{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T08:52:24Z","timestamp":1782118344725,"version":"3.54.5"},"reference-count":23,"publisher":"King Faisal Specialist Hospital and Research Centre","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Saudi Med"],"published-print":{"date-parts":[[2026,5]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Hysterectomy indications and surgical route selection may vary with age due to shifting case mix.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVES:<\/jats:title>\n To describe age-stratified hysterectomy indications and routes and identify factors independently associated with route selection.<\/jats:p>\n <\/jats:sec>\n \n DESIGN:<\/jats:title>\n Retrospective chart review<\/jats:p>\n <\/jats:sec>\n \n SETTINGS:<\/jats:title>\n Single-center, tertiary-care teaching and research hospital, Department of Obstetrics and Gynecology.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n Hysterectomies performed for benign or premalignant indications between 2022 and 2024 were identified and verified. Patients were grouped according to age [<50, 50\u201359, or \u226560 years]. Indications were assigned using PALM\u2013COEIN and grouped clinically. Routes were categorized as open abdominal, laparoscopic\/VNOTES, or vaginal. Comparisons used Kruskal\u2013Wallis and chi-square tests. Multinomial and binary logistic regression adjusted for age group, parity, comorbidity, smoking, and prior pelvic\/abdominal surgery.<\/jats:p>\n <\/jats:sec>\n \n MAIN OUTCOME MEASURES:<\/jats:title>\n age-stratified hysterectomy route and age-stratified indications and predictors of minimally invasive versus open surgery.<\/jats:p>\n <\/jats:sec>\n \n SAMPLE SIZE:<\/jats:title>\n 769 hysterectomies<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n Primary indications differed significantly by age group (\n P<\/jats:italic>\n <.001; Cramer's V=0.38): treatment-resistant abnormal uterine bleeding predominated in patients <50 and 50\u201359 years, whereas pelvic organ prolapse predominated in patients \u226560 years. Surgical route also varied by age (\n P<\/jats:italic>\n <.001; Cramer's V=0.34): open abdominal hysterectomy decreased from 47.3% in patients <50 years to 15.3% in those \u226560 years, while vaginal hysterectomy increased from 4.0% to 52.6%. In multinomial regression, age \u226560 years was associated with higher odds of laparoscopic\/VNOTES versus open surgery (aOR 1.97, 95% CI 1.08\u20133.61) and vaginal versus open surgery (adjusted odds ratio, aOR 21.60, 95% confidence interval, CI 10.02\u201346.60). In binary regression, age \u226560 years (aOR 4.18, 95% CI 2.41\u20137.26) and parity (aOR 1.18 per birth, 95% CI 1.06\u20131.32) favored minimally invasive surgery.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Age-related indication shifts accompanied major route changes, with greater vaginal and minimally invasive use among older patients.<\/jats:p>\n <\/jats:sec>\n \n LIMITATIONS:<\/jats:title>\n Single-center retrospective design; residual confounding by indication and uterine size; conversions and standardized complications were not analyzed; unmeasured clinical\/surgeon factors.<\/jats:p>\n <\/jats:sec>","DOI":"10.5144\/0256-4947.2026.178","type":"journal-article","created":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T08:38:07Z","timestamp":1780821487000},"page":"178-187","source":"Crossref","is-referenced-by-count":0,"title":["Age-related patterns in hysterectomy: indications and surgical route selection in a three-year tertiary-center cohort"],"prefix":"10.5144","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8516-5493","authenticated-orcid":true,"given":"Havva Bet\u00fcl","family":"Bacak","sequence":"first","affiliation":[{"name":"From the Department of Obstetrics and Gynecology, Gaziosmanpa\u015fa Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enes Serhat","family":"Co\u0219kun","sequence":"additional","affiliation":[{"name":"From the Department of Obstetrics and Gynecology, Gaziosmanpa\u015fa Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3134","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002108"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2015.11.012"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/13697137.2018.1520824"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003677.pub6"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xagr.2024.100320"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-024-07467-5"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.31486\/toj.20.0017"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-096265"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2021.01.010"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15539"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.08.014"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.15099"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17509"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2021.02.019"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318165f18c"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2014.01.012"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.4103\/GMIT"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/jpm14030265"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14238"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1080\/08941939.2025.2515054"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1080\/13645706.2025.2605629"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1080\/08941939.2021.1958111"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1080\/08941939.2021.1927262"}],"container-title":["Annals of Saudi Medicine"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T08:39:35Z","timestamp":1782117575000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.annsaudimed.net\/doi\/10.5144\/0256-4947.2026.178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.5144\/0256-4947.2026.178"],"URL":"https:\/\/doi.org\/10.5144\/0256-4947.2026.178","relation":{},"ISSN":["0256-4947","0975-4466"],"issn-type":[{"value":"0256-4947","type":"print"},{"value":"0975-4466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}