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Vaginal hysterectomy leads to better outcomes than abdominal surgery

A review of recent studies concludes that surgeons should perform vaginal rather than abdominal hysterectomies whenever possible in order to cut down on complications and the length of hospital stays.1

According to the systematic evidence review by Dr. Neil Johnson of the University of Auckland in New Zealand and colleagues, women who had vaginal hysterectomies had fewer infections and high temperatures after surgery compared to those who had abdominal hysterectomies.

Women with vaginal hysterectomies also returned to their normal activities quicker than those who had the abdominal surgery, the researchers found.

The better outcomes associated with vaginal hysterectomy suggest it "should be performed in preference to abdominal hysterectomy where possible," Johnson says.

But "the surgical approach to hysterectomy should be decided by a woman in discussion with her surgeon in light of the relative benefits and hazards," he adds.

The review appears in the January issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

In a vaginal hysterectomy, surgeons remove the uterus through the vaginal opening. Vaginal hysterectomies are usually performed when the uterus is a normal size. Abdominal hysterectomies, where the uterus is removed through an abdominal opening, has traditionally been used when a woman has an enlarged uterus, malignant tumors or conditions such as endometriosis.

The Cochrane researchers also reviewed the evidence comparing laparoscopic and abdominal hysterectomy. In laparoscopic hysterectomies, the uterus is removed with the help of specialized instruments and a small fiber optic camera inserted through a small incision in the abdomen. Some laparoscopic hystere
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Contact: Neil Johnson
n.johnson@auckland.ac.nz
Center for the Advancement of Health
23-Jan-2005


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