BMJ  2005;331:351-352 (6 August), doi:10.1136/bmj.331.7512.351-b

Letter

Methods of hysterectomy: should women have a say?

The first 150 words of the full text of this article appear below.

EDITOR—The review by Johnson et al shows that vaginal hysterectomy outperforms (open) abdominal hysterectomy on all outcomes for which there is evidence from randomised controlled trials, and laparoscopic hysterectomy outperforms abdominal hysterectomy on all except injuries to the bladder or ureter.¹ In practice, abdominal hysterectomy dominates, so Edozien in his editorial reasonably advocates more training in vaginal surgery and the development of evidence based guidelines about choice of surgical method.²

Questions must also be asked about how women should be informed about, and enabled to influence, the selection of a method for their hysterectomy.

We recently found that 25% of women surveyed before a hospital admission for hysterectomy had not been told what method they would have.³ Fewer than half had been told about the advantages or disadvantages of different methods. Women knew, or learnt as they discussed their forthcoming hysterectomy with friends, that there are different methods. . . . [Full text of this article]

v.a.entwistle@abdn.ac.uk
Health Services Research Unit, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD

Health Services Research Unit, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD

Dugald Baird Centre, University of Aberdeen

Social Dimensions of Health Institute, University of Dundee, Dundee DD1 4HJ

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