Past, present, and future of hysterectomy.
Until the late 1930s, the standard type of abdominal hysterectomy was subtotal, leaving the cervix behind to decrease the risk of peritonitis with its attendant high mortality. With the discovery of antibiotics, careful attention to antisepsis, and other medical and surgical advances, this method was gradually replaced by total abdominal hysterectomy in the United States and the United Kingdom, although the subtotal approach still remained popular, in particular in Scandinavian countries. With the advent of laparoscopic hysterectomy, many surgeons, wanting a simpler approach and for a variety of other reasons, have returned to performance of subtotal hysterectomy. The objectives of the present article is to review the development of the operation from a historical perspective, and to attempt to answer some of the dilemmas posed when choosing between a total and subtotal procedure, using results from evidence-based research when possible.
Sutton
Chris
C
Faculty of Health Sciences, University of Surrey Postgraduate Medical School, and the Department of Gynaecological Surgery, BMI-Mount Alvernia Hospital, Guildford, Surrey, England. chrislasersutton1@btinternet.com
D000556:Ambulatory Surgical Procedures; D003075:Coitus; D055356:Endometrial Ablation Techniques; D005260:Female; D005544:Forecasting; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007044:Hysterectomy / Q000266:history / Q000379:methods / Q000639:trends*; D010535:Laparoscopy; D007989:Libido; D009948:Orgasm; D017699:Pelvic Pain; D011183:Postoperative Complications / Q000517:prevention & control; D011788:Quality of Life; D013997:Time Factors; D014592:Uterine Hemorrhage