Total Hysterectomy at Time of Cesarean Section and in the Early Puerperium

A review of studies on tubal ligation and on uterine cancer is prese nted and clinical experience in performing total hysterectomy at the time of cesarean section and in early puerperium is reported. A total of 74 total hysterectomies were done since 1951 at the University Hospital at the University of Maryland School of Medicine and the Sinai Hospital Baltimore Maryland. The operation was carried out for the purpose of sterilization or as indicated for disease. There was no mortality in the series. The gross morbidity rate was 22.9%. The average hospital stay postoperative for all patients was 8.28 days and for patients with complications 11.45 days. Evidence indicates that the uterus is not prophylactic removal of both ovaries in women after the age of 40 should be done at the same time. A follow-up of 40 patients (54%) revealed good results psychologically anatomically and functionally. While tubal ligation or tubectomy does not guarantee sterilization nor is it free of mortality and morbidity total hysterectomy at the time of cesarean section and in the puerperium assures sterility and is a prevention against developing disease and/or malignancy in the removed genital organs.