[Are there still indications for an abdominal hysterectomy? 340 cases]

This retrospective study of 340 hysterectomies carried out abdominally concern cases only where the pathology was benign and strictly limited to the body of the uterus. This has made it possible to review the 240 cases carried out for fibroids (70.6%), 63 for simple endometrial hyperplasia (18.5%), 28 for adenomyosis (8.2%) and 9 for atrophy of the endometrium (2.6%). We looked for lesions that could have been treated laparoscopically among these pathologies: submucous fibroids with a diameter of less than 4 cms and where the uterus was less than 10 cms in height and weighted less than 200 g, simple endometrial hyperplasia (the height of the uterus less than 10 cms and the weight less than 200 g, adenomyosis (uterus less than 10 cms in height and less than 200 g weight), this last criteria still "debatable", We found that 110 lesions were selected because they could have been treated conservatively. This means that 32.5% where there seemed to have been indications for hysterectomy out of 340 cases, could have been treated otherwise. These can be divided aetiologically in to: 54 cases of simple hyperplasia of the endometrium (15.9%), 34 cases with submucous fibroids (10.6%), 26 cases of adenomyosis (5.9%). If the cases of adenomyosis are excluded 90 out of 340 hysterectomies carried out abdominally (about a quarter) could have been treated conservatively.(ABSTRACT TRUNCATED AT 250 WORDS)