Hysterectomy risks and best practices

Hysterectomy does not increase a woman's risk of death, according to a nested cohort study of over 7,000 women in Britain.

Researchers found that older women who had the operation actually had a 6% reduced risk of death compared to women of similar age who did not have it (adjusted hazard ratio [HR] 0.94, 95% CI; 0.75–1.18) And younger women who had the procedure had an adjusted HR for all-cause mortality of 0.82 (95% CI; 0.65–1.03) compared with younger women who didn't have a hysterectomy. Hysterectomy didn't alter the risk for death from cardiovascular disease or cancer regardless of age.

Which type of hysterectomy is preferable? Compared to the abdominal form, vaginal hysterectomy is associated with a faster return to normal activity, a shorter hospital stay, and fewer infections and febrile episodes, according to a recent systematic review and meta-analysis of 27 randomized controlled trials.

Iversen L, Hannaford PC, Elliott AM, et al. Long term effects of hysterectomy on mortality: nested cohort study. BMJ. 2005;330:1482-1485.

Johnson N, Barlow D, Lethaby A, et al. Methods of hysterectomy: systematic review and meta-analysis of randomised controlled trials. BMJ. 2005;330:1478-1481.