Feasibility and Outcomes of Opportunistic Bilateral Salpingectomy in Patients with Traditional Relative Contraindications to Vaginal Hysterectomy

Publication date: Available online 5 December 2019Source: Journal of Minimally Invasive GynecologyAuthor(s): Anna M. Chichura, Meng Yao, Carol Emi Bretschneider, Beri Ridgeway, Rosanne M KhoABSTRACTStudy ObjectiveTo compare the feasibility of opportunistic bilateral salpingectomy (OBS) at the time of vaginal hysterectomy (VH) for benign disease in patients with and without relative contraindications (RC) to the vaginal approach and to evaluate the factors that contribute to inability to perform OBS.DesignRetrospective chart reviewSettingTertiary medical centerPatientsWomen undergoing hysterectomy for benign indications between November 2014 and October 2017 that were consented for either “VH with or without removal of tube(s)" and/or “bilateral salpingectomy.”InterventionRC to the vaginal approach are defined as lack of prolapse (“cervix high, cervix not visualized, cervix tucked underneath pubis, minimal descent”), enlarged uterus (≥ 250 g or ≥ 12 week size uterus), nulliparity, obesity (BMI ≥ 30 kg/m2), prior cesarean section (CS), known adhesions, and known adnexal pathology.Measurements and Main resultsA total of 258 patients underwent VH and attempted OBS within the study period of whom 112 (43.4%) had no RC and 146 (56.6%) had one or more RC. Overall, successful salpingectomy was performed in 86.8% of patients. There was no significant difference in the rate of success in patients without or with one or more RC (84.9% vs 89%, ...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research

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ConclusionNOTES allows the surgeon to survey the pelvis for pathology and to complete other pelvic procedures transvaginally during TVH with no additional abdominal incisions. Transvaginal NOTES can be considered a “rescue” approach and can be a helpful tool for the pelvic surgeon.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Surgical infection less likely if obese women take prophylactic antibiotics for 48h after C-section Related items fromOnMedica Infection risk after caesarean 2.4 times higher in obese women Caesareans associated with increased risk of complications from hysterectomy Antibiotics during pregnancy increases risk of childhood obesity Wide European variations in C-section rates Antibiotics for women in early labour to combat Group B Strep
Source: OnMedica Latest News - Category: UK Health Source Type: news
Conclusions VH is a surgical option for patients with the conditions perceived as contraindications for vaginal surgery evaluated herein.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Conclusion The application of these recommendations should minimize risks associated with hysterectomy.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
CONCLUSION: The application of these recommendations should minimize risks associated with hysterectomy. PMID: 26530174 [PubMed - as supplied by publisher]
Source: Journal de Gynecologie, Obstetrique et Biologie de la Reproduction - Category: OBGYN Authors: Tags: J Gynecol Obstet Biol Reprod (Paris) Source Type: research
September’s Man of the Month is Dr. Neel Shah. Dr. Shah gave us permission to crosspost his article below which was first published in June on The Conversation. Dr. Shah was also recently featured in this Boston Globe article. In the article below he makes the argument that giving birth outside a hospital with a midwife could be safer and cheaper for many American women. Are hospitals the safest place for healthy women to have babies? An obstetrician thinks twice There is a good chance that your grandparents were born at home. I am going to go ahead and assume they turned out fine, or at least fine enough, sinc...
Source: Disruptive Women in Health Care - Category: Consumer Health News Authors: Tags: Childbirth Choice Man of the Month Quality Source Type: blogs
ConclusionThe studied obstetric complications are rare. Uniform definitions and valid reporting are essential for international comparisons. The main risk factors include previous cesarean section. The detailed information collected in the NOSS database provides a basis for epidemiologic studies, audits, and educational activities.
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: Main Research Article Source Type: research
ConclusionThe studied obstetric complications are rare. Uniform definitions and valid reporting is essential for international comparisons. The main risk factors include previous cesarean section. The detailed information collected in the NOSS database provides a basis for epidemiologic studies, audits and educational activities.This article is protected by copyright. All rights reserved.
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: Original Article Source Type: research
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