Factors influencing the choice of hysterectomy approach for the management offibroid uterus

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Journal Article
Gynecology and Minimally Invasive Therapy, 2013, 2 (2), pp. 61 - 64
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Aim: The aim of this study was to identify factors influencing the choice between different approaches in hysterectomy for uterine fibroids. Methods: A cross-sectional study was conducted involving 285 women who had undergone hysterectomy for uterine fibroids at the Liverpool Hospital, New South Wales, Australia. Results: This study shows that several factors influenced the choice of hysterectomy approach. First, concomitant adnexal surgery increased the likelihood of undergoing an abdominal hysterectomy rather than either a vaginal or a laparoscopic hysterectomy by 10- and fivefold (both p<0.01), respectively. Second, women with a larger uterus (>280g) had a 20 (. p<0.05) and 10 (. p<0.01) times greater chance of undergoing an abdominal hysterectomy than either a vaginal or a laparoscopic hysterectomy, respectively. Third, gynecologic endoscopists were more likely to perform laparoscopic hysterectomy than gynecologic generalists (. p<0.001). Conclusion: Certain clinical parameters determine the choice of hysterectomy approach. Surgeons' expertise also has significant influence over the choice between laparoscopic and traditional approaches for hysterectomy. © 2013.
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