Elective Hysterectomy: Benefits, Risks, and Costs

摘要

This study evaluated the effect of hysterectomy or hysterectomy and bilateral salpingo-oophorectomy (hysterectomy and oophorectomy) versus alternative medical management upon life expectancy, quality of life, and direct medical costs. Using techniques of decision analysis and available data on sequelae, the authors found that gains in life expectancy and quality of life can be expected when women aged 30 to 60 undergo hysterectomy for benign neoplasm, disorders of menstruation, acquired abnormal anatomy, cervical disease, or endometriosis, owing primarily to prevention of reproductive tract cancers, which outweighs the impact of operative mortality. However, women who have relatively high operative risk or low expected cancer risks, beyond thresholds estimated in sensitivity analysis, and women younger than 35 not treated with placement estrogens following hysterectomy and oophorectomy may expect net losses in life expectancy with surgical intervention.