[Which factors affect the choice of method for hysterectomy in benign disease?].
BACKGROUND
At Vestfold Hospital hysterectomy for benign disease is performed by five different methods with 14 subvariants. There are no national guidelines for choice of procedure. This study reports some of the preoperative patient characteristics and compares our hysterectomy data with national data.


METHODS
315 patients who had a hysterectomy at Vestfold Hospital in 2000-2001 were included. A central registry (Norwegian Patient Register) supplied hysterectomy data for 51 other Norwegian hospitals.


RESULTS
Hysterectomy was done by laparotomy in 59% of patients in our hospital compared to a national mean of 78%. Concomitant oophorectomy was done in 43% of our cases and 31% in all hospitals. Patient having similar preoperative characteristics at our hospital often had different procedures. There were wide variations between hospitals with regard to hysterectomy methods.


CONCLUSIONS
Patient characteristics only partly explain the choice of hysterectomy method in our hospital. Divergent hysterectomy practice in Norwegian hospitals reflects a lack of consensus between gynaecologists and perhaps suboptimal operative competence.
Oma
Jardar
J
Kvinneklinikken, Sykehuset i Vestfold, Postboks 2168, 3103 Tønsberg. jardar.oma@siv.no
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000706:statistics & numerical data; D010535:Laparoscopy; D007813:Laparotomy; D008875:Middle Aged; D009664:Norway; D010052:Ovariectomy; D010818:Practice Patterns, Physicians'; D014591:Uterine Diseases / Q000175:diagnosis / Q000601:surgery*