{"paper_id":"dd7c9c63-d48c-4538-ad89-14f9f18a7d05","body_text":"Medical Management of the Surgical Patient\nBuy print or eBook\n[Opens in a new window] A Textbook of Perioperative Medicine\nfrom Section 21 - Gynecologic Surgery\nPublished online by Cambridge University Press: 05 September 2013\nIn the late nineteenth and early twentieth century it was taught that vaginal hysterectomy could not be performed if the uterus was enlarged, but uterine size was never quantified. Other suggested contraindications included a ‘narrow vagina’ (pubic arch < 90°) and a diminished bituberous diameter (< 8.0 cm). The bituberous diameter represents the distance between the ischial tuberosities (or sitting bones) which are easily palpated when the patient is in the dorsal lithotomy position. Nulliparity and “a uterus that was too high or did not come down” were also considered as contraindications to the vaginal approach, as were “intra-abdominal conditions” such as endometriosis, adhesions, previous pelvic surgery, previous cesarean section, and chronic pelvic pain.\nHysterectomy became the second most common operation performed in the USA in the middle twentieth century, but the complications related to this operation were not re-evaluated until 1982. The Collaborative Review of Sterilization (CREST) from the CDC studied the complications of abdominal and vaginal hysterectomy. For operative indications that could have been performed by either route, abdominal hysterectomy had a complication rate twice that of the vaginal approach.\n- Type\n- Chapter\n- Information\n- Medical Management of the Surgical PatientA Textbook of Perioperative Medicine, pp. 654 - 656Publisher: Cambridge University PressPrint publication year: 2013\nVaginal length and incidence of dyspareunia after total abdominal versus vaginal hysterectomy. Eur J Obstet Gynecol Reprod Biol 2010; 151: 190–2.CrossRefGoogle ScholarPubMed\nCommittee Opinion No. 444: Choosing the route of hysterectomy for benign disease.\nFINHYST, a prospective study of 5279 hysterectomies: complications and their risk factors. Hum Reprod 2011; 26: 1741–51.CrossRefGoogle ScholarPubMed\n, , et al. When do we need to perform laparotomy for benign uterine disease? Factors involved with conversion in vaginal hysterectomy. J Obstet Gynaecol Res 2012; 38; 31–4.CrossRefGoogle ScholarPubMed\n, , , Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States. Am J Obstet Gynecol 1982; 144: 841–8.CrossRefGoogle ScholarPubMed\n, , et al. Abdominal, vaginal and total laparoscopic hysterectomy: perioperative morbidity. Arch Gynecol Obstet 2011; 284: 385–9.CrossRefGoogle ScholarPubMed\n, , et al. Minimally invasive hysterectomies – a survey on attitudes and barriers among practicing gynecologists. J Minim Invasive Gynecol 2010; 17: 167–75.CrossRefGoogle ScholarPubMed\n, , et al. The availability of vaginal hysterectomy in benign gynecologic diseases: a prospective, non-randomized trial. J Obstet Gynaecol Res 2010; 36: 832–7.CrossRefGoogle ScholarPubMed\n, , , Guidelines for the selection the route of hysterectomy: application in a resident clinic population. Am J Obstet Gynecol 2002; 187: 1521–7.CrossRefGoogle Scholar\n, , , , Laparoscopy-assisted vaginal hysterectomy. J Gynecol Surg 1990; 6: 185–93.CrossRefGoogle ScholarPubMed\n, , Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev. 2009; 8: CD003677.Google Scholar\n, , et al. Accessibility compliance for the PDF of this chapter is currently unknown\nand may be updated in the future.\nTo save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. 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