Patient Selection for Laparoscopically Assisted Vaginal Hysterectomy vs Vaginal Hysterectomy in a Private Hospital Setting.

The purpose of this study is to analyze the patient selection patterns of physicians in private practice performing laparoscopically assisted vaginal hysterectomy (LAVH). Forty-nine laparoscopic hysterectomies were compared to 30 vaginal hysterectomies (VH) performed during the same time period. There was no statistical difference with respect to patient age, gravity, and parity. There were no major complications in either group and no difference in minor complications. Significantly larger percentages of LAVH patients were operated on for fibroids, endometriosis, and pelvic pain. Fifty-one percent of LAVH patients but only 23% of VH patients underwent bilateral salpingo-oophorectomy. Blood loss was greater in the LAVH group. The mean operating time was 95±36 minutes for VH vs. 164±48 minutes for LAVH. The mean uterine weights were not statistically different, 149±66 g for VH and 161±92 g for LAVH. We conclude that patients undergoing LAVH in a private hospital setting are a different population than those undergoing VH and that those differences are reflected both in the indications for surgery and in the performance of oophorectomy.