Subtotal hysterectomy in modern gynecology: A decision analysis

J. R. Scott, H. T. Sharp, M. K. Dodson, P. A. Norton, H. R. Warner, H. T. Huddleston, M. K. Shepard

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

OBJECTIVE: Our purpose was to compare the risks and benefits of subtotal (supracervical) hysterectomy with those of total hysterectomy in women at low risk for cervical cancer. STUDY DESIGN: A decision analysis was performed. Baseline probabilities for operative and postoperative morbidity, mortality, and long-term quality of life were established for subtotal and total hysterectomy. RESULTS: Operative complication rates and ranges for total abdominal hysterectomy were infection 3.0% (3.0% to 20.0%), hemorrhage 2.0% (2.0% to 15.4%), and adjacent organ injury 1.0% (0.7% to 2.0%). Those for subtotal hysterectomy were infection 1.4% (1.0% to 5.0%), hemorrhage 2.0% (0.7% to 4.0%), and adjacent organ injury 0.7% (0.6% to 1.0%). Operative mortality, the risk for development of cervicovaginal cancer, and long-term adverse effects on sexual or vesicourethral function were low in both groups. CONCLUSIONS: Recently proposed benefits from subtotal hysterectomy are not well proven. Total hysterectomy remains the procedure of choice for most women.

Original languageEnglish (US)
Pages (from-to)1186-1192
Number of pages7
JournalAmerican Journal of Obstetrics and Gynecology
Volume176
Issue number6
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

Keywords

  • Decision analysis
  • Subtotal hysterectomy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Scott, J. R., Sharp, H. T., Dodson, M. K., Norton, P. A., Warner, H. R., Huddleston, H. T., & Shepard, M. K. (1997). Subtotal hysterectomy in modern gynecology: A decision analysis. American Journal of Obstetrics and Gynecology, 176(6), 1186-1192. https://doi.org/10.1016/S0002-9378(97)70333-8