Indications and alternatives to hysterectomy.
Hysterectomy remains one the most common procedures performed in North America. Because of a better understanding of a wide array of disease states and with emerging, more focused minimally invasive treatment options, a relative decline has been documented in the last several years. Although hysterectomy will ultimately eliminate all potential sources of abnormal uterine bleeding, various pharmacologic and surgical alternatives exist that may provide comparable benefit to the majority of women, especially if older than 40 years. Women experiencing chronic pelvic pain; however, should be counseled against hysterectomy until a more clear etiology has been identified.
*Division of Urogynecology, Center for Minimally Invasive Gynecologic Surgery, Cedars-Sinai Medical Center †Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA; ‡Gynecologic Services, Kaiser Permanente, Los Angeles Medical Center, Los Angeles, California.
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D062788:Adenomyosis / Q000628:therapy; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D059350:Chronic Pain / Q000628:therapy; D004714:Endometrial Hyperplasia / Q000628:therapy; D004715:Endometriosis / Q000628:therapy; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D015907:Hysteroscopy / Q000379:methods*; D007436:Intrauterine Devices, Medicated; D007889:Leiomyoma / Q000628:therapy; D016912:Levonorgestrel / Q000627:therapeutic use*; D017699:Pelvic Pain / Q000628:therapy; D011127:Polyps / Q000628:therapy; D055357:Uterine Artery Embolization / Q000379:methods*; D014591:Uterine Diseases / Q000628:therapy*; D014592:Uterine Hemorrhage / Q000628:therapy; D063186:Uterine Myomectomy / Q000379:methods*; D014594:Uterine Neoplasms / Q000628:therapy
D047072:Aromatase Inhibitors; D007987:Gonadotropin-Releasing Hormone; D016912:Levonorgestrel