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Press Release: January 31, 2002
The rate of hysterectomy for various non-cancerous uterine conditions was virtually unchanged from 1990 through 1997 despite some new therapeutic techniques. During the same period, an increasing number of these procedures were performed laparoscopically rather than abdominally, according to research supported by the Agency for Healthcare Research and Quality (AHRQ). The study was published in the February issue of Obstetrics and Gynecology.
Researchers Cynthia M. Farquhar, M.D., F.A.N.Z.C.O.G., of the University of Auckland's National Women's Hospital, and Claudia A. Steiner, M.D., M.P.H., of AHRQ, studied data from AHRQ's Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project. They found that rates of hysterectomy in 1997 were 5.6 per 1000 women, only slightly higher than the 1990 rate of 5.5 per 1000 women. Laparoscopically assisted vaginal hysterectomy (LAVH) accounted for 9.9 percent of those cases in 1997, up from .3 percent in 1990. At the same time, the use of abdominal hysterectomy dropped from 73.6 percent in 1990 to 63 percent in 1997. Vaginal hysterectomy rates did not change, remaining at around 24 percent.
Hysterectomy, or the surgical removal of the uterus, is the most common non-pregnancy-related procedure performed in the United States. Each year approximately 600,000 women undergo the procedure, most commonly due to leiomyomas, non-cancerous growths also known as fibroids. The other top reasons, in descending order, are menstrual disorders, endometriosis, uterine prolapse, and cancer of the cervix, uterus or ovary.
Existing research indicates that both LAVH and vaginal hysterectomy have advantages over abdominal hysterectomy of shorter hospital stays, reduced complications, and better surgical outcomes. In addition, a number of non-surgical treatments have been developed for uterine conditions other than cancer, such as myomectomy, uterine artery embolization and endometrial ablation. However, the researchers state that before the type and number of hysterectomies performed each year can be reduced, more long-term research needs to be conducted to see which treatments are the most effective for different types of patients.
Details can be found in "Hysterectomy Rates in the United States: 1990-1997," Obstetrics and Gynecology 2002;99:229-34.
For more information, please contact AHRQ Public Affairs, (301) 427-1364: Karen Carp, 301-427-1858 (KCarp@ahrq.gov).