title: Total versus subtotal hysterectomy: a survey of gynecologists.
abstract: OBJECTIVE
  To estimate the attitudes and practice of gynecologists in the Washington, DC, Maryland, and Virginia area regarding total versus subtotal abdominal hysterectomy.
  
  
  METHODS
  A questionnaire with 18 questions on physicians' attitudes and practice regarding total versus subtotal hysterectomy was mailed to 1647 gynecologists in Washington, Maryland, and Virginia.
  
  
  RESULTS
  The corrected response rate was 51.2%. Forty-five percent of respondents stated that they always removed the cervix. The most common reason cited was to eliminate the risk of cervical cancer. The most common reason for subtotal hysterectomy was surgical difficulty leading to an intraoperative change of procedure. Only 17.8% of respondents always counseled women regarding the advantages and disadvantages of both total and subtotal hysterectomy; 63% rarely or never did. Nineteen percent always offered women a choice between the procedures; 61% rarely or never did. Eighty-eight percent of respondents felt that the risk of cancer in the cervical stump was small or negligible. Gender of the physicians or year of completion of residency made no significant impact on patients being counseled about both procedures or being offered a choice between the two.
  
  
  CONCLUSIONS
  Most gynecologists surveyed favor total abdominal hysterectomy over subtotal hysterectomy. Few counsel women regarding the options of total and subtotal hysterectomy or offer a choice between the procedures. Given that there are no convincing data proving the superiority of either procedure over the other, it may be reasonable to discuss the potential advantages and disadvantages of both procedures with women undergoing hysterectomy for benign disease and to offer them a choice.
authors.affiliation: Department of Obstetrics & Gynecology, Georgetown University Medical Center, Washington, DC, USA.
authors.forename: Nadine
authors.initials: N
authors.lastname: Zekam
authors.forename: Yinka
authors.initials: Y
authors.lastname: Oyelese
authors.forename: Katie
authors.initials: K
authors.lastname: Goodwin
authors.forename: Caroline
authors.initials: C
authors.lastname: Colin
authors.forename: Irit
authors.initials: I
authors.lastname: Sinai
authors.forename: John T
authors.initials: JT
authors.lastname: Queenan
mesh_terms: D000328:Adult; D005260:Female; D006176:Gynecology; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008297:Male; D010818:Practice Patterns, Physicians'