Womens Clinic of Seattle

Vaginal Approach to Surgery

 It is well documented that if hysterectomy can be accomplished by a vaginal approach there are many benefits to the patient including:
  • the patient's recovery is greatly shortened (by as much as 2-3 weeks),
  • the patient's hospital stay is shorter by about 24-48 hours,
  • the postoperative discomfort is considerably less for the patient and
  • the cost of vaginal surgery is generally significantly less than abdominal surgery.

However, primarily due to lack of familiarity with the techniques of vaginal surgery many physicians still perform most of their hysterectomy surgery using the less comfortable abdominal approach. In fact, several studies have documented that the rate of vaginal hysterectomy in the United States is only 25-40% (1-4).

Given similar types of patients, one measure of the skill of a given surgeon is the proportion of hysterectomies which are performed by the vaginal route vs. the abdominal route. For most patients choosing a surgeon capable of vaginal hysterectomy and committed to offering it to as many of patients as is clinically possible is desireable.

Dr. Waszak's 1997 hysterectomy case list was reviewed. It demonstrates that 80% of the hysterectomies performed by him were accomplished by the vaginal approach.

We hope this gives you some background information when discussing surgery with your physician or in choosing between surgeons. Ask for their vaginal hysterectomy rate. Generally, the higher the percentage the more favorable will be your chances of being offered this improved method of hysterectomy if your clinical circumstances warrant it.

References:
  1. Wilcox, L.S., Koonin, L.M., Pokras, R., et al, Hysterectomy in the United States, Obstet Gynecol 83:549-555, 1994.
  2. California Office of Statewide Health Planning and Development Database, 1992.
  3. New York Hospital Discharge Database, 1993.
  4. Dicker, R.C., Greenspan, J.R., Strause, L.T., et al, Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States, Obstet Gynecol 144:841-848, 1982.

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