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

Abstract

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 280 g) 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.

Keywords

• Clinical parameter
• Hysterectomy
• Risk factors
• Surgeon's expertise
• Uterine fibroids