1170 consecutive hysterectomies: indications and pathology

MacKenzie, I.Z.; Naish, Caroline; Rees, Margaret; Manek, Sanjiv

doi:10.1258/1362180043654593

Cited by 21 publications

(20 citation statements)

References 17 publications

(34 reference statements)

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“…Although the rates of hysterectomy vary across continents, Denmark and other industrialized countries share important features: 20% of women will have undergone hysterectomy before the age of 55 [1,3,37] , 80% of hysterectomies are performed for benign indications [1,3,37] , bilateral oophorectomy is frequently performed in connection with hysterectomy (35-50%) [4,37] , and hysterectomy is associated with low socioeconomic status and cardiovascular risk factors [24,31,38] . Possibly, our findings can also be generalized to women older than 40 years in Western industrialized countries.…”

Section: Discussionmentioning

confidence: 99%

Hysterectomy, Oophorectomy and Risk of Dementia: A Nationwide Historical Cohort Study

Phung

Waltoft

Laursen

et al. 2010

Dement Geriatr Cogn Disord

166

124

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Background: This study aimed to determine whether there is an association between hysterectomy and dementia. Methods: All female Danish residents born before 1966, alive on their 40th birthday and without a dementia diagnosis prior to 1977 (n = 2,313,388) were followed from January 1, 1977, or the age of 40, whichever came later, until dementia diagnosis, death, emigration or December 31, 2006, whichever came first. The relative risks (RR) for developing dementia in women with hysterectomy/oophorectomy compared to referent women were calculated. Results: Overall, hysterectomy did not increase the risk of dementia. When stratified by age at dementia diagnosis, hysterectomy was associated with an increased risk for early-onset dementia before the age of 50: hysterectomy alone (RR = 1.38, 95% confidence interval (CI) = 1.07–1.78), with unilateral oophorectomy (RR = 2.10, 95% CI = 1.28–3.45), with bilateral oophorectomy (RR = 2.33, 95% CI = 1.44–3.77). The younger the age at hysterectomy/oophorectomy, the greater was the risk. Conclusions: Although statistically significant, the association between premenopausal hysterectomy and early-onset dementia is uncertain due to study limitations. Premenopausal bilateral oophorectomy is associated with a higher risk, suggesting a dose effect of premature estrogen deficiency on dementia. The age-dependent effect suggests that the younger brain is probably more vulnerable to estrogen deficiency.

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Section: Discussionmentioning

confidence: 99%

Hysterectomy, Oophorectomy and Risk of Dementia: A Nationwide Historical Cohort Study

Phung

Waltoft

Laursen

et al. 2010

Dement Geriatr Cogn Disord

166

124

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“…Most commonly, hysterectomy includes removal of the uterine cervix, but subtotal or supracervical hysterectomy, in which the cervix is left intact, is also an option. The latter approach is not a common procedure in the United States (7.5%), 6 in the United Kingdom (4%), 7 and in Germany (4.8%), 8 whereas it has been more common in the Scandinavian countries such as Sweden and Denmark during the past 20 years. 9,10 The percentage of subtotal hysterectomies in Denmark was 22% in the period 1988e1998, 9 but since then the rate has declined to 15% in 2008 11 and to 8% in 2011.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Global epidemiology of hysterectomy: possible impact on gynecological cancer rates

Hammer

Rositch

Kahlert

et al. 2015

American Journal of Obstetrics and Gynecology

109

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“…The lifetime risk of hysterectomies ranges from 20% to 35% [1][2][3] . With the surge of medicolegal law suits, risk of premature surgical menopause after hysterectomy, surgical and anaesthetic risks involved and availability of alternative non invasive management options, every effort should be made to avoid hysterectomy wherever possible.…”

Section: Introductionmentioning

confidence: 99%

Histopathologic audit of hysterectomy specimens in a tertiary care hospital

Siwatch¹,

Kundu²,

Mohan³

et al. 2013

Sri Lanka J Obstet & Gynae

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Aims: To explore the pre-operative diagnosis, surgery performed and histopathological findings in teaching and non teaching hospitals in Chandigarh, India. Methods:A retrospective analysis of preoperative diagnosis made available to the pathologist and the final histopathologic findings was done for age, indication of hysterectomy, type of surgery, hospital setting where surgery was performed and histopathology including gross and microscopic findings of the specimens.Results: A total of 1,270 specimens were analyzed. More hysterectomies for malignant indications were done in teaching than in non teaching hospitals (p <0.001). One or both ovaries were removed in 46% of women undergoing hysterectomy in teaching hospitals and 54.3% in non teaching hospitals. Majority of the women were 30-45 years of age. Fibroid uterus was the commonest indication (246 cases, 40%) followed by prolapsed uterus (141 cases, 23%) and menstrual dysfunction (117 cases, 19%). Majority of the verifiable causes of hysterectomy were confirmed on histopathology. Besides, various incidental findings were noted in majority of the specimens.Conclusions: There were significantly fewer hysterectomies for malignancy and a higher rate of oophorectomies with hysterectomy in non teaching than in teaching hospitals. Regular careful audit and review can help in improving the quality of health care in our country.

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1170 consecutive hysterectomies: indications and pathology

Cited by 21 publications

References 17 publications

Hysterectomy, Oophorectomy and Risk of Dementia: A Nationwide Historical Cohort Study

Hysterectomy, Oophorectomy and Risk of Dementia: A Nationwide Historical Cohort Study

Global epidemiology of hysterectomy: possible impact on gynecological cancer rates

Histopathologic audit of hysterectomy specimens in a tertiary care hospital

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