Early Emergency Visits After Laparoscopic Hysterectomy: Risk Factors and Prevention.

Abstract

Objective: This study evaluates emergency department (ED) visits within the first 30 days following hysterectomy for benign gynecologic conditions, identifying risk factors and strategies for prevention.

Methods: A retrospective cohort analysis was conducted on 2,119 patients who underwent hysterectomy at a high-volume tertiary center between January 2023 and December 2024. Demographic, perioperative, and postoperative variables were analyzed, and predictors of ED visits were assessed using multivariable logistic regression.

Results: ED visits occurred in 8.6% of patients, with older age, higher intraoperative blood loss, longer operative time, and prior abdominal surgery being significant predictors (P < .05). Vaginal cuff hematoma (29.7%) was the most common cause of hospitalization, whereas abdominal pain (39.3%) and nausea/vomiting (40.7%) were the most frequent nonhospitalized complaints. Minimally invasive techniques were associated with lower ED visit rates compared to total abdominal hysterectomy.

Conclusion: Identifying high-risk patients and implementing structured postoperative monitoring may reduce unnecessary ED visits. Optimizing surgical techniques, perioperative management, and patient education is crucial for enhancing outcomes and reducing healthcare burden. Multicenter prospective studies are needed to validate these findings and refine perioperative strategies.