Surgical approaches and indications associated with hysterectomies:analysis of 10 155 cases

Objective To examine the approaches of hysterectomies and their indications. Methods Hospital discharge record data on hysterectomies performed in Peking Union Medical College (PUMC) Hospital from 1996 to 2006 were retrieved. Cases were classified into three groups: abdominal, laparoscopic and vaginal hysterectomy. Operative indications for hysterectomy were analyzed retrospectively and compared with data in literatures. Results Records of 10155 women who underwent hysterectomies due to benign or certain malignant gynecological conditions were analyzed. Operations included abdominal (70.9%), laparoscopic (20.6%) and vaginal (8.5%) hysterectomy. The proportion of laparoscopic hysterectomy increased from 2.4% in 1996 to 25.4% in 2006. The common indications for hysterectomy were uterine leiomyoma (53.3%~56.2%), endometriosis including adenomyosis (17.5%~19.1%), benign ovarian tumor (7.8%~9.2%), and genital prolapse (7.6%~7.7%). Compared with 1996~2001, more patients with cervical lesion and endometrial lesion received standard total hysterectomy and more treated via laparoscope. Conclusion Laparoscopic hysterectomy has been increasingly used in PUMC hospital, with similar operative indications to abdominal hysterectomy. Increasing number of patients with cervical and endometrial lesions receive standard total hysterectomy and are treated more via laparoscope.