[Indications for hysterectomy]

Large deviations, regional differences and the decline in hysterectomy frequencies suggest that the indication for hysterectomy has not always been based on well defined medical standards. Paramedical factors also have an influence on the indication. The patient has to decide in many cases whether she would like to tolerate the clinical symptoms, which could have been improved or healed by hysterectomy, or not. New endoscopic techniques as alternative to or support of the classical hysterectomy procedure have not yet been sufficiently proved. Influences on the costs of operations, the rate of complications and above all the setting of indications need further careful observation and analyses. It is difficult to establish quality assessment procedures in hysterectomy, because controlling the indication by histopathological examination of the exstirpated uterus cannot regard the variety of indications.