Observational studyBJOG : an international journal of obstetrics and gynaecology2021
The Large Uterus Classification System: a prospective observational study.
Observational study in BJOG : an international journal of obstetrics and gynaecology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Advanced bipolar vessel sealing devices vs conventional bipolar energy in minimally invasive hysterectomy: a systematic review and meta-analysis.Archives of gynecology and obstetrics · 2024Pooled it
- Complex vaginal natural orifice transluminal endoscopic surgery hysterectomy for symptomatic giant polymyomatous uteri in nulliparous women.Archives of gynecology and obstetrics · 2026Article
- Article
- Robotic versus open hysterectomy for very large uterus (more than 1000 g): A bicentric retrospective study of 150 patients.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Innovative classification system for enlarged uterus in laparoscopic and robotic hysterectomy with complications and pain scores.Journal of robotic surgery · 2025Article
- A systematic approach to laparoscopic hysterectomy for enlarged uteri: The Ship Theory.Frontiers in surgery · 2025Article
- Charting Proficiency: The Learning Curve in Robotic Hysterectomy for Large Uteri Exceeding 1000 g.Journal of clinical medicine · 2024Article
- Defining a Uterine Extraction Score based on a Volume/Access Ratio in Total Hysterectomy: a retrospective cohort study.Facts, views & vision in ObGyn · 2024Article
- A Vagino-Laparoscopic Strategy for Hysterectomy of Large Uteri to Ease Surgical Challenges.International journal of women's health · 2023Article
- The Large Uterus Classification System: a prospective observational study.BJOG : an international journal of obstetrics and gynaecology · 2021Observational
- Hysterectomy for Large Uterus by Minimally Invasive Surgery (MIS).JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the Large Uterus Classification System (LUCS) ability to predict surgical outcomes and complications in total laparoscopic hysterectomies (TLHs) for large uteri.
designProspective observational study.
settingTwo referral centres. POPULATION OR SAMPLE: Three hundred and ninety-two women who underwent TLH for a large uterus (uterine fundus at or over the transverse umbilical line).
methodsBetween 2004 and 2019, the intraoperative LUCS was estimated in all patients. The LUCS considers the uterine and adnexal vascular pedicles displacement. Type 1 is without vascular pedicles displacement. Type 2 has the cephalad displacement of adnexal vascular pedicles. The uterine vessels displacement regardless of adnexal pedicles defines Type 3.
main outcome measuresPatients' characteristics with perioperative outcomes were prospectively collected and compared between the three types of large uteri.
resultsTwo hundred and fifty-one (64%), 82 (20.9%) and 59 (15.1%) women had Type 1, Type 2 and Type 3 uteri, respectively. Women with Type 1 uteri had a lower uterine weight, shorter operative time, less blood loss and lower complication rates than women with Types 2 and 3. The conversion rate to laparotomy in Type 1 was similar to that in Type 2 (odds ratio [OR] 0.98; 95% CI 0.32-3.56) but lower than Type 3 (OR 0.35; 95% CI 0.14-0.97); in Type 2 it was lower than Type 3, although without the conventional statistical significance (OR 0.36; 95% CI 0.13-1.13; P = 0.07). Multivariable analysis showed that the uterine Type (1 versus 2-3) was independently associated with the total complications rate (OR 2.00; 95% CI 1.09-3.68; P = 0.02).
conclusionsThe LUCS appears associated with surgical outcomes and complications, potentially stratifying the surgical risk and guiding the surgical technique in TLHs for large uteri. TWEETABLE ABSTRACT: The Large Uterus Classification System may predict outcomes in total laparoscopic hysterectomy of large uteri.
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