Hysterectomy: An Examination of a Common Surgical Procedure

Abstract

This paper presents a study of 34,441 hysterectomies performed in Maryland during a 4-year period, 1986–1989. The analyses presented examine indications for hysterectomy, age at time of surgery, mortality, surgical procedures, length of hospital stay, and hospital costs. Fibroids, uterine prolapse, and menstrual problems were the three most common indications for hysterectomy. In women under the age of 20 the most common indication was obstetrical problems; in women aged 20–59 fibroids, menstrual problems, and endometriosis were the most common indications; and in women aged 60 and over uterine prolapse and cancer were the most common indications. The median age of hysterectomy was 42 years old, with more than 70% of the hysterectomies occurring in women aged 30–49. The in-hospital mortality rate was nearly 12 times higher among women having hysterectomy for cancer indications than among women with noncancer indications, and increased with age. Of the hysterectomies, 77% were performed abdominally and 23% vaginally. One or both ovaries were removed during 52% of the hysterectomies. The most common and costly set of procedures was abdominal hysterectomy with both ovaries removed, which also required the longest hospital stay.