The Experts below are selected from a list of 8541 Experts worldwide ranked by ideXlab platform
Charles Botz - One of the best experts on this subject based on the ideXlab platform.
-
economic evaluation of hysteroscopic endometrial ablation versus Vaginal Hysterectomy for menorrhagia
Obstetrics & Gynecology, 1996Co-Authors: George A Vilos, John T Pispidikis, Charles BotzAbstract:Objectives To estimate society's expenses and benefits of hysteroscopic endometrial ablation and Vaginal Hysterectomy for the treatment of women with menorrhagia. Methods Between June 1992 and July 1993, 40 women with menorrhagia underwent Vaginal Hysterectomy by five surgeons in one hospital. These patients were compared retrospectively with the first 40 patients having had endometrial ablation for menorrhagia during the same period by the senior author (GAV). The age, parity, weight of patients, and uterine size were similar in both groups. Measurable variables that would incur costs included surgical time, procedure time (anesthetist and resource use in operating room), length of hospital stay, convalescence (value of patient time), and indirect costs associated with subsequent surgical procedures. Measurable benefits included reduction in blood loss and complications, and effectiveness of procedure. Results The total cost per episode of care was estimated to be $5373 and $2279 (1995 Canadian dollars) for Vaginal Hysterectomy and hysteroscopic endometrial ablation, respectively, a mean savings of $3094. The benefits derived from both procedures were comparable. Vaginal Hysterectomy eliminated bleeding in 100% of patients and had a complication rate of 41%. Endometrial ablation eliminated or improved bleeding in 90% of patients (amenorrhea 46%, hypomenorrhea 35%, eumenorrhea 9%, no significant change 10%), was associated with no complications, and resulted in 82% patient satisfaction. Conclusion Endometrial ablation is 82% effective and 58% less expensive than Vaginal Hysterectomy for the treatment of women with menorrhagia.
-
economic evaluation of hysteroscopic endometrial ablation versus Vaginal Hysterectomy for menorrhagia
Journal of The American Association of Gynecologic Laparoscopists, 1996Co-Authors: George A Vilos, John T Pispidikis, Charles BotzAbstract:: Between June 1992 and July 1993, 40 women with menorrhagia underwent Vaginal Hysterectomy, performed by 5 surgeons in one hospital. The patients were retrospectively compared with the first 40 women having endometrial ablation for menorrhagia performed during the same period by senior author. The age, parity, weight, and uterine size were similar in both groups. Measurable costs were surgical time, procedure time (anesthetist and resource use in operating room), length of hospital stay, convalescence (value of patient time), and indirect costs associated with subsequent surgical procedures. Measurable benefits were estimated blood loss, complications, and effectiveness of the procedure. The total cost per episode of care was estimated to be $5373 and $2279 (1995 $ Canadian) for Vaginal Hysterectomy and hysteroscopic endometrial ablation, respectively, for a mean saving of $3094. The benefits derived from both procedures were comparable. Vaginal Hysterectomy eliminated bleeding in 100% of women and was associated with a complication rate of 41%. Endometrial ablation eliminated or improved bleeding in 90% of women (amenorrhea 46%, hypomenorrhea 35%, eumenorrhea 9%, no significant change 10%), was associated with no complications, and resulted in 82% satisfaction. Endometrial ablation is 82% effective and 58% less expensive than Vaginal Hysterectomy for the treatment of women with menorrhagia.
Edward J Mascha - One of the best experts on this subject based on the ideXlab platform.
-
prospective randomized clinical trial of laparoscopically assisted Vaginal Hysterectomy versus total abdominal Hysterectomy
American Journal of Obstetrics and Gynecology, 1999Co-Authors: Tommaso Falcone, Marie Fidela R Paraiso, Edward J MaschaAbstract:Abstract Objective: We compared operative time, length of hospital stay, postoperative recovery, return to work, and costs for women undergoing laparoscopically assisted Vaginal Hysterectomy or abdominal Hysterectomy. Study Design: A prospective randomized clinical trial of laparoscopically assisted Vaginal Hysterectomy (n = 24) versus abdominal Hysterectomy (n = 24) was carried out in a tertiary care setting. The main outcome variables were operative time, length of hospital stay, and return to work. Secondary outcomes were postoperative pain and return to normal activity as determined by weekly visual analog scales and daily diary. Hospital costs were calculated. Results: The laparoscopically assisted Vaginal Hysterectomy group had longer operative times (median and quartiles, laparoscopically assisted Vaginal Hysterectomy 180 [139, 225] minutes vs abdominal Hysterectomy 130 [97, 155] minutes), lower requirements for postoperative intravenous analgesia (patient-controlled analgesia pump, median and quartiles: laparoscopically assisted Vaginal Hysterectomy 22.1 [15.9, 23.5] hours, abdominal Hysterectomy 36.7 [26.2, 45.0] hours), shorter length of hospital stay (median and quartiles, laparoscopically assisted Vaginal Hysterectomy 1.5 [1.0, 2.3] days, abdominal Hysterectomy 2.5 [1.5, 2.5] days), and quicker return to work (Kaplan-Meier analysis, P = .03). Both procedures had similar hospital costs ( P = .21). Conclusion: Laparoscopically assisted Vaginal Hysterectomy appears to allow patients a more rapid postoperative recovery and an earlier return to work with hospital costs similar to those of abdominal Hysterectomy. (Am J Obstet Gynecol 1999;180:955-62.)
Kathryn F Mcgonigle - One of the best experts on this subject based on the ideXlab platform.
-
retained uterine fundus after Vaginal Hysterectomy
European Journal of Radiology Extra, 2008Co-Authors: Matthew E Brown, Eugene C Lin, Kathryn F McgonigleAbstract:Abstract We report a case of a 53-year-old female with a retained uterine fundus, presenting 2 years following a Vaginal Hysterectomy. It is important for imagers to be aware that morcellation techniques can result in retained portions of the uterus following Vaginal Hysterectomy.
Byounggie Kim - One of the best experts on this subject based on the ideXlab platform.
-
single port access laparoscopic assisted Vaginal Hysterectomy versus conventional laparoscopic assisted Vaginal Hysterectomy a comparison of perioperative outcomes
Surgical Endoscopy and Other Interventional Techniques, 2010Co-Authors: Taejoong Kim, Yooyoung Lee, Hyun Hwa Cha, Chuljung Kim, Chel Hun Choi, Jeongwon Lee, Duksoo Bae, Jeho Lee, Byounggie KimAbstract:Background The objective of the study was to compare the perioperative outcomes, including the operative time, length of hospital stay, and postoperative pain, of a single-port-access laparoscopic-assisted Vaginal Hysterectomy (SPA-LAVH) and conventional LAVH.
Rebecca G Rogers - One of the best experts on this subject based on the ideXlab platform.
-
effect of Vaginal mesh hysteropexy vs Vaginal Hysterectomy with uterosacral ligament suspension on treatment failure in women with uteroVaginal prolapse a randomized clinical trial
JAMA, 2019Co-Authors: Charles W Nager, Marie Fidela R Paraiso, Rebecca G Rogers, Holly E Richter, Anthony G Visco, Charles R Rardin, Heidi S Harvie, Halina M Zyczynski, Donna MazloomdoostAbstract:Importance Vaginal Hysterectomy with suture apical suspension is commonly performed for uteroVaginal prolapse. TransVaginal mesh hysteropexy is an alternative option. Objective To compare the efficacy and adverse events of Vaginal Hysterectomy with suture apical suspension and transVaginal mesh hysteropexy. Design, Setting, Participants At 9 clinical sites in the US Pelvic Floor Disorders Network, 183 postmenopausal women with symptomatic uteroVaginal prolapse were enrolled in a randomized superiority clinical trial between April 2013 and February 2015. The study was designed for primary analysis when the last randomized participant reached 3 years of follow-up in February 2018. Interventions Ninety-three women were randomized to undergo Vaginal mesh hysteropexy and 90 were randomized to undergo Vaginal Hysterectomy with uterosacral ligament suspension. Main Outcomes and Measures The primary treatment failure composite outcome (re-treatment of prolapse, prolapse beyond the hymen, or prolapse symptoms) was evaluated with survival models. Secondary outcomes included operative outcomes and adverse events, and were evaluated with longitudinal models or contingency tables as appropriate. Results A total of 183 participants (mean age, 66 years) were randomized, 175 were included in the trial, and 169 (97%) completed the 3-year follow-up. The primary outcome was not significantly different among women who underwent hysteropexy vs Hysterectomy through 48 months (adjusted hazard ratio, 0.62 [95% CI, 0.38-1.02];P = .06; 36-month adjusted failure incidence, 26% vs 38%). Mean (SD) operative time was lower in the hysteropexy group vs the Hysterectomy group (111.5 [39.7] min vs 156.7 [43.9] min; difference, −45.2 [95% CI, −57.7 to −32.7];P = Conclusions and Relevance Among women with symptomatic uteroVaginal prolapse undergoing Vaginal surgery, Vaginal mesh hysteropexy compared with Vaginal Hysterectomy with uterosacral ligament suspension did not result in a significantly lower rate of the composite prolapse outcome after 3 years. However, imprecision in study results precludes a definitive conclusion, and further research is needed to assess whether Vaginal mesh hysteropexy is more effective than Vaginal Hysterectomy with uterosacral ligament suspension. Trial Registration ClinicalTrials.gov Identifier:NCT01802281
-
abdominal Hysterectomy for the enlarged myomatous uterus compared with Vaginal Hysterectomy with morcellation
American Journal of Obstetrics and Gynecology, 2003Co-Authors: Susan M Taylor, Audrey A Romero, Dorothy Kammererdoak, Clifford Qualls, Rebecca G RogersAbstract:Abstract Objective The purpose of this study was to compare intraoperative and postoperative complications of abdominal Hysterectomy for the enlarged, myomatous uterus with Vaginal Hysterectomy with morcellation. Study design Medical records of 139 patients who underwent Vaginal Hysterectomy with morcellation and 244 patients who underwent total abdominal Hysterectomy for an enlarged, myomatous uterus between August 1990 and July 2001 were reviewed. Uterine weights of >982 g were excluded because this was the largest uterus removed Vaginally, which left 208 evaluable cases of total abdominal Hysterectomy. The perioperative and postoperative course of the two groups was compared. The Student t test was used for continuous variables, and the Fisher exact test was used for binary or categoric data. Results There were no significant differences between the two groups in surgical or anesthetic risk factors (P > .05). Operative time was similar between the groups (P > .05). Length of hospital stay was increased significantly with total abdominal Hysterectomy (mean, 3.9 days vs 2.6 days; P Conclusion In this large series, uterine morcellation at the time of Vaginal Hysterectomy is safe and facilitates the removal of moderately enlarged and well-supported uteri and is associated with decreased hospital stay and perioperative morbidity rate compared with the abdominal route.
