Defining a Uterine Extraction Score based on a Volume/Access Ratio in Total Hysterectomy: a retrospective cohort...

Area of Science:

• Gynecology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Uterine extraction is a critical step in hysterectomy, regardless of surgical approach.
• Currently, no standardized scoring system exists to predict the feasibility of uterine extraction.

Purpose of the Study:

• To develop and validate a predictive score for uterine extraction feasibility in total hysterectomy.
• To optimize surgical planning and improve perioperative outcomes.
• To analyze the correlation between preoperative ultrasound-estimated uterine volume and actual specimen weight.
• To assess the impact of uterine extraction methods on operative and hospitalization durations.

Main Methods:

• A Uterine Extraction Score (UES) was developed based on uterine size and vaginal access.
• The UES was retrospectively applied to 178 patients undergoing hysterectomy for benign conditions (January 2019 - December 2022).
• The score categorizes extraction feasibility into three groups (green, orange, red) corresponding to different surgical approaches.

Main Results:

• The UES accurately predicted the observed extraction route in 92% of cases.
• A strong correlation was found between estimated uterine volume and final specimen weight.
• Uterine morcellation was associated with increased operative time and longer hospital stays.

Conclusions:

• The Uterine Extraction Score (UES) is a reliable tool for predicting uterine extraction routes in total hysterectomy.
• The UES empowers surgeons with critical information for enhanced perioperative planning and outcomes.