A randomized comparison of total or supracervical hysterectomy

Surgical complications and clinical outcomes

Lee A. Learman, Robert L. Summitt, R. Edward Varner, S. Gene McNeeley, Deborah Goodman-Gruen, Holly E. Richter, Feng Lin, Jonathan Showstack, Christine C. Ireland, Eric Vittinghoff, Stephen B. Hulley, A. Eugene Washington

Research output: Contribution to journalArticle

153 Citations (Scopus)

Abstract

OBJECTIVE: To compare surgical complications and clinical outcomes after total versus supracervical abdominal hysterectomy for control of abnormal uterine bleeding, symptomatic uterine leiomyomata, or both. METHODS: We conducted a randomized intervention trial in four US clinical centers among 135 patients who had abdominal hysterectomy for symptomatic uterine leiomyomata, abnormal uterine bleeding refractory to hormonal treatment, or both. Patients were randomly assigned to receive a total or supracervical hysterectomy performed using the surgeon's customary technique. Using an intention-to-treat approach, we compared surgical complications and clinical outcomes for 2 years after randomization. RESULTS: Sixty-eight participants were assigned to supracervical hysterectomy (SCH) and 67 to total abdominal hysterectomy (TAH). Hysterectomy by either technique led to statistically significant reductions in most symptoms, including pelvic pain or pressure, back pain, urinary incontinence, and voiding dysfunction. Patients randomly assigned to (SCH) tended to have more hospital readmissions than those randomized to TAH, but this difference was not statistically significant. There were no statistically significant differences in the rate of complications, degree of symptom improvement, or activity limitation. Participants weighing more than 100 kg at study entry were twice as likely to be readmitted to the hospital during the 2-year follow-up period (relative risk [RR] 2.18, 95% confidence interval [CI] 1.06, 4.48, P = .034). CONCLUSION: We found no statistically significant differences between (SCH) and TAH in surgical complications and clinical outcomes during 2 years of follow-up.

Original languageEnglish (US)
Pages (from-to)453-462
Number of pages10
JournalObstetrics and Gynecology
Volume102
Issue number3
DOIs
StatePublished - Sep 2003
Externally publishedYes

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Hysterectomy
Uterine Hemorrhage
Leiomyoma
Patient Readmission
Pelvic Pain
Urinary Incontinence
Back Pain
Random Allocation
Confidence Intervals
Pressure

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Learman, L. A., Summitt, R. L., Varner, R. E., McNeeley, S. G., Goodman-Gruen, D., Richter, H. E., ... Washington, A. E. (2003). A randomized comparison of total or supracervical hysterectomy: Surgical complications and clinical outcomes. Obstetrics and Gynecology, 102(3), 453-462. https://doi.org/10.1016/S0029-7844(03)00664-1

A randomized comparison of total or supracervical hysterectomy : Surgical complications and clinical outcomes. / Learman, Lee A.; Summitt, Robert L.; Varner, R. Edward; McNeeley, S. Gene; Goodman-Gruen, Deborah; Richter, Holly E.; Lin, Feng; Showstack, Jonathan; Ireland, Christine C.; Vittinghoff, Eric; Hulley, Stephen B.; Washington, A. Eugene.

In: Obstetrics and Gynecology, Vol. 102, No. 3, 09.2003, p. 453-462.

Research output: Contribution to journalArticle

Learman, LA, Summitt, RL, Varner, RE, McNeeley, SG, Goodman-Gruen, D, Richter, HE, Lin, F, Showstack, J, Ireland, CC, Vittinghoff, E, Hulley, SB & Washington, AE 2003, 'A randomized comparison of total or supracervical hysterectomy: Surgical complications and clinical outcomes', Obstetrics and Gynecology, vol. 102, no. 3, pp. 453-462. https://doi.org/10.1016/S0029-7844(03)00664-1
Learman, Lee A. ; Summitt, Robert L. ; Varner, R. Edward ; McNeeley, S. Gene ; Goodman-Gruen, Deborah ; Richter, Holly E. ; Lin, Feng ; Showstack, Jonathan ; Ireland, Christine C. ; Vittinghoff, Eric ; Hulley, Stephen B. ; Washington, A. Eugene. / A randomized comparison of total or supracervical hysterectomy : Surgical complications and clinical outcomes. In: Obstetrics and Gynecology. 2003 ; Vol. 102, No. 3. pp. 453-462.
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AU - Richter, Holly E.

AU - Lin, Feng

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