Are hysterectomy volumes in the US really falling?

摘要

Hysterectomy is the most common nonobstetric surgical procedure performed on women, with 1 out of 9 women undergoing it in their lifetime. Recent reports have indicated a sharp decline in the number of hysterectomies performed annually in the United States. According to Wright et al, annual hysterectomy volume declined from 681,234 in 2002 to 433,621 cases in 2010. This was based on data from the National Inpatient Sample (NIS), which is the largest publicly available national inpatient care database and represents approximately 20% of discharges from hospitals within the United States. Another study from Desai et al reported further reduction in hysterectomy numbers in 2012, with only 311,820 cases performed that year based on query of data from the NIS. According to that report, abdominal hysterectomy (AH) accounted for 52.8% of cases, while vaginal hysterectomy (VH) accounted for 14.7% and laparoscopic hysterectomy (LH) for 32.4% of cases for all nonobstetric indications. The reduction in number of hysterectomies has been attributed to a variety of alternative uterine-sparing treatment options for uterine fibroids and abnormal uterine bleeding, which are the 2 leading indications for hysterectomy.