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Evidence Basis for Hysterectomy.

Jenifer N Byrnes¹, Emanuel C Trabuco¹

¹Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.

Obstetrics and Gynecology Clinics of North America

|August 14, 2016

Summary

Vaginal hysterectomy, the preferred uterine removal method, is declining despite evidence supporting it. This review examines comparative data and controversies in hysterectomy trends.

Keywords:

Costs Cuff dehiscence Hysterectomy Laparoscopic Robotic Vaginal

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Area of Science:

Gynecology
Surgical Procedures
Uterine Surgery

Background:

Vaginal hysterectomy is recommended by the American College of Obstetricians and Gynecologists.
Nationwide utilization of vaginal hysterectomy has shown a steady decline.

Purpose of the Study:

To review evidence comparing vaginal hysterectomy with alternative hysterectomy methods.
To highlight controversies surrounding vaginal hysterectomy, including contraindications, prolapse risk, and resident training.

Main Methods:

Literature review of comparative studies on hysterectomy techniques.
Analysis of current trends and their implications.

Main Results:

Evidence comparing vaginal hysterectomy to other methods is reviewed.
Areas of controversy such as surgical contraindications, risk of subsequent prolapse, and impact on surgical education are discussed.

Conclusions:

Despite recommendations, vaginal hysterectomy rates are decreasing.
Ongoing debates regarding surgical approach, patient outcomes, and medical education persist.