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Considerations to Improve the Evidence-Based Use of Vaginal Hysterectomy in Benign Gynecology

Moen, Michael MD; Walter, Andrew MD; Harmanli, Oz MD; Cornella, Jeffrey MD; Nihira, Mikio MD, MPH; Gala, Rajiv MD; Zimmerman, Carl MD; Richter, Holly E. PhD, MD

doi: 10.1097/AOG.0000000000000398
Contents: Current Commentary

Vaginal hysterectomy fulfills the evidence-based requirements as the preferred route of hysterectomy for benign gynecologic disease. Despite proven safety and effectiveness, the vaginal approach for hysterectomy has been and remains underused in surgical practice. Factors associated with underuse of vaginal hysterectomy include challenges during residency training, decreasing case numbers among practicing gynecologists, and lack of awareness of evidence supporting vaginal hysterectomy. Strategies to improve resident training and promote collaboration and referral among practicing physicians and increasing awareness of evidence supporting vaginal hysterectomy can improve the primary use of this hysterectomy approach.

Vaginal hysterectomy currently is underused, and evidence supports developing strategies to increase its use as the preferred route of hysterectomy for benign gynecologic conditions.

Advocate Lutheran General Hospital, Park Ridge, Illinois; Kaiser Permanente–North Valley, Roseville, California; Tufts University School of Medicine, Boston, Massachusetts; the Mayo Clinic, Scottsdale, Arizona; the University of Oklahoma College of Medicine, Oklahoma City, Oklahoma; the University of Queensland Ochsner Clinical School, New Orleans, Louisiana; Vanderbilt University School of Medicine, Nashville, Tennessee; and the Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.

Corresponding author: Michael Moen, MD, 1875 Dempster Street, #665, Park Ridge, IL 60068; e-mail: michael.moen@advocatehealth.com.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists.