[Factors considered to choose type of a hysterectomy for benign uterus lesions (excluding prolapsus and obstetrical indications)].
OBJECTIVE
We searched for the factors determining the type of hysterectomy (vaginal, laparoscopy or laparotomy) performed in women with supposedly benign uterine disease.


METHODS
We conducted a retrospective study of 101 consecutive hysterectomies performed on voluminous uteruses, prolapsus and obstetrical indications excluded. The following factors likely to have influenced the decisions were examined: patient age, nulliparity, menopausal status, history of laparotomy, uterus weight, narrow vagina, nature of uterus lesions, associated unilateral or bilateral annexectomy, complications.


RESULTS
The frequencies were: vaginal route 58.4% (average uterine weight 249.4 g, range 93-1149 g), laparoscopic preparation 37.6% (average uterine weight 348 g, range 92-818 g), and laparotomy 4% (average uterine weight 586.2 g, range 112-1216 g). Factors determining type of hysterectomy were uterine weight (and therefore volume) (p < 0.05), nulliparity (p < 0.04), narrow vagina probed by compulsory Schuchardt incision (p < 0.02), associated annexectomy (p < 0.01). No other factors were significantly determinant. The vaginal route appears to be highly preferred.


CONCLUSIONS
Vaginal hysterectomy is clearly the most preferred and practiced. Laparoscopy may be helpful for vaginal hysterectomy and laparotomy is exceptional.
Melis
A
A
CHU Grenoble, BP 217, 38043 Grenoble Cedex.
Buisson
S
S
Lutz
J-M
JM
Salvat
J
J
D000367:Age Factors; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods* / Q000706:statistics & numerical data*; D007045:Hysterectomy, Vaginal; D010535:Laparoscopy; D008593:Menopause; D009929:Organ Size; D010298:Parity; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D014591:Uterine Diseases / Q000473:pathology / Q000601:surgery*; D014599:Uterus / Q000473:pathology; D014621:Vagina / Q000473:pathology