Nationwide rates of conversion from laparoscopic or vaginal hysterectomy to open abdominal hysterectomy in Germany

Abstract

Introduction: The aim of this study was to provide population-based German-wide

I What Do We Know About Hysterectomy?

“…In Germany, 4% and 26% of all hysterectomies for benign diseases of the genital tract included bilateral oophorectomy among peri-and postmenopausal women respectively. The highest hysterectomy rates were among women aged 40-49 years (9.9 per 1,000 women) (Stang 2011). Twenty-six percent of hysterectomies for benign diseases among women aged 50 or older were bilateral oophorectomy.…”

“…In one of the German studies for all performed hysterectomies only 6% were laparoscopically assisted vaginal hysterectomies and 5% laparoscopic hysterectomies. 10% of laparoscopical hysterectomies and 1% of vaginal hysterectomies necessitated a conversion to an abdominal hysterectomy (Stang 2011). …”

“…The vaginal route of hysterectomy is considered as a first choice of all benign indications as the post-operative rates of morbidity and complications are lower than abdominal open hysterectomies according to the Society of Obstetricians and Gynaecologists of Canada (SOGC) clinical guidelines (Lefebvre 2002, Stang 2011. Abdominal hysterectomy involves removal of the uterus through an incision on the lower abdomen.…”

“…Based on German studies from 2005 and 2006 (overall 305 015 hysterectomies performed during the study period) the hysterectomy rate for benign diseases of the genital tract among women aged 20 or older (3.6 out of 1000 women) was higher than in Sweden but lower than in the US or Australia , Stang 2011. The United States still has the highest incidence of hysterectomy, with about 550 000 women undergoing this operation annually, at a cost of more than $5 billion.…”

Subtotal Versus Total Abdominal Hysterectomy for Benign Gynecological Conditions

“…In a study from Germany the rates of conversion were highest for neoplastic disorders. The crude rates of conversion from laparoscopic to open abdominal hysterectomy for benign conditions were 10.5% (17).…”