectomy: Protocol for a randomised, double-blind trial. Hysterectomy is often carried out as same-day surgery. Treatment of postoperative pain is, therefore, of utmost importance to ensure timely discharge from hospital. Methadone has several desirable pharmacological features, including a long elimination half-life. Theoretically, a single intraoperative dose could provide long-lasting pain relief.This is a single-centre (...) , investigator-initiated, randomised, double-blind study. Two-hundred and fifty women, scheduled to undergo hysterectomy at Horsens Region Hospital, Denmark, are randomized to receive methadone (0.2 mg/kg) or morphine (0.2 mg/kg) intraoperatively, 60 minutes before extubation. Primary outcomes are opioid consumption at 6 and 24 hours. Secondary outcomes include pain intensity at rest and during coughing at 1, 3, 6, 24 and 48 hours; patient satisfaction at 3 and 24 hours, postoperative nausea and vomiting

2019 Acta Anaesthesiologica Scandinavica Controlled trial quality: predicted high

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