Prognostic Factors for Morcellation During Vaginal Hysterectomy

Megan Wasson, Kristina Butler, Paul Magtibay, Mʼhamed Temkit, Javier Magrina

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

OBJECTIVE:: To determine prognostic factors associated with cold-knife morcellation during vaginal hysterectomy. METHODS:: We conducted a retrospective cohort study evaluating all consecutive patients undergoing a vaginal hysterectomy between January 1, 2009, and August 31, 2014. The primary outcome was the utilization of uncontained vaginal morcellation performed using cold-knife wedge resection at the time of vaginal hysterectomy. Secondary outcomes included perioperative data. Significant factors were included in a multivariate logistic regression model to the binary variable vaginal morcellation at the time of vaginal hysterectomy. RESULTS:: A total of 743 women met study inclusion criteria and underwent vaginal hysterectomy with intact uterine removal (n=383) or with uterine morcellation (n=360) with and without other vaginal procedures. A nonparametric Wilcoxon-rank-sum test and χ test were used to compare the cohorts of patients with and without morcellation. Characteristics associated with significantly increased likelihood of morcellation included younger age, non-Caucasian race, American Society of Anesthesiologists class 1 or 2, lower parity, lower number of prior vaginal deliveries, absence of prolapse, presence of leiomyoma, and an enlarged uterus. A multivariate logistic model utilizing factors most likely associated with morcellation revealed lack of prolapse (adjusted odds ratio [OR] 3.87, P

Original languageEnglish (US)
JournalObstetrics and Gynecology
DOIs
StateAccepted/In press - Mar 7 2016

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ASJC Scopus subject areas

  • Obstetrics and Gynecology

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