Risk factors for trachelectomy following supracervical hysterectomy

Ziv Tsafrir, Tsafrir Z, Joelle Aoun, Aoun J, Eleni Papalekas, Papalekas E, Andrew Taylor, Andrew M. Taylor, Taylor A, Schiff L, Lauren Schiff, Theoharis E, Evan Theoharis, D. Eisenstein, Eisenstein D, David Eisenstein
Acta obstetricia et gynecologica Scandinavica · 2017 · vol. 96(4) , pp. 421–425 · doi:10.1111/aogs.13099 · PMID:28107774 · W2578501271
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Younger age and a history of endometriosis were identified as significant risk factors for requiring a trachelectomy after supracervical hysterectomy for symptom persistence.

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Abstract

INTRODUCTION: We identified risk factors for trachelectomy after supracervical hysterectomy (SCH) due to persistence of symptoms. MATERIAL AND METHODS: A retrospective case-control study in a university-affiliated hospital. Seventeen women who underwent a trachelectomy following SCH for nonmalignant indications between June 2002 and October 2014 were compared with 68 randomly selected women (controls) who underwent a SCH within the same time period. Demographics and clinical characteristics were compared between the study and control groups. Univariate analysis identified potential risk factors for trachelectomy following SCH. Univariate logistic regression models predicted which patients would have a trachelectomy following SCH. RESULTS: The occurrence of trachelectomy following SCH during the study period was 0.9% (17/1892). The study group was younger than the control group (mean age 38 ± 6 years vs. 44 ± 5 years; p < 0.001). Patients who had a history of endometriosis [odds ratio (OR) 6.23, 95% CI 1.11-40.5, p = 0.038] had increased risk for trachelectomy. Pathology diagnosed endometriosis only among women in the study group. Preoperative diagnosis of abnormal uterine bleeding (OR 0.22, 95% CI 0.06-0.075, p = 0.016), anemia (OR 0.12, 95% CI 0.01-0.53; p = 0.003), and fibroid uterus (OR 0.24, 95% CI 0.07-0.82, p = 0.024) reduced the risk for future trachelectomy. CONCLUSION: Young age and endometriosis are significant risk factors for trachelectomy following SCH.

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Condition tags

chronic_pelvic_painendometriosis

MeSH descriptors

Cervix Uteri Hysterectomy Pelvic Pain Postoperative Complications Adult Case-Control Studies Cervix Uteri Cervix Uteri Female Humans Hysterectomy Hysterectomy Michigan Michigan Pelvic Pain Pelvic Pain Postoperative Complications Postoperative Complications Retrospective Studies Risk Factors

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