Hysterectomy for benign conditions

Patients and doctors will benefit from evidence based guidelines

In contemporary clinical practice, patients should be given sufficient information about the reason for any treatment offered, the risks and benefits of the treatment, and the alternative options. For women undergoing hysterectomy, this ideal has scarcely been fulfilled. One reason for this has been the paucity of evidence on which to base counselling; the other is that gynaecologists, owing to limitations in their training, have not always been in a position to offer their patients a genuine choice of treatment options.

Hysterectomy has long been regarded as an operation performed by “hyster-happy,”1 mostly male, surgeons. The medical historian Roy Porter counted the rising tide of hysterectomies among manifestations of the “abuse of gynaecological surgery to control women” in the 19th century.2 Although campaigns against unnecessary hysterectomy have been vocal,3 this operation survived the feminist whirlwind of the mid to late 20th century and remains one of the most commonly performed operations in the world. In the United States, 600 …