title: Hysterectomy and perioperative morbidity in women who have undergone renal transplantation.
abstract: OBJECTIVE
  The purpose of this study was to compare complications from vaginal hysterectomy with abdominal hysterectomy in renal transplant recipients.
  
  
  METHODS
  Women who underwent renal transplantation then hysterectomy from 1966-2008 at Mayo Clinic, Rochester, MN, were identified. Data were collected about preoperative, intraoperative, and postoperative events. Main outcome measure was loss of allograft function; secondary outcomes included types of complications and treatment methods.
  
  
  RESULTS
  Of 58 women with renal transplants, 42 women (72.4%) underwent abdominal hysterectomy. The most common indication for hysterectomy was menorrhagia (n = 20; 34.5%). Overall, 24 women (41.4%) had complications, the most common of which were infection (n = 15) and transfusion (n = 8). Women who underwent abdominal hysterectomy were no more likely to have perioperative complications than were women who underwent vaginal hysterectomy (odds ratio, 1.25; 95% confidence interval, 0.38-4.08).
  
  
  CONCLUSIONS
  Although patients with renal transplants had perioperative complications, none of these complications led to renal graft loss. Hysterectomy can be considered in these patients when accompanied by diligent postoperative care.
authors.affiliation: Division of Gynecologic Surgery, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Heisler
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Casiano
authors.forename: John B
authors.initials: JB
authors.lastname: Gebhart
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007045:Hysterectomy, Vaginal / Q000009:adverse effects*; D016030:Kidney Transplantation; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D014591:Uterine Diseases / Q000601:surgery