The VALUE national hysterectomy study: description of the patients and their surgery.
Maresh MJ, Metcalfe MA, McPherson K, Overton C, Hall V, Hargreaves J, Bridgman S, Dobbins J, Casbard A.
Royal College of Obstetricians and gynaecologists, London, UK.
BJOG 2002 Mar;109(3):302-12
Objectives:
To describe hysterectomies practised in 1994 and 1995: the patients, their surgery and short term outcomes.
Design:
One of two large cohorts, with prospective follow up, recruited to compare the outcomes of endometrial destruction with those of hysterectomy.
Setting:
England, Wales and Northern Ireland.
Population:
All women who had hysterectomies for non-malignant indications carried out during a 12-month period.
Methods:
Gynaecologistsin NHS and independent hospitals were asked to report cases. Follow up data were obtained at outpatient follow up approximately six weeks post-surgery.
Settings, Design and Main Outcome Measures:
Indication for surgery, method of hysterectomy, ovarian status post-surgery, surgical complications.
Results:
37,298 cases were reported which is estimated to reflect about 45% of hysterectomies performed during the period studied. The median age was 45 years, and the most common indication for surgery was dysfunctional uterine bleeding (46%). Most hysterectomies were carried out by consultants (55%). The proportions of women having abdominal, vaginal or laparoscopically-assisted hysterectomy were 67%, 30% and 3%, respectively. Forty-three percent of women had no ovaries conserved after surgery. The median length of stay was five days. The overall operative complication rate was 3.5%, and highest for the laparoscopic techniques. The overall post-operative complication rate was 9%. One percent of these was regarded as severe, with the highest rate for severe in the laparoscopic group (2%). There were no operative deaths; 14 deaths were reported within the six-week post-operative period: a crude mortality rate soon after surgery of 0.38 per thousand (95% CI 0.25-0.64).
Conclusions:
This large study describes women who undergo hysterectomy in the UK, and presents results on early complications associated with the surgery. Operative complications occurred in one in 30 women, and post-operative complications in at least one in 10. Laparoscopic techniques tend to be associated with higher complication rates than other methods.
Please click on the required question.
- 1 Are heavy periods a common problem?
- 2 What is in my menstrual flow?
- 3 What range of menstrual cycle length is considered to be normal?
- 4 How can menstrual blood loss be measured?
- 5 How can I tell if my periods are abnormally heavy?
- 6 What could be the cause of my very heavy menstrual periods?
- 7 I have been sterilised. Could this be the cause of my heavy periods?
- 8 Should I have tests to find the reason for my heavy periods?
- 9 How will my heavy period problems be investigated?
- 10 What is meant by anaemia due to heavy periods?
- 11 What is intermenstrual bleeding?
- 12 What is a hysteroscopy and D and C?
- 13 What is cervical cautery?
- 14 What happens after the D and C?
- 15 What treatments are available for my heavy periods?
- 16 What are the medical treatments available for heavy periods?
- 17 How do the various medical treatments for heavy periods work?
- 18 What would be reasonable initial treatment for a teenager or young woman with heavy periods?
- 19 What is a hysterectomy?
- 20 What are the indications for hysterectomy?
- 21 What are the risks (complications) of hysterectomy?
- 22 What is vault granulation?
- 23 What are the different types of hysterectomy?
- 24 Is it essential to remove the neck of the womb at hysterectomy?
- 25 Should my ovaries be removed or conserved during hysterectomy?
- 26 How long will I be in hospital when I have my hysterectomy?
- 27 I have had a hysterectomy. Do I still need to have smear tests?
- 28 What are the other surgical alternatives to hysterectomy?
- 29 How do endometrial ablation and hysterectomy compare?
- 30 Are there any psychological effects following hysterectomy?
- 31 How do we decide the best treatment for my period problems?
- 32 Could I have some recommended hysterectomy support groups?
- 33 Are there any support groups?
- Intermenstrual Bleeding - Bleeding between periods.
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