Attitudes toward mode of hysterectomy: a survey-based study among German gynecologists

To determine the attitudes of Germany's gynecologists to mode of hysterectomy (HE) for benign indications.

In this cross-sectional study a postal questionnaire was sent to all members of the North-Eastern German Society of Gynecological Oncology (NOGGO) and the German Society of Psychosomatic Obstetrics and Gynecology (DGPFG). Questions examined attitudes to mode of HE based on three clinical scenarios with different conditions of the uterus. Gynecologists were also asked to estimate how the distribution of the different modes of HE for benign conditions should be. Analyses were performed with multiple logistic regression, chi-square tests and univariate nonparametric ANOVA. The main outcome measure was the analysis of current attitudes toward three well-defined settings regarding HE amongst German gynecologists.

The response rate was 27%, giving a sample size of 354, and 36% (n=128) of the gynecologists performed HE as part of their daily work. In this subgroup the following results were statistically significant. (1) Female gynecologists chose total vaginal hysterectomy (TVH) more often than male gynecologists. (2) With increasing professional experience of the female gynecologists the choice of TVH grew. (3) Gynecologists in private practice preferred laparoscopic-assisted vaginal hysterectomy (LAVH) compared to gynecologists in hospital. Personal choice of mode of HE varied significantly depending on the gender and place of work.

The preferred mode of HE varied significantly depending on gynecologist's gender, type of clinical setting and professional experience.