hysterectomy

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Epidemiology

  • most common gynecologic surgery in U.S.[10]
  • 23% of black women, 21% of white women[13]
  • many surgeries unnecessary or not indicated
    • alternative treatments underutilized[10]

Indications

Procedure

Complications

Management

Notes

  • sexual pleasure may improve after hysterectomy[2]
  • supracervical hysterectomy no better than total hysterectomy for sexual function[4]
  • robotic hysterectomy is best used for unusual & complex clinical conditions[8]
  • ovarian reserve declines faster after hysterectomy than in women with intact reproductive tracts[12]

More general terms

More specific terms

Additional terms

References

  1. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  2. 2.0 2.1 Journal Watch 23(23):184, 2003 Roovers-J-PWR et al, BMJ 327:774, 2003 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/14525872 <Internet> http://bmj.com/cgi/content/full/327/7418/774
  3. 3.0 3.1 Internal Medicine News, June 2005, pg 22 cites evidence from the Women's Health Initiative study
  4. 4.0 4.1 Journal Watch 25(16):131, 2005 Kuppermann M, Summitt RL Jr, Varner RE, McNeeley SG, Goodman-Gruen D, Learman LA, Ireland CC, Vittinghoff E, Lin F, Richter HE, Showstack J, Hulley SB, Washington AE; Total or Supracervical Hysterectomy Research Group. Sexual functioning after total compared with supracervical hysterectomy: a randomized trial. Obstet Gynecol. 2005 Jun;105(6):1309-18. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15932822
  5. 5.0 5.1 Parker WH, Broder MS, Liu Z, Shoupe D, Farquhar C, Berek JS. Ovarian conservation at the time of hysterectomy for benign disease. Obstet Gynecol. 2005 Aug;106(2):219-26. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16055568
  6. 6.0 6.1 Parker WH et al. Ovarian conservation at the time of hysterectomy and long-term health outcomes in the Nurses' Health Study. Obstet Gynecol 2009 May; 113:1027. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19384117
  7. 7.0 7.1 Jacoby VL et al. Oophorectomy vs ovarian conservation with hysterectomy: Cardiovascular disease, hip fracture, and cancer in the Women's Health Initiative Observational Study. Arch Intern Med 2011 Apr 25; 171:760. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21518944
    Arnold LD and Colditz GA. Hysterectomy with oophorectomy: Implications for clinical decision making. Arch Intern Med 2011 Apr 25; 171:768. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21518945
  8. 8.0 8.1 ACOG President James T. Breeden, MD Statement on Robotic Surgery March 14, 2013 http://www.acog.org/About_ACOG/News_Room/News_Releases/2013/Statement_on_Robotic_Surgery
  9. 9.0 9.1 Physician's First Watch, May 15, 2013 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society
    Matthews KA, Gibson CJ, El Khoudary SR, Thurston RC. Changes in Cardiovascular Risk Factors by Hysterectomy Status with and without Oophorectomy: Study of Women's Health across the Nation. J Am Coll Cardiol. 2013 May 15 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23684687
  10. 10.0 10.1 10.2 Corona LE et al. Use of other treatments before hysterectomy for benign conditions in a statewide hospital collaborative. Am J Obstet Gynecol 2015 Mar; 212:304.e1 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25542564 <Internet> http://www.ajog.org/article/S0002-9378%2814%2902355-2/abstract
  11. 11.0 11.1 Chi AM, Curran DS, Morgan DM, Fenner DE, Swenson CW. Universal cystoscopy after benign hysterectomy: Examining the effects of an institutional policy. Obstet Gynecol 2016 Feb; 127:369 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26942367 <Internet> http://journals.lww.com/greenjournal/Abstract/2016/02000/Universal_Cystoscopy_After_Benign_Hysterectomy_.27.aspx
  12. 12.0 12.1 Trabuco EC et al. Association of ovary-sparing hysterectomy with ovarian reserve. Obstet Gynecol 2016 Apr 4; PMID: https://www.ncbi.nlm.nih.gov/pubmed/27054925
  13. 13.0 13.1 Beavis AL, Gravitt PE, Rositch AF et al Hysterectomy-corrected cervical cancer mortality rates reveal a larger racial disparity in the United States. Cancer. Jan 23, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28112816 <Internet> http://onlinelibrary.wiley.com/doi/10.1002/cncr.30507/abstract
    Dalton HJ, Farley JH Racial disparities in cervical cancer: Worse than we thought. Cancer. Jan 23, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28112811 <Internet> http://onlinelibrary.wiley.com/doi/10.1002/cncr.30501/abstract