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Indications and Alternatives to Hysterectomy

SOLNIK, M. JONATHAN MD, FACOG, FACS*,†; MUNRO, MALCOLM G. MD, FACOG, FRCS(C)†,‡

Clinical Obstetrics and Gynecology: March 2014 - Volume 57 - Issue 1 - p 14–42
doi: 10.1097/GRF.0000000000000010
Hysterectomy 2014: Indications and Techniques

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

The authors declare that they have nothing to disclose.

Correspondence: M. Jonathan Solnik, MD, FACOG, FACS, Division of Urogynecology, Center for Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center & David Geffen School of Medicine at UCLA, Suite 160W, Los Angeles, CA. E-mail: solnikm@cshs.org

© 2014 by Lippincott Williams & Wilkins.