Uterine myomas and factors associated with hysterectomy in premenopausal women

Article Abstract:

Certain factors may increase the likelihood of menstruating women having a hysterectomy for uterine fibroid tumors. Researchers reviewed the charts of 421 premenopausal women who had uterine fibroid tumors. Three-quarters saw their gynecologist initially because of abnormal bleeding or pain. Over an average follow-up of 2-1/2 years, another 10% developed symptoms and 40% experienced tumor growth. Twenty-two percent eventually had a hysterectomy. Women who had previous gall bladder surgery or surgery for adhesions were more likely to have hysterectomies. With increasing age, uterine size played a larger role in the decision to perform hysterectomy.

Planning, Physiological aspects, Uterine fibroids

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Prospective randomized clinical trial of laparoscopically assisted vaginal hysterectomy versus total abdominal hysterectomy

Article Abstract:

Laparoscopically assisted vaginal hysterectomy appears to be more cost-effective than abdominal hysterectomy. In a vaginal hysterectomy, the uterus is removed through the vagina. In a study of 24 women who had laparoscopically assisted vaginal hysterectomy and 24 who had an abdominal hysterectomy, those who had laparoscopically assisted vaginal hysterectomy had shorter hospital stays, used less painkillers, and returned to work faster. Although laparoscopically assisted vaginal hysterectomy took slightly longer than abdominal hysterectomy, the costs of both operations were similar.

Economic aspects

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Guidelines to determine the role of laparoscopically assisted vaginal hysterectomy

Article Abstract:

Evidence-based guidelines indicate that all surgeons should attempt a vaginal hysterectomy before doing a laparoscopic or abdominal hysterectomy. The laparoscopic approach has been promoted as less invasive and cheaper, with fewer complications. However most of the studies that compared the various techniques were too small to provide definitive evidence. Some studies found laparoscopic hysterectomy more expensive because of the use of disposable instruments and longer operating room times.

Methods

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