Hysterectomy in Veterans Affairs Medical Centers

Objective: To examine the indications and surgical morbidity for women vete rans who underwent hysterectomies in Department of Veterans Affairs Medical Centers (VAs). Methods: Data on hysterectomies performed in VAs from 1991 to 1997 were abs tracted from a surgical quality improvement program. Results: Records of 1722 women who had hysterectomies in VAs over 6 years w ere examined. Women were predominately white (62%) and their average age wa s 42.5 years. Operations included abdominal (74%), vaginal (22%), and lapar oscopic-assisted (4%) methods. The most common indications for surgery incl uded uterine leiomyomas (31%), abnormal uterine bleeding (14%), and endomet riosis (11%). Indications differed by race (P < .01); nonwhite women were m ost likely to have surgery for leiomyoma (51%), whereas white women had hys terectomies for leiomyomas (19%), abnormal bleeding (15%), endometriosis (1 3%), and genital prolapse (11%). The mean postoperative stay was significan tly longer for abdominal hysterectomies (4.51 days) than either vaginal or laparoscopic-assisted hysterectomies (2.92 and 2.21 days, respectively; P < .001). The overall complication rate within 30 days was 9%, and the most f requent complication was urinary tract infection (3.3%). Conclusion: Women who underwent hysterectomies in VAs had low complication rates, comparable to hysterectomy complication rates in the United States g enerally. (Obstet Gynecol 2001;97:880-4. (C) 2001 by The American College o f Obstetricians and Gynecologists.).