Evidence Basis for Hysterectomy

Obstet Gynecol Clin North Am. 2016 Sep;43(3):495-515. doi: 10.1016/j.ogc.2016.04.009.

Abstract

Although vaginal hysterectomy has long been championed by the American College of Obstetricians and Gynecologists as the preferred mode of uterine removal, nationwide vaginal hysterectomy utilization has steadily declined. This article reviews the evidence comparing vaginal with other modes of hysterectomy and highlights areas of ongoing controversy regarding contraindications to vaginal surgery, risk of subsequent prolapse development, and impacts of changing hysterectomy trends on resident education.

Keywords: Costs; Cuff dehiscence; Hysterectomy; Laparoscopic; Robotic; Vaginal.

Publication types

  • Review

MeSH terms

  • Evidence-Based Medicine
  • Female
  • Humans
  • Hysterectomy* / adverse effects
  • Hysterectomy* / methods
  • Laparoscopy*
  • Leiomyoma / surgery*
  • Practice Guidelines as Topic
  • Risk Factors
  • Robotic Surgical Procedures* / adverse effects
  • Robotic Surgical Procedures* / methods
  • Surgical Wound Dehiscence* / etiology
  • Surgical Wound Dehiscence* / prevention & control
  • United States
  • Uterine Hemorrhage / surgery*
  • Uterine Neoplasms / surgery*
  • Vagina / surgery
  • Vaginal Diseases* / etiology
  • Vaginal Diseases* / prevention & control