title: Considerations to improve the evidence-based use of vaginal hysterectomy in benign gynecology.
abstract: Vaginal hysterectomy fulfills the evidence-based requirements as the preferred route of hysterectomy for benign gynecologic disease. Despite proven safety and effectiveness, the vaginal approach for hysterectomy has been and remains underused in surgical practice. Factors associated with underuse of vaginal hysterectomy include challenges during residency training, decreasing case numbers among practicing gynecologists, and lack of awareness of evidence supporting vaginal hysterectomy. Strategies to improve resident training and promote collaboration and referral among practicing physicians and increasing awareness of evidence supporting vaginal hysterectomy can improve the primary use of this hysterectomy approach.
authors.affiliation: Advocate Lutheran General Hospital, Park Ridge, Illinois; Kaiser Permanente-North Valley, Roseville, California; Tufts University School of Medicine, Boston, Massachusetts; the Mayo Clinic, Scottsdale, Arizona; the University of Oklahoma College of Medicine, Oklahoma City, Oklahoma; the University of Queensland Ochsner Clinical School, New Orleans, Louisiana; Vanderbilt University School of Medicine, Nashville, Tennessee; and the Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Michael
authors.initials: M
authors.lastname: Moen
authors.forename: Andrew
authors.initials: A
authors.lastname: Walter
authors.forename: Oz
authors.initials: O
authors.lastname: Harmanli
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Cornella
authors.forename: Mikio
authors.initials: M
authors.lastname: Nihira
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gala
authors.forename: Carl
authors.initials: C
authors.lastname: Zimmerman
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
mesh_terms: D002983:Clinical Competence; D055317:Evidence-Based Practice / Q000191:economics / Q000379:methods / Q000592:standards; D005260:Female; D006300:Health Services Misuse / Q000517:prevention & control; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000191:economics / Q000193:education / Q000379:methods / Q000592:standards; D007396:Internship and Residency / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures; D010358:Patient Participation; D010818:Practice Patterns, Physicians'; D011364:Professional Practice / Q000592:standards*; D058996:Quality Improvement; D013663:Teaching / Q000592:standards; D014591:Uterine Diseases / Q000601:surgery*