Hum. Reprod. Advance Access originally published online on July 10, 2009
Human Reproduction 2009 24(10):2515-2522; doi:10.1093/humrep/dep229
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FINHYST 2006—national prospective 1-year survey of 5 279 hysterectomies
1 Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, PO Box 140, 00029 HUS, Helsinki, Finland 2 Department of Gynaecology, Suomen Terveystalo, Gyldénintie 2, 00200 Helsinki, Finland 3 Department of Obstetrics and Gynaecology, North Karelia Central Hospital, Tikkamäentie 16, 80210 Joensuu, Finland 4 Department of Obstetrics and Gynaecology, Kuopio University Hospital, PO Box 1777, 70211 Kuopio, Finland 5 Department of Obstetrics and Gynaecology, Turku University Hospital, PO Box 52, 20521 Turku, Finland 6 Department of Obstetrics and Gynaecology, Oulu University Hospital, PO Box 24, 90029 OYS, Oulu, Finland 7 Department of Obstetrics and Gynaecology, Tampere University Hospital, PO Box 2000, 33521 Tampere, Finland
8 Correspondence address. E-mail: tea.brummer{at}hus.fi
BACKGROUND: In Finland, the number of hysterectomies during one decade has decreased by 34%. The national prospective FINHYST study in 1996 showed abdominal hysterectomy (AH) as being most common: 58%. In Finland since 2002, vaginal hysterectomy (VH) has been most preferred, with laparoscopic hysterectomy (LH) surpassing AH in 2005.
METHODS: FINHYST 2006 is a national prospective hysterectomy study in which all hospitals collaborated from 1 January to 31 December 2006. Questionnaires, completed by gynaecologists, covered their experience, patient characteristics and surgical data.
RESULTS: The 5279 hysterectomies distributed by approaches were 44% VHs, 32% LHs and 24% AHs. Less than 2% were subtotal. The main indications for hysterectomy were myomas (33%), uterine prolapse (28%) and menorrhagia (21%). The main indication for VH was not related to uterine prolapse in 39%. Bilateral salpingo-ooforectomy was performed in 36% of AHs, 32% of LHs and 2% of VHs. Antibiotic prophylaxis was used in 97%, and thrombosis prophylaxis in 65%. Haemorrhage was least and operation time shortest with VH, and hospital stay and sick leave were shortest after LH.
CONCLUSIONS: In Finland, less invasive approaches comprise 76% of hysterectomies. This trend has resulted nationally in shortening of hospital stay and of convalescence time.
Key words: hysterectomy/salpingo-ooforectomy/epidemiology/experience/laparoscopy
Submitted on March 19, 2009; resubmitted on May 29, 2009; accepted on June 3, 2009.