Hysterectomy on benign indications in Sweden 1987-2003: a nationwide trend analysis.
OBJECTIVE
To investigate the annual rates, types and indications for hysterectomy on benign indications in Sweden 1987-2003.


METHODS
A nationwide register-based cohort study.


METHODS
The Swedish Inpatient Register.


METHODS
All women hysterectomized for benign disease in Sweden from 1987 through 2003 (n=121,947).


METHODS
Hysterectomy on benign indications calculated as proportions or rates/100,000 person-years.


RESULTS
From 1987 to 1999, the annual overall hysterectomy rate increased from 178 to 232/100,000 person-years. Thereafter, the overall hysterectomy rate declined and phased out around 210/100,000 person-years in 2003, a decrease of 11%. Comprising only 4% of hysterectomies performed in 1987, vaginal hysterectomy increased to 31% in 2003. Rates of vaginal hysterectomy by prolapse indication increased by a five-fold, whereas rates of vaginal hysterectomy by other benign indications increased by a near 20-fold. Total and subtotal abdominal hysterectomy decreased from 63% and 32%, respectively, in 1987, to 48% and 18% in 2003.


CONCLUSIONS
The overall rate of hysterectomy on benign indications has remained reasonably stable in Sweden over the last decade. Major trends involved a considerable decrease in rates of abdominal hysterectomy, increased use of vaginal hysterectomy and increased number of hysterectomies performed for pelvic organ prolapse.
Lundholm
Cecilia
C
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Forsgren
Catharina
C
Johansson
Anna L V
AL
Cnattingius
Sven
S
Altman
Daniel
D
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001707:Biopsy, Needle; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data* / Q000639:trends*; D007045:Hysterectomy, Vaginal / Q000706:statistics & numerical data / Q000639:trends; D015907:Hysteroscopy / Q000706:statistics & numerical data / Q000639:trends; D007150:Immunohistochemistry; D015994:Incidence; D038801:International Classification of Diseases; D007813:Laparotomy / Q000706:statistics & numerical data / Q000639:trends; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011336:Probability; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000473:pathology* / Q000601:surgery*