{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:26:42Z","timestamp":1777483602561,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T00:00:00Z","timestamp":1695168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate whether a previous cesarean section increases the risk of perioperative and postoperative complications during vaginal hysterectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study of women who had undergone a vaginal hysterectomy for benign indications between 2014 and 2019 was conducted, comparing patients with or without a previous cesarean section. Perioperative and postoperative complications during vaginal hysterectomy were assessed according to the Clavien\u2010Dindo classification system within 30\u2009days of surgery. Duration of surgery, estimated blood loss, and postoperative hospitalization days were also recorded. A two\u2010sided <jats:italic>P<\/jats:italic> value of less than 0.05 was considered significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 185 women were included, 25 (13.5%) patients had undergone a previous cesarean section (study group) and 160 (86.5%) had no history of cesarean section (comparison group). We found no significant differences in demographic and clinical characteristics as well as postoperative complications and interventions, duration of surgery, estimated blood loss, and postoperative hospitalization days (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). However, patients who underwent two or more cesarean sections had a significantly (<jats:italic>P<\/jats:italic>\u2009=\u20090.01) higher rate and grade of complications during vaginal hysterectomy, compared with women with only one previous cesarean section. All women who underwent two or more cesarean sections had mild complications during vaginal hysterectomy (40% grade I and 60% grade II, <jats:italic>P<\/jats:italic>\u2009=\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Vaginal hysterectomy is a safe procedure with few severe complications, regardless of a previous cesarean section. More than one previous cesarean section may increase the risk of minor complications during a vaginal hysterectomy. Patients who underwent a previous cesarean section could be reassured that they do not face an increased risk of complications during a vaginal hysterectomy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15105","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T07:23:59Z","timestamp":1695194639000},"page":"557-562","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The impact of a previous cesarean section on the risk of perioperative and postoperative complications during vaginal hysterectomy"],"prefix":"10.1002","volume":"164","author":[{"given":"Moran","family":"Weiss","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Soroka University Medical Center, Faculty of Health Sciences, Ben\u2010Gurion University of the Negev  Beer\u2010Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8133-0356","authenticated-orcid":false,"given":"Yael","family":"Baumfeld","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Soroka University Medical Center, Faculty of Health Sciences, Ben\u2010Gurion University of the Negev  Beer\u2010Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reut","family":"Rotem","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Shaare Zedek Medical Center  Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuval","family":"Gedalia","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Soroka University Medical Center, Faculty of Health Sciences, Ben\u2010Gurion University of the Negev  Beer\u2010Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Erenberg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Soroka University Medical Center, Faculty of Health Sciences, Ben\u2010Gurion University of the Negev  Beer\u2010Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adi Y.","family":"Weintraub","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Soroka University Medical Center, Faculty of Health Sciences, Ben\u2010Gurion University of the Negev  Beer\u2010Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31927-5"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0148343"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2017.08.008"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39363.706956.55"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2019.08.001"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.05.044"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.12.037"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1285829"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2014.00096"},{"issue":"6","key":"e_1_2_9_11_1","first-page":"e155","article-title":"Choosing the route of hysterectomy for benign disease committee on gynecologic practice","volume":"129","author":"American College of Obstetricians and Gynecologists","year":"2017","journal-title":"Replace Comm Opin Number"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2017.07.015"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2014.11.005"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.2825"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.07.021"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/SPV.0b013e3181c29c8a"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.07.090"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2020.02.019"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.4695"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.12.017"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.04.039"}],"container-title":["International Journal of Gynecology &amp; 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