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Objective To compare laparoscopic hysterectomy and abdominal total hysterectomy regarding influence on postoperative psychological wellbeing and surgical measures.Design A prospective, open, randomised multicentre trial.Setting Five hospitals in the South East of Sweden.Population Hundred and twenty-five women scheduled for hysterectomy for benign conditions were enrolled in the study, and 119 women completed the study. Fifty-six women were randomised to abdominal hysterectomy and 63 to laparoscopic hysterectomy.Methods Psychometric tests measuring general wellbeing, depression and anxiety preoperatively and 5 weeks and 6 months postoperatively.Main outcome measures Effects of operating method on the psychological wellbeing postoperatively. Analysis of data regarding operating time, peroperative and postoperative complications, blood loss, hospital stay and recovery time.Results No significant differences in the scores were observed between the two groups in any of the four psychometric tests. Both the surgical methods were associated with a significantly higher degree of psychological wellbeing 5 weeks postoperatively compared with preoperatively. The operating time was significantly longer for the laparoscopic hysterectomy group, but the duration of the stay in hospital and sick-leave were significantly shorter for laparoscopic hysterectomy group compared with the abdominal hysterectomy group.Conclusions General psychological wellbeing is equal after laparoscopic and abdominal hysterectomy within 6 months after the operation. The advantages of the laparoscopic hysterectomy are the shorter stay in hospital and shorter sick-leave, but these issues must be balanced by a longer duration of the operation.Keywords Hysterectomy, multicentre study, psychological wellbeing, psychometry, randomised.Please cite this paper as: Persson P, Wijma K, Hammar M, Kjølhede P. Psychological wellbeing after laparoscopic and abdominal hysterectomy-a randomised controlled multicentre study.

Second trimester amniocentesis seems to be a safe method for prenatal diagnosis. The risk for pregnancy loss was low (1.3%) and was only slightly and nonsignificantly affected by the operator's experience and multiple needle insertions. Transplacental needle passage did not affect the risk of pregnancy loss.

1. Previously it has been impossible to perform studies of human breast tissue in vivo. In this study, we investigated whether the microdialysis technique is applicable in human breast tissue and whether the concentrations of amino acids, lactate and pyruvate change during the menstrual cycle. 2. Microdialysis was performed twice during the menstrual cycle in eight healthy women, in the breast and subcutaneous fat. Amino acids, lactate and pyruvate were analysed by HPLC. 3. None of the women showed any complications, such as bleeding or infection, after the experiments. The concentrations of aspartic acid, asparagine, serine, glycine, threonine, tyrosine and ornithine were decreased in the breast late in the menstrual cycle. In the subcutaneous fat, the concentration of glycine decreased late in the cycle. 4. This study has shown that microdialysis is a safe technique and is suitable for investigations of human breast tissue. Our data indicate that metabolism in the breast changes during the menstrual cycle. The lower levels of specific amino acids late in the menstrual cycle could indicate a higher proliferative and/or apoptotic activity during this period. However, the data we have obtained cannot yet be fully explained.

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