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Influence of a decisional tree on the route of hysterectomy for benign disease in Italy: personal experience.

BACKGROUND
Mainly to report our experience in the route of hysterectomy after introducing specific guidelines according to the Society of Pelvic Reconstructive Surgeons and to record all hysterectomy-related complications after abdominal and vaginal hysterectomies.


METHODS
The records of 22 patients who underwent abdominal hysterectomy and 59 who underwent vaginal hysterectomy for benign disease were reviewed. Complications related to hysterectomy were recorded during surgery, postoperative hospital stay and a period of six weeks. Statistical methods used were t-tests and chi square analysis.


RESULTS
Operation time was shorter with the vaginal route. Patients operated on via the vaginal route had less blood loss and shorter hospital stay.


CONCLUSIONS
The main standard to select the route for hysterectomy is the severity of the clinical status. Decreasing the ratio between the abdominal and vaginal route is possible, but it is crucial to make the indications clear, based on scientific evidence.