title: Randomised controlled trial of total compared with subtotal hysterectomy with one-year follow up results.
abstract: OBJECTIVE
  To compare total abdominal hysterectomy and subtotal abdominal hysterectomy performed for benign uterine diseases.
  
  
  METHODS
  Randomised, controlled, unblinded trial with central, computer-generated randomisation.
  
  
  METHODS
  Danish trial performed in 11 departments of gynaecology.
  
  
  METHODS
  Women referred for benign uterine diseases were randomised to total abdominal hysterectomy (n = 158) or subtotal abdominal hysterectomy (n = 161). One-year follow up questionnaires had a response rate of 87%.
  
  
  METHODS
  Patients were followed by strict data collection procedures, including postal questionnaires. The results after one year of follow up were analysed by intention-to-treat analyses.
  
  
  METHODS
  (1) Primary: urinary incontinence and (2) secondary: post-operative complications, quality of life (SF-36), constipation, prolapse of the vaginal vault/cervical stump, satisfaction with sexual life, pelvic pain and vaginal bleeding.
  
  
  RESULTS
  A significantly (P = 0.043) smaller proportion of women had urinary incontinence one year after total abdominal hysterectomy compared with subtotal abdominal hysterectomy [9% vs 18% (OR 2.08, 95% CI 1.01-4.29)]. The lower proportion of incontinent women in the total abdominal hysterectomy group was a result of a higher proportion of symptom relief (total abdominal hysterectomy: 20/140, subtotal abdominal hysterectomy: 14/136) as well as a lower proportion of women with new symptoms (total abdominal hysterectomy: 3/140, subtotal abdominal hysterectomy: 10/137). Twenty-seven women (20%) from the subtotal abdominal hysterectomy group had vaginal bleeding and two of them had to have their cervix removed. No other clinically important differences were found between the two hysterectomy methods.
  
  
  CONCLUSIONS
  A smaller proportion of women suffered from urinary incontinence after total abdominal hysterectomy than after subtotal abdominal hysterectomy one year post-operatively.
authors.affiliation: Department of Obstetrics and Gynaecology, Roskilde County Hospital, Denmark.
authors.forename: Helga
authors.initials: H
authors.lastname: Gimbel
authors.forename: Vibeke
authors.initials: V
authors.lastname: Zobbe
authors.forename: Birthe Margrethe
authors.initials: BM
authors.lastname: Andersen
authors.forename: Thomas
authors.initials: T
authors.lastname: Filtenborg
authors.forename: Christian
authors.initials: C
authors.lastname: Gluud
authors.forename: Ann
authors.initials: A
authors.lastname: Tabor
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology; D011788:Quality of Life; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology; D014591:Uterine Diseases / Q000601:surgery*; D014592:Uterine Hemorrhage / Q000209:etiology