Our Summary

This study looked at whether the time a surgery starts can impact the outcomes for women getting a hysterectomy for non-cancer-related reasons. The researchers looked at data from almost 3,000 women, some of whom had their surgery before noon and some after. They found that surgeries that started in the afternoon resulted in more blood loss and longer hospital stays, and were less likely to lead to patients being discharged on the same day. However, they didn’t find any differences in terms of complications during or after the surgery. Interestingly, the afternoon surgeries were also less expensive. These findings could help hospitals plan surgeries in a way that improves patient outcomes and reduces costs.

FAQs

  1. Does the time of day a hysterectomy surgery starts have an impact on its outcome?
  2. Are there any differences in complications during or after a hysterectomy based on the time of day it is performed?
  3. How could the findings on the timing of hysterectomies potentially help hospitals improve patient outcomes and reduce costs?

Doctor’s Tip

A doctor might tell a patient undergoing a hysterectomy to schedule their surgery in the morning if possible, as studies have shown that surgeries starting in the afternoon can result in more blood loss, longer hospital stays, and lower likelihood of same-day discharge. This can help improve patient outcomes and potentially reduce costs.

Suitable For

Patients who are recommended for hysterectomy typically include those with conditions such as:

  • Fibroids: noncancerous growths in the uterus that can cause pain, heavy menstrual bleeding, and other symptoms.
  • Endometriosis: a condition where tissue similar to the lining of the uterus grows outside of the uterus, leading to pain and other symptoms.
  • Uterine prolapse: when the uterus slips down into the vaginal canal due to weakened pelvic floor muscles.
  • Adenomyosis: a condition where the tissue that lines the uterus grows into the muscular wall of the uterus, causing heavy periods and pain.
  • Chronic pelvic pain: ongoing pain in the pelvic region that does not have a clear cause.
  • Abnormal uterine bleeding: heavy, prolonged, or irregular menstrual bleeding that does not respond to other treatments.
  • Gynecologic cancers: in some cases, a hysterectomy may be recommended as part of the treatment for uterine, ovarian, or cervical cancer.

Timeline

Before hysterectomy:

  1. Consultation with a doctor to discuss the reasons for the surgery and potential risks and benefits.
  2. Pre-operative testing, such as blood work and imaging, to ensure the patient is healthy enough for surgery.
  3. Pre-surgical preparations, such as fasting and discontinuing certain medications.
  4. Admission to the hospital or surgical center on the day of surgery.

After hysterectomy:

  1. Recovery in the hospital or surgical center, typically for one to two days.
  2. Pain management and monitoring for complications, such as bleeding or infection.
  3. Discharge from the hospital with instructions for at-home care, including rest and avoiding heavy lifting or strenuous activity.
  4. Follow-up appointments with the surgeon to monitor healing and address any concerns.
  5. Gradual return to normal activities, with limitations on certain activities for a few weeks to months.

What to Ask Your Doctor

  1. What are the reasons for recommending a hysterectomy in my case?
  2. Are there any alternative treatments or procedures that I could consider before opting for a hysterectomy?
  3. What are the potential risks and complications associated with a hysterectomy?
  4. How will a hysterectomy affect my hormonal balance and menopausal symptoms?
  5. What is the expected recovery time and post-operative care for a hysterectomy?
  6. Will a hysterectomy impact my fertility or sexual function?
  7. Are there any long-term effects or considerations I should be aware of after having a hysterectomy?
  8. How many hysterectomies have you performed, and what is your experience with this procedure?
  9. Are there any specific pre-operative tests or preparations that I should be aware of?
  10. What are the different types of hysterectomy procedures available, and which one would be most suitable for my condition?

Reference

Authors: Brah T, AlAshqar A, Borahay MA. Journal: J Minim Invasive Gynecol. 2023 May;30(5):389-396. doi: 10.1016/j.jmig.2023.01.008. Epub 2023 Jan 26. PMID: 36708764