Hysterectomies in one Canadian Province: a new look at risks and benefits

This paper assesses the risks and benefits associated with hysterectomy by comparing the age-adjusted health care usage patterns of all women receiving hysterectomy in the Province of Manitoba in 1974 during the two years before and the two years after surgery with those of women undergoing cholecystectomy, and with those of an age and sex matched population sample. Less than half of the women have dilation and curettage of the uterus prior to hysterectomy, despite the fact that menstrual disorders are the most frequent problem bringing women to the physician's office. Despite a low mortality rate, there is a significant risk (40 per 1,000 cases) of complications requiring hospital readmission during the two years after hysterectomy and associated repair procedures. Although women visit their physician less frequently with gynecologic problems after surgery, they visit more frequently for psychological problems, urinary tract infections, and menopausal symptoms. Both before and after surgery women visit the physicians more frequently than do the age-matched comparison groups.