title: Risk factors for trachelectomy following supracervical hysterectomy.
abstract: BACKGROUND
  We identified risk factors for trachelectomy after supracervical hysterectomy (SCH) due to persistence of symptoms.
  
  
  METHODS
  A retrospective case-control study in a university-affiliated hospital. Seventeen women who underwent a trachelectomy following SCH for nonmalignant indications between June 2002 and October 2014 were compared with 68 randomly selected women (controls) who underwent a SCH within the same time period. Demographics and clinical characteristics were compared between the study and control groups. Univariate analysis identified potential risk factors for trachelectomy following SCH. Univariate logistic regression models predicted which patients would have a trachelectomy following SCH.
  
  
  RESULTS
  The occurrence of trachelectomy following SCH during the study period was 0.9% (17/1892). The study group was younger than the control group (mean age 38 ± 6 years vs. 44 ± 5 years; p < 0.001). Patients who had a history of endometriosis [odds ratio (OR) 6.23, 95% CI 1.11-40.5, p = 0.038] had increased risk for trachelectomy. Pathology diagnosed endometriosis only among women in the study group. Preoperative diagnosis of abnormal uterine bleeding (OR 0.22, 95% CI 0.06-0.075, p = 0.016), anemia (OR 0.12, 95% CI 0.01-0.53; p = 0.003), and fibroid uterus (OR 0.24, 95% CI 0.07-0.82, p = 0.024) reduced the risk for future trachelectomy.
  
  
  CONCLUSIONS
  Young age and endometriosis are significant risk factors for trachelectomy following SCH.
authors.affiliation: Division of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Henry Ford Health System, Detroit, MI, USA.
authors.forename: Ziv
authors.initials: Z
authors.lastname: Tsafrir
authors.affiliation: Division of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Henry Ford Health System, Detroit, MI, USA.
authors.forename: Joelle
authors.initials: J
authors.lastname: Aoun
authors.affiliation: Department of Obstetrics and Gynecology, Beaumont Health System, Royal Oak, MI, USA.
authors.forename: Eleni
authors.initials: E
authors.lastname: Papalekas
authors.affiliation: Division of Biostatistics, Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Taylor
authors.affiliation: Division of Advanced Laparoscopy and Pelvic Pain, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Schiff
authors.affiliation: Division of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Henry Ford Health System, Detroit, MI, USA.
authors.forename: Evan
authors.initials: E
authors.lastname: Theoharis
authors.affiliation: Division of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Henry Ford Health System, Detroit, MI, USA.
authors.forename: David
authors.initials: D
authors.lastname: Eisenstein
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000293:injuries* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D008824:Michigan / Q000453:epidemiology; D017699:Pelvic Pain / Q000453:epidemiology* / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D000069339:Trachelectomy / Q000706:statistics & numerical data; D014932:Women's Health Services
keywords: Benign gynecologic disease; risk factors; supracervical hysterectomy; trachelectomy