[Caesarean hysterectomy or tubal coagulation following caesarean section--a comparison]

From 1973 to 1982 a total of 99 Caesarean hysterectomies and 105 Caesarean sections with subsequent tubal coagulation were performed. This represents 6.5% and 6.9%, respectively, of all Caesarean sections. After excluding the emergency cases, 86 planned Caesarean hysterectomies and 99 Caesarean sections combined with tubal coagulation remained. Statistical evaluation showed that the postoperative course was more favourable and less febrile with Caesarean hysterectomy than with tubal coagulation after Caesarean section. The somewhat greater loss of blood after hysterectomy is practically without any sequel. Hysterectomy saves the patient from subsequent uterine diseases, ascending infections, menstrual anaemias, problems of hygiene, etc. Caesarean hysterectomy appears to be the method of choice if surgical sterilisation is deemed appropriate besides performing the Caesarean section; if the patient has been informed of the operation in detail; if the patient feels no emotional ties towards the uterus; if there has been ample opportunity to think things over calmly; and if the surgeon is really skilled in performing hysterectomy.