[Extended indication for hysterectomy. Changes in the incidence and indications in hysterectomy within 2 decades]

At the Gynaecological Department of the Medical Hospital of the University of Hannover, the medical reports of two periods (1960 to 1963 and 1978 to 1980) were employed to investigate hysterectomies and a number of uterus-preserving procedures, the indications for which could also have served as an indication for hysterectomy. As compared with the first period, the average hysterectomy rate per age group was almost twice as high in the second period, while uterus-preserving surgery was virtually insignificant in the later period. In the second period, patients were younger and had less severe complaints. In the second period, sterilization and carcinoma prophylaxis represented major secondary indications for the operation. Overall, the result point to a considerable expansion of indications in the second period. However, owing to the fact that the operation carries a risk that cannot be neglected, sterilization of carcinoma prophylaxis alone cannot be considered a sufficient reason for hysterectomy.