Total or subtotal hysterectomy for benign uterine diseases? A meta-analysis.
نویسنده
چکیده
BACKGROUND Total and subtotal abdominal hysterectomy for benign indications have been compared in randomized clinical trials and observational studies. A meta-analysis is performed to summarize the evidence. METHODS Thirty-four randomized clinical trials and observational studies comparing total and subtotal abdominal hysterectomy for benign indications were included. Endpoints were self-reported urinary incontinence, postoperative complications, operation time, quality of life, constipation, prolapse, sexual functioning, pelvic pain, and cervical stump problems after subtotal hysterectomy. Odds ratios and tests for heterogeneity and overall effect were calculated. RESULTS Urinary incontinence and prolapse showed a significant difference favoring the total hysterectomy. Some of the women having a subtotal hysterectomy had cervical stump problems (bleeding and abnormal smear). Operation time and peroperative bleeding are postoperative complications were significantly in favor of the subtotal hysterectomy. Lower urinary tract symptoms other than incontinence, quality of life, constipation, pelvic pain, and sexual life were not in favor of either of the hysterectomy methods. CONCLUSION Less women suffered from urinary incontinence and prolapse and cervical stump problems after total than after subtotal hysterectomy. However, subtotal hysterectomy is faster to perform, has less peroperative bleeding, and seems to have less intra- and postoperative complications.
منابع مشابه
Hysterectomy for benign gynaecological disease
nt matter & 2006 gyn.2006.04.004 thor. Tel.: +44 20 . [email protected]. Summary Hysterectomy, the commonest major gynaecological operation, is the only definitive cure for dysfunctional uterine bleeding, rates highest in satisfaction scores compared with other treatments, and improves quality of life. Although research indicates that vaginal hysterectomy is safer and cheaper than total abdominal...
متن کاملTotal and subtotal abdominal hysterectomy for benign gynaecological disease
In both the UK and USA, hysterectomy remains the commonest major gynaecological operation. It is the only definitive cure for dysfunctional uterine bleeding, and rates highest in satisfaction scores compared to other treatments, and improves quality of life. Conservative alternatives to hysterectomy, including endometrial ablative techniques, the Mirena Intrauterine System (IUS) and uterine art...
متن کاملHysterectomy—Current Methods and Alternatives for Benign Indications
Hysterectomy is the commonest gynecologic operation performed not only for malignant disease but also for many benign conditions such as fibroids, endometrial hyperplasia, adenomyosis, uterine prolapse, dysfunctional uterine bleeding, and cervical intraepithelial neoplasia. There are many approaches to hysterectomy for benign disease: abdominal hysterectomy, vaginal hysterectomy, laparoscopic a...
متن کاملComparison of laparoscopy-assisted hysterectomies with conventional hysterectomies.
OBJECTIVE To compare operative and early postoperative outcomes of laparoscopic-assisted vaginal hysterectomy (LAVH) and laparoscopy assisted supracervical hysterectomy (LASH) with conventional hysterectomy by laparotomy or vaginally, including patients undergoing total or subtotal hysterectomy for benign gynecologic disease. METHODS Three different methods of hysterectomies: laparoscopic, va...
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عنوان ژورنال:
- Acta obstetricia et gynecologica Scandinavica
دوره 86 2 شماره
صفحات -
تاریخ انتشار 2007