Hysterectomy: evolution and trends

Best Pract Res Clin Obstet Gynaecol. 2005 Jun;19(3):295-305. doi: 10.1016/j.bpobgyn.2004.11.007. Epub 2004 Dec 30.

Abstract

Hysterectomy was mentioned in Greek manuscripts 2000 years ago, but there is no proof that it was performed. Early--usually fatal--attempts at vaginal hysterectomy are recorded from the 16th century. The origins of vaginal and abdominal hysterectomy are traced from the 19th century after the pioneering work of Langenbeck and Clay. Advances in anaesthesia, blood transfusion, antibiotics and surgical technique led to hysterectomy becoming the second most common operation in women. In the first part of the 20th century subtotal abdominal hysterectomy was standard, but by the 1950s this was replaced by total abdominal hysterectomy. There has been a recent, albeit minor, resurgence of interest in subtotal hysterectomy. The development of laparoscopic assisted hysterectomy in the 1990s has, ironically, led to the re-emergence of standard vaginal hysterectomy as the method of choice for most cases of benign gynaecological disease requiring hysterectomy. At the start of the 21st century there are signs that alternatives to hysterectomy-such as hysteroscopic surgery, uterine fibroid embolization, and the levonorgestrel intrauterine device-are leading to a reduction in hysterectomy rates.

Publication types

  • Biography
  • Historical Article
  • Portrait

MeSH terms

  • Cesarean Section / history
  • Female
  • History, 19th Century
  • History, 20th Century
  • Humans
  • Hysterectomy / history*
  • Hysterectomy / methods
  • Hysterectomy / trends
  • Laparoscopy / history
  • Pregnancy

Personal name as subject

  • Conrad Johan Martin Langenbeck
  • Charles Clay