Hysterectomy - Knowledge

47: 1341:, of the 617,000 hysterectomies performed in 2004, 73% also involved the surgical removal of the ovaries. There are currently an estimated 22 million women in the United States who have undergone this procedure. Nearly 68 percent were performed for benign conditions such as endometriosis, irregular bleeding and uterine fibroids. Such rates being highest in the industrialized world has led to the controversy that hysterectomies are being largely performed for unwarranted reasons. More recent data suggests that the number of hysterectomies performed has declined in every state in the United States. From 2010 to 2013, there were 12 percent fewer hysterectomies performed, and the types of hysterectomies were more minimally invasive in nature, reflected by a 17 percent increase in laparoscopic procedures. 978: 688:) is injected into the uterine arteries in order to block the flow of blood through those vessels. The restriction in blood supply usually results in significant reduction of fibroids and improvement of heavy bleeding tendency. The 2012 Cochrane review comparing hysterectomy and UAE did not find any major advantage for either procedure. While UAE is associated with shorter hospital stay and a more rapid return to normal daily activities, it was also associated with a higher risk for minor complications later on. There were no differences between UAE and hysterectomy with regards to major complications. 869:. Historically, the biggest problem with this technique was infections, but infection rates are well-controlled and not a major concern in modern medical practice. An open hysterectomy provides the most effective way to explore the abdominal cavity and perform complicated surgeries. Before the refinement of the vaginal and laparoscopic vaginal techniques, it was also the only possibility to achieve subtotal hysterectomy; meanwhile, the vaginal route is the preferable technique in most circumstances. 717: 966: 990: 942: 954: 602: 594: 771:, and vaginal cuff granulations. These theoretical advantages were not confirmed in practice, but other advantages over total hysterectomy emerged. The principal disadvantage is that risk of cervical cancer is not eliminated and women may continue cyclical bleeding (although substantially less than before the surgery). These issues were addressed in a systematic review of total versus supracervical hysterectomy for 191: 1374:, the number of hysterectomies from the 1980s to the 1990s decreased by 38 percent. In 1988, there were 173 such surgeries per 100,000 women, and by 1998 this number had been reduced to 107. The proportion of abdominal supracervical hysterectomies in the same time period grew from 7.5 to 41 percent. A total of 67,096 women underwent hysterectomy during these years. 1025:

be "a safe alternative to laparotomy" in patients receiving total hysterectomy for endometrial cancer. Researchers concluded the procedure "offers markedly improved perioperative outcomes with a lower reoperation rate and fewer postoperative complications when the standard of care shifts from open surgery to laparoscopy in a university hospital".

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former is a sudden hormonal shock to the body that causes rapid onset of menopausal symptoms such as hot flashes, while the latter is a gradually occurring decrease of hormonal levels over a period of years with uterus intact and ovaries able to produce hormones even after the cessation of menstrual periods.

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A 2014 Cochrane review found that robotic assisted surgery may have a similar complication rate when compared to conventional laparoscopic surgery. In addition, there is evidence to suggest that although the surgery make take longer, robotic assisted surgery may result in shorter hospital stays. More

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In one 2004 study conducted in the UK comparing abdominal (laparotomic) and laparoscopic techniques, laparoscopic surgery was found to cause longer operation time and a higher rate of major complications while offering much quicker healing. In another study conducted in 2014, laparoscopy was found to

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Vaginal hysterectomy is recommended over other variants where possible for women with benign diseases. Vaginal hysterectomy was shown to be superior to LAVH and some types of laparoscopic surgery causing fewer short- and long-term complications, more favorable effect on sexual experience with shorter

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In 1995, the short-term mortality (within 40 days of surgery) was reported at 0.38 cases per 1000 when performed for benign causes. Risks for surgical complications were presence of fibroids, younger age (vascular pelvis with higher bleeding risk and larger uterus), dysfunctional uterine bleeding and

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of hysterectomies between 2008 and 2009 was almost 47,000. The national rate for the same timeline was 338 per 100,000 population, down from 484 per 100,000 in 1997. The reasons for hysterectomies differed depending on whether the woman was living in an urban or rural location. Urban women opted for

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Hysterectomy can be performed in different ways. The oldest known technique is vaginal hysterectomy. The first planned hysterectomy was performed by Konrad Langenbeck - Surgeon General of the Hannovarian army, although there are records of vaginal hysterectomy for prolapse going back as far as 50BC.

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which is an outpatient procedure in which the lining of the uterus is destroyed with heat, mechanically or by radio frequency ablation. Endometrial ablation greatly reduces or eliminates monthly bleeding in ninety percent of patients with DUB. It is not effective for patients with very thick uterine

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One study showed that risk of subsequent cardiovascular disease is substantially increased for women who had hysterectomy at age 50 or younger. No association was found for women undergoing the procedure after age 50. The risk is higher when ovaries are removed but still noticeable even when ovaries

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After hysterectomy for benign indications the majority of patients report improvement in sexual life and pelvic pain. A smaller share of patients report worsening of sexual life and other problems. The picture is significantly different for hysterectomy performed for malignant reasons; the procedure

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Long-term effect on all case mortality is relatively small. Women under the age of 45 years have a significantly increased long-term mortality that is believed to be caused by the hormonal side effects of hysterectomy and prophylactic oophorectomy. This effect is not limited to pre-menopausal women;

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are well known adverse effects that develop with high frequency a very long time after the surgery. Typically, those complications develop 10–20 years after the surgery. For this reason exact numbers are not known, and risk factors are poorly understood. It is also unknown if the choice of surgical

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after hysterectomy with ovarian conservation is 3.7 years earlier than average. This has been suggested to be due to the disruption of blood supply to the ovaries after a hysterectomy or due to missing endocrine feedback of the uterus. The function of the remaining ovaries is significantly affected

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Hospital stay is 3 to 5 days or more for the abdominal procedure and between 1 and 2 days (but possibly longer) for vaginal or laparoscopically assisted vaginal procedures. After the procedure, the American College of Obstetricians and Gynecologists recommends not inserting anything into the vagina

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Vaginal hysterectomy is performed entirely through the vaginal canal and has clear advantages over abdominal surgery such as fewer complications, shorter hospital stays and shorter healing time. Abdominal hysterectomy, the most common method, is used in cases such as after caesarean delivery, when

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has been constant for many years. In 2006, 149,456 hysterectomies were performed. Additionally, of these, 126,743 (84.8%) successfully benefitted the patient without incident. Women between the ages of 40 and 49 accounted for 50 percent of hysterectomies, and those between the ages of 50 and 59

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Hysterectomy is the second most common major surgery among women in the United States (the first is cesarean section). In the 1980s and 1990s, this statistic was the source of concern among some consumer rights groups and puzzlement among the medical community, and brought about informed choice

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Estrogen levels fall sharply when the ovaries are removed, removing the protective effects of estrogen on the cardiovascular and skeletal systems. This condition is often referred to as "surgical menopause", although it is substantially different from a naturally occurring menopausal state; the

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Total laparoscopic hysterectomy (TLH) was developed in the early 90s by Prabhat K. Ahluwalia in Upstate New York. TLH is performed solely through the laparoscopes in the abdomen, starting at the top of the uterus, typically with a uterine manipulator. The entire uterus is disconnected from its

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and is completed such that the final removal of the uterus (with or without removing the ovaries) is via the vaginal canal. Thus, LAVH is also a total hysterectomy; the cervix is removed with the uterus. If the cervix is removed along with the uterus, the upper portion of the vagina is sutured

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Hysterectomy is a major surgical procedure that has risks and benefits. It affects the hormonal balance and overall health of patients. Because of this, hysterectomy is normally recommended as a last resort after pharmaceutical or other surgical options have been exhausted to remedy certain

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has been widely used especially in laparoscopic techniques and sometimes for the vaginal technique, but now appears to be associated with a considerable risk of spreading benign or malignant tumors. In April 2014, the FDA issued a memo alerting medical practitioners to the risks of power

566:. The increased risk is particularly pronounced for young women; the risk was lower after vaginally performed hysterectomies. Hormonal effects or injury of the ureter were considered as possible explanations. In some cases the renal cell carcinoma may be a manifestation of an undiagnosed 1028:

The abdominal technique is very often applied in difficult circumstances or when complications are expected. Given these circumstances the complication rate and time required for surgery compares very favorably with other techniques, however time required for healing is much longer.

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Subtotal (supracervical) hysterectomy was originally proposed with the expectation that it may improve sexual functioning after hysterectomy, it has been postulated that removing the cervix causes excessive neurologic and anatomic disruption, thus leading to vaginal shortening,

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technique has any effect. It has been assessed that the risk for urinary incontinence is approximately doubled within 20 years after hysterectomy. One long-term study found a 2.4 fold increased risk for surgery to correct urinary stress incontinence following hysterectomy.

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Previously reported marginal advantages of robotic assisted surgery could not be confirmed; only differences in hospital stay and cost remain statistically significant. In addition, concerns over widespread misleading marketing claims have been raised.

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Boosz A, Haeberle L, Renner SP, Thiel FC, Mehlhorn G, Beckmann MW, Mueller A (December 2014). "Comparison of reoperation rates, perioperative outcomes in women with endometrial cancer when the standard of care shifts from open surgery to laparoscopy".

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Patient characteristics such as the reason for needing a hysterectomy, uterine size, descent of the uterus, presence of diseased tissues surrounding the uterus, previous surgery in the pelvic region, obesity, history of pregnancy, the possibility of

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Prolapse may also be corrected surgically without removal of the uterus. There are several strategies that can be utilized to help strengthen pelvic floor muscles and prevent the worsening of prolapse. These include, but are not limited to, use of

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occurs in approximately 3% of cases of abdominal hysterectomy. The risk is increased by obesity, diabetes, immunodeficiency disorder, use of systemic corticosteroids, smoking, wound hematoma, and preexisting infection such as chorioamnionitis and

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is a particular risk after hysterectomy because of the extent of dissection involved as well as the fact the hysterectomy wound is in the most gravity-dependent part of the pelvis into which a loop of bowel may easily fall. In one review,

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are associated with hysterectomies. This has been attributed to the modulatory effect of estrogen on calcium metabolism and the drop in serum estrogen levels after menopause can cause excessive loss of calcium leading to bone wasting.

150:), and other surrounding structures. The term “partial” or “total” hysterectomy are lay-terms that incorrectly describe the addition or omission of oophorectomy at the time of hysterectomy. These procedures are usually performed by a 890:

because compared with the abdominal procedure it is less invasive and the post-operative recovery is much faster. It also allows better exploration and slightly more complicated surgeries than the vaginal procedure. LAVH begins with

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the greatest access to the reproductive structures and is normally done for removal of the entire reproductive complex. The recovery time for an open hysterectomy is 4–6 weeks and sometimes longer due to the need to cut through the

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this treatment is controversial at best. In the United States, specific cases of sterilization due to developmental disabilities have been found by state-level Supreme Courts to violate the patient's constitutional and common-law

530:. The dressing should be changed and the wound irrigated with normal saline at least twice each day. In addition, it is recommended to administer an antibiotic active against staphylococci and streptococci, preferably 1362:

accounted for 20 percent. In 2007, the number of hysterectomies decreased to 138,164. In recent years, the technique of laparoscopic or laparoscopically assisted hysterectomies has been raised into the foreground.

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Robotic assisted surgery is presently used in several countries for hysterectomies. Additional research is required to determine the benefits and risks involved, compared to conventional laparoscopic surgery.

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Length of surgery and amount of blood lost during surgery were significantly reduced during supracervical hysterectomy compared to total hysterectomy, but there was no difference in post-operative transfusion

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The risk for vaginal prolapse depends on factors such as number of vaginal deliveries, the difficulty of those deliveries, and the type of labor. Overall incidence is approximately doubled after hysterectomy.

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In modern medicine today, laparoscopic vaginal (with additional instruments passing through ports in small abdominal incisions, close or in the navel) and total laparoscopic techniques have been developed.

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Hysterectomy, in the literal sense of the word, means merely removal of the uterus. However other organs such as ovaries, fallopian tubes, and the cervix are very frequently removed as part of the surgery.

5827: 162:) and has surgical risks as well as long-term effects, so the surgery is normally recommended only when other treatment options are not available or have failed. It is the second most commonly performed 5245:

Schiavone MB, Kuo EC, Naumann RW, Burke WM, Lewin SN, Neugut AI, et al. (September 2012). "The commercialization of robotic surgery: unsubstantiated marketing of gynecologic surgery by hospitals".

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Ureteral injury is not uncommon and occurs in 0.2 per 1,000 cases of vaginal hysterectomy and 1.3 per 1,000 cases of abdominal hysterectomy. The injury usually occurs in the distal ureter close to the

581:; over 20 other cases have been discussed in additional medical literature. On very rare occasions, sexual intercourse after hysterectomy may cause a transvaginal evisceration of the small bowel. The 267:: depending on the type of hysterectomy, can aid in treatment of cancer or precancer of the endometrium, cervix, or uterus. In order to protect against or treat cancer of the ovaries, would need an 199:

intractable and severe uterine/reproductive system conditions. There may be other reasons for a hysterectomy to be requested. Such conditions and/or indications include, but are not limited to:

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a form of endometriosis, where the uterine lining has grown into and sometimes through the uterine wall musculature. This can thicken the uterine walls and also contribute to pain and bleeding.

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is often more radical with substantial side effects. A proportion of patients who undergo a hysterectomy for chronic pelvic pain continue to have pelvic pain after a hysterectomy and develop

935:"Robotic hysterectomy" is a variant of laparoscopic surgery using special remotely controlled instruments that allow the surgeon finer control as well as three-dimensional magnified vision. 4712: 2315:

Petri Nahás EA, Pontes A, Nahas-Neto J, Borges VT, Dias R, Traiman P (February 2005). "Effect of total abdominal hysterectomy on ovarian blood supply in women of reproductive age".

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levels as compared to those left intact. Reduced levels of testosterone in women are predictive of height loss, which may occur as a result of reduced bone density, while increased

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Hysterectomies have also been linked with higher rates of heart disease and weakened bones. Those who have undergone a hysterectomy with both ovaries removed typically have reduced

5799: 542:. Alternatively, if the infection is cleared and healthy granulation tissue is evident at the base of the wound, the edges of the incision may be reapproximated, such as by using 680:. Under local anesthesia a catheter is introduced into the femoral artery at the groin and advanced under radiographic control into the uterine artery. A mass of microspheres or 3900: 932:

Dual-port laparoscopy is a form of laparoscopic surgery using two 5 mm midline incisions: the uterus is detached through the two ports and removed through the vagina.

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Supracervical (subtotal) laparoscopic hysterectomy (LSH) is performed similar to the total laparoscopic surgery but the uterus is amputated between the cervix and fundus.

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Barmparas G, Branco BC, Schnüriger B, Lam L, Inaba K, Demetriades D (October 2010). "The incidence and risk factors of post-laparotomy adhesive small bowel obstruction".

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The first abdominal hysterectomy recorded was by Ephraim McDowell. He performed the procedure in 1809 for a mother of five for a large ovarian mass on her kitchen table.

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Laparoscopic surgery offers certain advantages when vaginal surgery is not possible but also has the disadvantage of significantly longer time required for the surgery.

4765:"The eVALuate study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy" 3948: 3495:

Zapata LB, Whiteman MK, Tepper NK, Jamieson DJ, Marchbanks PA, Curtis KM (July 2010). "Intrauterine device use among women with uterine fibroids: a systematic review".

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is the uppermost region of the vagina that has been sutured closed. A rare complication, it can dehisce and allow the evisceration of the small bowel into the vagina.

965: 4276: 554:. Sexual intercourse remains possible after hysterectomy. Reconstructive surgery remains an option for women who have experienced benign and malignant conditions. 5824: 886:

With the development of laparoscopic techniques in the 1970s and 1980s, the "laparoscopic-assisted vaginal hysterectomy" (LAVH) has gained great popularity among

182:. It is expected that the frequency of hysterectomies for non-malignant indications will continue to fall given the development of alternative treatment options. 5594: 661:) is released in low concentration locally. There is now substantial evidence that Levongestrel-IUDs provide good symptomatic relief for women with fibroids. 241:

when the uterus sags down due to weakened or stretched pelvic floor muscles potentially causing the uterus to protrude out of the vagina in more severe cases.

224:: irregular or excessive menstrual bleeding for greater than a week. It can disturb regular quality of life and may be indicative of a more serious condition. 5770: 577:

due to an undetected fertilization that had yet to descend into the uterus before surgery. Two cases have been identified and profiled in an issue of the

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Altman D, Granath F, Cnattingius S, Falconer C (October 2007). "Hysterectomy and risk of stress-urinary-incontinence surgery: nationwide cohort study".

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McPherson K, Herbert A, Judge A, Clarke A, Bridgman S, Maresh M, Overton C (July 2005). "Self-reported bladder function five years post-hysterectomy".

232:: benign growths on the uterus wall. These muscular noncancerous tumors can grow in single form or in clusters and can cause extreme pain and bleeding. 4021: 3705: 793:

In the short-term, randomized trials have shown that cervical preservation or removal does not affect the rate of subsequent pelvic organ prolapse.

311:(a placenta that has grown into and through the wall of the uterus to attach itself to other organs), as well as a last resort in case of excessive 5389:

Nesbitt-Hawes EM, Maley PE, Won HR, Law KS, Zhang CS, Lyons SD, et al. (2013). "Laparoscopic subtotal hysterectomy: evidence and techniques".

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Jassal SK, Barrett-Connor E, Edelstein SL (April 1995). "Low bioavailable testosterone levels predict future height loss in postmenopausal women".

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Febrile morbidity was less likely and ongoing cyclic vaginal bleeding one year after surgery was more likely after supracervical hysterectomy.

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Gago-Dominguez M, Castelao JE, Yuan JM, Ross RK, Yu MC (November 1999). "Increased risk of renal cell carcinoma subsequent to hysterectomy".

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Blank SV (February 2011). "Prophylactic and risk-reducing bilateral salpingo-oophorectomy: recommendations based on risk of ovarian cancer".

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due to intestinal adhesion was found to be 15.6% in non-laparoscopic total abdominal hysterectomies vs. 0.0% in laparoscopic hysterectomies.

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Lethaby A, Mukhopadhyay A, Naik R (April 2012). Lethaby A (ed.). "Total versus subtotal hysterectomy for benign gynaecological conditions".

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attachments using long thin instruments through the "ports". Then all tissue to be removed is passed through the small abdominal incisions.

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The "laparoscopic-assisted supracervical hysterectomy" (LASH) was later developed to remove the uterus without removing the cervix using a

692: 134:. Supracervical hysterectomy refers to removal of the uterus while the cervix is spared. These procedures may also involve removal of the 4356:"Feasibility of myomatous tissue extraction in laparoscopic surgery by contained in - bag morcellation: A retrospective single arm study" 2967:

Altman D, Falconer C, Cnattingius S, Granath F (May 2008). "Pelvic organ prolapse surgery following hysterectomy on benign indications".

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are highly effective in limiting menstrual blood flow and improving other symptoms. Side effects are typically very moderate because the

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Wiseman DM (July 2008). "Disorders of adhesions or adhesion-related disorder: monolithic entities or part of something bigger--CAPPS?".

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There was no difference in the rates of incontinence, constipation, measures of sexual function, or alleviation of pre-surgery symptoms.

518:, but only an incisional abscess confers purulent drainage. The recommended treatment of an incisional abscess after hysterectomy is by 5735:

Gimbel H, Settnes A, Tabor A (March 2001). "Hysterectomy on benign indication in Denmark 1988-1998. A register based trend analysis".

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even women who have already entered menopause were shown to have experienced a decrease in long-term survivability post-oophorectomy.

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Ridgeway BM, Buechel M, Nutter B, Falcone T (December 2015). "Minimally Invasive Hysterectomy: An Analysis of Different Techniques".

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Milsom I (June 2007). "The levonorgestrel-releasing intrauterine system as an alternative to hysterectomy in peri-menopausal women".

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In the UK, 1 in 5 women is likely to have a hysterectomy by the age of 60, and ovaries are removed in about 20% of hysterectomies.

4967:"Safety Communications – UPDATED Laparoscopic Uterine Power Morcellation in Hysterectomy and Myomectomy: FDA Safety Communication" 5905: 46: 1963:

Shoupe D, Parker WH, Broder MS, Liu Z, Farquhar C, Berek JS (2007). "Elective oophorectomy for benign gynecological disorders".

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Removal of one or both ovaries is performed in a substantial number of hysterectomies that were intended to be ovary sparing.

5571: 5283:"Hysterectomy in very obese and morbidly obese patients: a systematic review with cumulative analysis of comparative studies" 3963: 3944: 3911: 3896: 1432:

Bahamondes L, Bahamondes MV, Monteiro I (July 2008). "Levonorgestrel-releasing intrauterine system: uses and controversies".

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Hysterectomy by abdominal laparotomy is correlated with much higher incidence of intestinal adhesions than other techniques.

4917:"Parasitic myomas after laparoscopic surgery: an emerging complication in the use of morcellator? Description of four cases" 350:

The mortality rate is several times higher when performed in patients who are pregnant, have cancer or other complications.

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Lethaby A, Mukhopadhyay A, Naik R (April 2012). "Total versus subtotal hysterectomy for benign gynaecological conditions".

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Sheth SS, Paghdiwalla KP, Hajari AR (April 2011). "Vaginal route: a gynaecological route for much more than hysterectomy".

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Quiróz-Guadarrama CD, Martínez-Ordaz JL, Rojano-Rodríguez ME, Beristain-Hernández JL, Moreno-Portillo M (June 2013). "".

736:. Indicated for cancer. Lymph nodes, ovaries, and fallopian tubes are also usually removed in this situation, such as in 364:

or as a ureter crosses below the uterine artery, often from blind clamping and ligature placement to control hemorrhage.

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growth of the uterine lining outside the uterine cavity. This inappropriate tissue growth can lead to pain and bleeding.

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since the cervix itself is left intact and may be contraindicated in women with increased risk of this cancer; regular

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and other psychic and physical conditions caused by menstrual period and causing suffering and diminishing life quality

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King CR, Giles D (September 2016). "Total Laparoscopic Hysterectomy and Laparoscopic-Assisted Vaginal Hysterectomy".

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van der Voort DJ, Geusens PP, Dinant GJ (2001). "Risk factors for osteoporosis related to their outcome: fractures".

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Jäger C, Sauer G, Kreienberg R (2007). "Die laparoskopisch assistierte vaginale Hysterektomie – Sinn oder Unsinn?".

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Wingo PA, Huezo CM, Rubin GL, Ory HW, Peterson HB (August 1985). "The mortality risk associated with hysterectomy".

668:". A myomectomy may be performed through an open incision, laparoscopically, or through the vagina (hysteroscopy). 17: 3531: 2795:

Brown JS, Sawaya G, Thom DH, Grady D (August 2000). "Hysterectomy and urinary incontinence: a systematic review".

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which cuts the uterus into small pieces that can be removed from the abdominal cavity via the laparoscopic ports.

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Removal of the uterus without removing the ovaries can produce a situation that on rare occasions can result in

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Oophorectomy before the age of 45 is associated with a fivefold mortality from neurologic and mental disorders.

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No evidence that this technique improves sexual function or reduces operative risk of urinary or bowel damage

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research is necessary to determine if robotic assisted hysterectomies are beneficial for people with cancer.

989: 1409:"Plotting the downward trend in traditional hysterectomy | Institute for Healthcare Policy & Innovation" 6350: 5657:

Mettler L, Ahmed-Ebbiary N, Schollmeyer T (2005). "Laparoscopic hysterectomy: challenges and limitations".

4966: 4481:"A Novel Approach to Total Laparoscopic Hysterectomy Using Only Two 5mm Ports: Initial Clinical Experience" 4029: 1904: 2703:

Segraves R, Woodard T (May 2006). "Female hypoactive sexual desire disorder: History and current status".

6309: 6039: 2170:"Hysterectomy, oophorectomy, and endogenous sex hormone levels in older women: the Rancho Bernardo Study" 789:

There was no difference in the rates of other complications, recovery from surgery, or readmission rates.

672: 503: 390: 284:, prevention of future gynecologic problems, and transition to obtaining new legal gender documentation. 6360: 5922: 4709:"Laparoscopic Hysterectomy and Health Care in America – Finding the Balance Between Costs and Outcomes" 740: 361: 289: 5155:"Total laparoscopic hysterectomy versus da Vinci robotic hysterectomy: is using the robot beneficial?" 6276: 5509: 3722:

Greer WJ, Richter HE, Wheeler TL, Varner RE, Szychowski JM, Kuppermann M, Learman LA (January 2010).

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Gunter J (September 2003). "Chronic pelvic pain: an integrated approach to diagnosis and treatment".

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Cervical stump (white) after removal of the uterine corpus at laparoscopic supracervical hysterectomy

941: 175: 3553:"Uterine artery embolization for treatment of symptomatic fibroids; a single institution experience" 3234:

Zucchetto A, Talamini R, Dal Maso L, Negri E, Polesel J, Ramazzotti V, et al. (November 2008).

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A Gynecologist's Second Opinion: The Questions & Answers You Need to Take Charge of Your Health

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advocacy groups like Hysterectomy Educational Resources and Services (HERS) Foundation, founded by

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laparoscopic (all variants) 82.5 minutes average, range 10–325 (combined data from both trial arms)

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Devassy R, Cezar C, Krentel H, Verhoeven HC, Devassy R, de Wilde MS, et al. (February 2019).

3325: 2008:"What We Know about the Long-Term Risks of Hysterectomy for Benign Indication-A Systematic Review" 6286: 6253: 2748:"Increased mortality for neurological and mental diseases following early bilateral oophorectomy" 2358:

Maas CP, Weijenborg PT, ter Kuile MM (2003). "The effect of hysterectomy on sexual functioning".

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McPherson K, Metcalfe MA, Herbert A, Maresh M, Casbard A, Hargreaves J, et al. (July 2004).

708:", vaginal pessary, constipation relief, weight management, and care when lifting heavy objects. 487: 878:

the indication is cancer, when complications are expected, or surgical exploration is required.

6044: 5114:"Robotically assisted vs laparoscopic hysterectomy among women with benign gynecologic disease" 3011: 768: 4180:"Methods of hysterectomy: systematic review and meta-analysis of randomised controlled trials" 1692:

Roopnarinesingh R, Fay L, McKenna P (May 2003). "A 27-year review of obstetric hysterectomy".

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Menorrhagia (heavy or abnormal menstrual bleeding) may also be treated with the less invasive

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Approximately 35% of women after hysterectomy undergo another related surgery within 2 years.

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Pickett CM, Seeratan DD, Mol BW, Nieboer TE, Johnson N, Bonestroo T, Aarts JW (August 2023).

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Cocks PS (May 1980). "Early ectopic pregnancy after vaginal hysterectomy. Two case reports".

845: 519: 163: 250:: especially if there is a strong family history of reproductive system cancers (especially 6340: 6100: 4869: 3481: 2924:

Lukanovic A, Drazic K (July 2010). "Risk factors for vaginal prolapse after hysterectomy".

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Unclear if subtotal approach leads to a reduction in pelvic organ prolapse in the long-term

632: 563: 394: 3236:"Reproductive, menstrual, and other hormone-related factors and risk of renal cell cancer" 2141: 8: 6151: 6034: 5952: 5748: 5112:

Wright JD, Ananth CV, Lewin SN, Burke WM, Lu YS, Neugut AI, et al. (February 2013).

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Aarts JW, Nieboer TE, Johnson N, Tavender E, Garry R, Mol BW, Kluivers KB (August 2015).

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No significant clinical improvements compared with conventional laparoscopic hysterectomy

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Stovall TG, Summitt RL (August 1996). "Laparoscopic hysterectomy--is there a benefit?".

4253: 4228: 3614: 3593: 3508: 3409: 2394:"Hysterectomy improves sexual response? Addressing a crucial omission in the literature" 2266:

Bofill Rodriguez M, Lethaby A, Grigore M, Brown J, Hickey M, Farquhar C (January 2019).

337:, in order to prevent problems caused by uterus and uselessness of reproductive function 154:. Removal of the uterus renders the patient unable to bear children (as does removal of 6226: 6168: 6123: 6095: 5717: 5682: 5634: 5609: 5493: 5307: 5282: 5227: 5179: 5154: 5086: 5061: 5032: 5007: 4892: 4857: 4856:

Seidman MA, Oduyebo T, Muto MG, Crum CP, Nucci MR, Quade BJ (2012). Sullivan DJ (ed.).

4838: 4650: 4615: 4456: 4439: 4385: 4331: 4306: 4076: 4051: 3832: 3807: 3748: 3723: 3656: 3569: 3552: 3457: 3432: 3378: 3308: 3296: 3265: 3083: 3037: 2949: 2906: 2863: 2820: 2772: 2747: 2728: 2685: 2642: 2512: 2485: 2466: 2454: 2418: 2393: 2340: 2292: 2267: 2248: 2199: 2083: 2058: 2034: 2007: 1988: 1880: 1855: 1801: 1717: 1615: 1590: 1526: 1501: 1475: 1457: 1318: 805: 527: 507: 4789: 4764: 4416: 4204: 4179: 3366: 2851: 2808: 1832: 6248: 6163: 6072: 5752: 5721: 5674: 5639: 5567: 5444: 5406: 5362: 5312: 5263: 5219: 5184: 5135: 5091: 5037: 4948: 4933: 4916: 4897: 4858:"Peritoneal dissemination complicating morcellation of uterine mesenchymal neoplasms" 4830: 4794: 4742: 4690: 4655: 4461: 4420: 4377: 4336: 4258: 4209: 4157: 4119: 4081: 3997: 3939: 3878: 3837: 3788: 3753: 3619: 3574: 3512: 3462: 3433:"Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding" 3413: 3370: 3335: 3300: 3257: 3216: 3189: 3146: 3123: 3075: 3041: 3029: 2984: 2941: 2898: 2855: 2812: 2777: 2720: 2716: 2677: 2634: 2599: 2558: 2517: 2458: 2423: 2367: 2332: 2297: 2240: 2235: 2218: 2191: 2088: 2039: 1980: 1945: 1885: 1836: 1793: 1788: 1771: 1752: 1709: 1638: 1620: 1531: 1449: 857: 681: 574: 308: 246: 167: 73: 57: 5686: 5231: 4842: 4763:

Garry R, Fountain J, Mason S, Hawe J, Napp V, Abbott J, et al. (January 2004).

4389: 4102:

Thomas B, Magos A (April 2011). "Subtotal hysterectomy and myomectomy - vaginally".

3382: 3312: 3269: 3087: 2953: 2910: 2867: 2732: 2689: 2470: 2344: 2252: 1992: 1805: 1735:

Lamvu G (May 2011). "Role of hysterectomy in the treatment of chronic pelvic pain".

1721: 664:

Uterine fibroids may be removed and the uterus reconstructed in a procedure called "

5744: 5709: 5666: 5629: 5621: 5440: 5436: 5398: 5354: 5302: 5294: 5255: 5211: 5174: 5166: 5125: 5081: 5077: 5073: 5027: 5023: 5019: 4938: 4928: 4887: 4877: 4822: 4784: 4776: 4682: 4645: 4635: 4631: 4627: 4525: 4492: 4451: 4412: 4367: 4326: 4318: 4248: 4244: 4240: 4199: 4191: 4149: 4111: 4071: 4063: 3959: 3940: 3868: 3827: 3819: 3784: 3780: 3743: 3735: 3609: 3605: 3601: 3564: 3504: 3452: 3448: 3444: 3405: 3362: 3292: 3247: 3184: 3179: 3167: 3115: 3067: 3021: 2976: 2933: 2890: 2847: 2804: 2767: 2759: 2712: 2669: 2646: 2626: 2589: 2548: 2507: 2497: 2450: 2413: 2405: 2324: 2287: 2283: 2279: 2230: 2203: 2181: 2078: 2070: 2029: 2019: 1972: 1937: 1875: 1867: 1828: 1783: 1744: 1701: 1610: 1602: 1521: 1513: 1441: 645: 543: 461: 304: 281: 236: 5819: 5281:

Blikkendaal MD, Schepers EM, van Zwet EW, Twijnstra AR, Jansen FW (October 2015).

4545: 4153: 4115: 2824: 2537:"Hysterectomy and risk of cardiovascular disease: a population-based cohort study" 2168:

Laughlin GA, Barrett-Connor E, Kritz-Silverstein D, von Mühlen D (February 2000).

1461: 1127:

Less pain medication and lower hospital costs compared with laparoscopic technique

1035:

Time required for completion of surgery in the eVAL trial is reported as follows:

103: 6301: 5920: 5867: 5831: 5794: 5514: 5215: 4882: 3739: 2389: 2385: 2167: 1976: 1941: 1913: 1909: 1748: 1606: 1314: 797: 677: 551: 547: 498: 400:

A substantial number of women develop benign ovarian cysts after a hysterectomy.

227: 179: 89: 4780: 4686: 1705: 1573: 1220:

Associated with a high quality of life in the long term, compared with abdominal

393:. Surprisingly, a similar and only slightly weaker effect has been observed for 170:, in the United States. Nearly 68 percent were performed for conditions such as 6291: 6056: 5990: 5980: 5962: 5402: 5259: 5153:

Soto E, Lo Y, Friedman K, Soto C, Nezhat F, Chuang L, Gretz H (December 2011).

4530: 4513: 4497: 4480: 4372: 4355: 4322: 4067: 3989: 2980: 2937: 2553: 2536: 2409: 1667: 1331: 1245:

Improved cosmetic outcomes compared with conventional laparoscopic hysterectomy

1014:, will influence a surgeon's surgical approach when performing a hysterectomy. 866: 705: 654: 159: 143: 5670: 5625: 5358: 5298: 5170: 4826: 4195: 3823: 3071: 2894: 2328: 1517: 6329: 6243: 6216: 5975: 5789: 5608:

Müller A, Thiel FC, Renner SP, Winkler M, Häberle L, Beckmann MW (May 2010).

3806:

Müller A, Thiel FC, Renner SP, Winkler M, Häberle L, Beckmann MW (May 2010).

3127: 2502: 2074: 1671: 1661: 1445: 1007: 617: 434: 255: 251: 204: 171: 147: 3724:"Long-Term Outcomes of the Total or Supracervical Hysterectomy (TOSH) Trial" 2673: 2268:"Endometrial resection and ablation techniques for heavy menstrual bleeding" 6238: 6178: 6067: 6019: 5970: 5947: 5756: 5678: 5643: 5448: 5410: 5366: 5316: 5267: 5223: 5188: 5139: 5095: 5041: 4952: 4901: 4834: 4798: 4746: 4659: 4465: 4381: 4340: 4262: 4213: 4161: 4123: 4085: 4001: 3882: 3841: 3792: 3757: 3623: 3578: 3516: 3466: 3417: 3374: 3339: 3261: 3220: 3193: 3079: 3033: 3025: 2988: 2945: 2902: 2859: 2816: 2781: 2724: 2638: 2603: 2562: 2521: 2462: 2427: 2371: 2336: 2301: 2244: 2219:"The association of hysterectomy and menopause: a prospective cohort study" 2195: 2186: 2169: 2092: 2043: 1984: 1949: 1889: 1871: 1797: 1756: 1713: 1624: 1535: 1453: 1049: 1011: 897: 887: 753: 650: 582: 446: 442: 430: 268: 139: 5713: 5130: 5113: 4694: 4424: 3304: 2681: 2630: 2576:

Kelsey JL, Prill MM, Keegan TH, Quesenberry CP, Sidney S (November 2005).

1840: 1664:"Growth Attenuation and Sterilization Procedures – "The Ashley Treatment"" 1578:. Institute for Quality and Efficiency in Health Care (IQWiG). 2017-11-16. 1069:

Summary—Advantages and disadvantages of different hysterectomy techniques

983:

Transvaginal extraction of the uterus in total laparoscopical hysterectomy

6281: 6206: 6084: 6029: 5814: 4915:

Cucinella G, Granese R, Calagna G, Somigliana E, Perino A (August 2011).

4178:

Johnson N, Barlow D, Lethaby A, Tavender E, Curr L, Garry R (June 2005).

3873: 3856: 2594: 2577: 909: 892: 841: 733: 716: 625: 410: 320: 275: 213: 151: 97: 64: 31: 5060:

Lawrie TA, Liu H, Lu D, Dowswell T, Song H, Wang L, Shi G (April 2019).

5006:

Lawrie TA, Liu H, Lu D, Dowswell T, Song H, Wang L, Shi G (April 2019).

4440:"Laparoscopic supracervical hysterectomy compared to total hysterectomy" 3638: 3119: 2024: 796:

Supracervical hysterectomy does not eliminate the possibility of having

376: 6271: 6233: 6221: 6211: 6146: 6112: 4943: 4640: 3353:

Jelovsek JE, Maher C, Barber MD (March 2007). "Pelvic organ prolapse".

1856:"Prophylactic oophorectomy in premenopausal women and long-term health" 1240:

Single-port laparoscopic hysterectomy / mini laparoscopic hysterectomy

849: 837: 665: 531: 511: 299: 5854: 5825:

Oncolex.org features live footage videos showing radical hysterctomies

3537: 3252: 3235: 3166:

Altman D, Yin L, Johansson A, Lundholm C, Grönberg H (December 2010).

2763: 449:

levels in women are associated with a greater sense of sexual desire.

307:(a placenta that has either formed over or inside the birth canal) or 113: 5873: 4616:"Surgical approach to hysterectomy for benign gynaecological disease" 4405:

The Journal of the American Association of Gynecologic Laparoscopists

4229:"Surgical approach to hysterectomy for benign gynaecological disease" 3895: 3855:

Thakar R, Ayers S, Clarkson P, Stanton S, Manyonda I (October 2002).

3639:"Having Prolapse, Cystocele and Rectocele Fixed Without Hysterectomy" 2111: 1106:

May have a higher risk of bleeding compared with laparoscopic surgery

861: 801: 691:

Uterine fibroids can be removed with a non-invasive procedure called

658: 385: 325:

should try to obtain pain etiology, although may have no known cause.

5280: 1193:

Malignancies can only be removed by this approach if they are intact

1109:

Vaginal or Laparoscopic technique preferred for people who are obese

609:

Depending on the indication there are alternatives to hysterectomy:

6172: 5836: 5466: 4142:

Best Practice & Research. Clinical Obstetrics & Gynaecology

4104:

Best Practice & Research. Clinical Obstetrics & Gynaecology

2265: 1165:

Women must have regular cervical cancer screening following surgery

903: 601: 515: 373:

for the first 6 weeks (including inserting tampons or having sex).

5878: 4735:

Journal de Gynécologie, Obstétrique et Biologie de la Reproduction

4514:"Dual Port Hysterectomy: A Novel Technique and Initial Experience" 3536:(revised ed.). Plume. pp. 89–92, 105–150. Archived from 1211:

Allows the possibility to diagnose and treat other pelvic diseases

593: 6183: 4914: 2314: 1854:

Shuster LT, Gostout BS, Grossardt BR, Rocca WA (September 2008).

1371: 1358: 1277:

Similar complication rate compared with conventional laparoscopic

1217:

Less bleeding, fevers, infections compared with abdominal surgery

685: 155: 3430: 2966: 2837: 2534: 2005: 1502:"Endometriosis: Epidemiology, Diagnosis and Clinical Management" 1180:

Possible with a larger uterus, depending on the surgeon's skills

1147:

Laparoscopic supracervical hysterectomy (subtotal hysterectomy)

1096:

No increase in post-surgical complications compared with vaginal

562:

Hysterectomy may cause an increased risk of the relatively rare

6198: 6135: 6000: 5985: 5808: 5656: 5501: 4437: 4403:

Ahluwalia PK (August 1996). "Total Laparoscopic Hysterectomy".

3551:

Laios A, Baharuddin N, Iliou K, Gubara E, O'Sullivan G (2014).

1902: 1305: 853: 809: 263: 190: 131: 127: 3594:"Uterine artery embolization for symptomatic uterine fibroids" 3233: 3206: 2535:

Ingelsson E, Lundholm C, Johansson AL, Altman D (March 2011).

1769: 1589:

Temkin SM, Bergstrom J, Samimi G, Minasian L (December 2017).

6263: 5939: 3857:"Outcomes after total versus subtotal abdominal hysterectomy" 3482:"5 operations you don't want to get – and what to do instead" 3431:

Bofill Rodriguez M, Lethaby A, Fergusson RJ (February 2021).

2659: 2006:

Madueke-Laveaux OS, Elsharoud A, Al-Hendy A (November 2021).

1588: 881: 752:: complete removal of the uterus and cervix, with or without 523: 397:

which is often considered as an alternative to hysterectomy.

135: 5201: 4353: 4177: 4052:"The transverse-vertical incision (Alazzam hybrid incision)" 3494: 3057: 2575: 1853: 1431: 1168:

Possibility of cyclical bleeding following subtotal approach

1093:

Combination with reduction and incontinence surgery possible

852:, as close to the upper hair line of the individual's lower 732:: complete removal of the uterus, cervix, upper vagina, and 455: 4613: 2880: 2216: 1214:

Quicker return to normal activities compared with abdominal

1140:

Limited ability to evaluate the fallopian tubes and ovaries

535: 472: 51:

Diagram showing what is removed with a radical hysterectomy

4478: 3854: 3550: 3165: 2745: 2616: 2217:

Farquhar CM, Sadler L, Harvey SA, Stewart AW (July 2005).

1208:

Short inpatient treatment duration compared with abdominal

4226: 3721: 3592:

Gupta JK, Sinha A, Lumsden MA, Hickey M (December 2014).

1691: 676:(UAE) is a minimally invasive procedure for treatment of 403: 5607: 5388: 5244: 4811: 3805: 5426: 3770: 3591: 2384: 2357: 1772:"Severe complications of hysterectomy: the VALUE study" 1103:

Longest recovery period and return to normal activities

506:. Such wound infections mainly take the form of either 5111: 4855: 4762: 4438:

Cipullo L, De Paoli S, Fasolino L, Fasolino A (2009).

4307:"Vaginal cuff dehiscence: risk factors and management" 4139: 1670:: National Disabilities Rights Network. Archived from 1230:

Requires a high degree of laparoscopic surgical skills

1137:

Limited by the size of the uterus and previous surgery

848:

is made through the abdominal wall, usually above the

836:

Most hysterectomies in the United States are done via

416: 5384: 5382: 5380: 5378: 5376: 4479:

Lii SJ, Becker SF, Danilyants NE, MacKoul PJ (2010).

3956:

Choosing Wisely: An Initiative of the ABIM Foundation

3908:

Choosing Wisely: An Initiative of the ABIM Foundation

3901:"Five Things Physicians and Patients Should Question" 3108:"Diagnosis and Management of Postoperative Infection" 2746:

Rivera CM, Grossardt BR, Rhodes DJ, Rocca WA (2009).

1962: 1905:"Five Things Physicians and Patients Should Question" 1196:

Not suggested for people with cardiopulmonary disease

377:

Unintended oophorectomy and premature ovarian failure

5844: 5699: 5659:

Minimally Invasive Therapy & Allied Technologies

4049: 4022:"Hysterectomy: Then and Now - Oxford Women's Health" 2794: 2174:

The Journal of Clinical Endocrinology and Metabolism

762:: removal of the uterus, leaving the cervix in situ. 5059: 5005: 4546:"Robotic surgery: MedlinePlus Medical Encyclopedia" 3728:

Female Pelvic Medicine & Reconstructive Surgery

3352: 2926:

International Journal of Gynaecology and Obstetrics

2578:"Risk factors for pelvis fracture in older persons" 1662:Washington (state) Protection and Advocacy System. 5734: 5373: 5347:Obstetrics and Gynecology Clinics of North America 5152: 4304: 3949:"Pap tests: When you need them—and when you don't" 2610: 1818: 1233:May have a higher risk of bladder or ureter injury 1183:Combination with reduction operations are possible 1175:Laparoscopic-assisted vaginal hysterectomy (LAVH) 915: 389:in about 40% of people, some of them even require 5769:: CS1 maint: DOI inactive as of September 2024 ( 5587:Wolfrum C (1 June 2008). "Vorschnelle Schnitte". 5536:"Hysterectomy Procedures Pacing A Downward Trend" 4805: 3987: 3168:"Risk of renal cell carcinoma after hysterectomy" 3053: 3051: 1499: 1124:Short recovery period and discharge from hospital 433:(decrease in bone density) and increased risk of 6327: 3209:Cancer Epidemiology, Biomarkers & Prevention 2163: 2161: 1403: 1401: 1399: 904:Laparoscopic-assisted supracervical hysterectomy 856:as possible, similar to the incision made for a 5693: 5422: 5420: 5238: 4908: 3996:. Treasure Island (FL): StatPearls Publishing. 2923: 2702: 1903:American Urogynecologic Society (May 5, 2015), 568:hereditary leiomyomatosis and renal cell cancer 5107: 5105: 4672: 4511: 4097: 4095: 3048: 2874: 2378: 2116: 1763: 1591:"Ovarian Cancer Prevention in High-risk Women" 1425: 1317:and rural women had hysterectomies mostly for 579:Blackwell Journal of Obstetrics and Gynecology 5906: 5737:Acta Obstetricia et Gynecologica Scandinavica 5728: 5650: 5601: 5580: 5559: 5248:American Journal of Obstetrics and Gynecology 4758: 4756: 4609: 4607: 4605: 4603: 4601: 4599: 4597: 4595: 4593: 4591: 4589: 4587: 4585: 4583: 4581: 4579: 4311:American Journal of Obstetrics and Gynecology 4305:Cronin B, Sung VW, Matteson KA (April 2012). 3712:. 2008. Encyclopedia.com. (October 13, 2010). 3706:encyclopedia.com > Wertheim's hysterectomy 3285:British Journal of Obstetrics and Gynaecology 3145:. New York: McGraw-Hill Medical. p. 65. 2969:American Journal of Obstetrics and Gynecology 2696: 2528: 2210: 2158: 2056: 1821:American Journal of Obstetrics and Gynecology 1396: 840:(abdominal incision, not to be confused with 628:and should be considered before any surgery. 5417: 4849: 4577: 4575: 4573: 4571: 4569: 4567: 4565: 4563: 4561: 4559: 4135: 4133: 4050:Alazzam M, Khalifa MA, Al-Ani A (May 2022). 3529: 2483: 1847: 1655: 1039:abdominal 55.2 minutes average, range 19–155 693:Magnetic Resonance guided Focused Ultrasound 341: 258:), or as part of recovery from such cancers. 5429:The Cochrane Database of Systematic Reviews 5340: 5338: 5336: 5334: 5332: 5330: 5328: 5326: 5102: 5066:The Cochrane Database of Systematic Reviews 5012:The Cochrane Database of Systematic Reviews 4732: 4620:The Cochrane Database of Systematic Reviews 4233:The Cochrane Database of Systematic Reviews 4101: 4092: 3933: 3773:The Cochrane Database of Systematic Reviews 3598:The Cochrane Database of Systematic Reviews 3488: 3437:The Cochrane Database of Systematic Reviews 3389: 3159: 3134: 3101: 3099: 3097: 2960: 2831: 2653: 2569: 2272:The Cochrane Database of Systematic Reviews 1956: 1500:Parasar P, Ozcan P, Terry KL (March 2017). 1000: 5913: 5899: 4971:Center for Devices and Radiological Health 4753: 2788: 2059:"Management of iatrogenic ureteral injury" 1685: 1042:vaginal 46.6 minutes average, range 14–168 882:Laparoscopic-assisted vaginal hysterectomy 720:Schematic drawing of types of hysterectomy 45: 6336:Gender-affirming surgery (female-to-male) 5633: 5610:"Hysterectomy-a comparison of approaches" 5344: 5306: 5178: 5129: 5085: 5031: 4942: 4932: 4891: 4881: 4788: 4649: 4639: 4556: 4529: 4496: 4455: 4402: 4371: 4330: 4277:"Surgery - Foundation for Women's Cancer" 4252: 4203: 4130: 4075: 3872: 3831: 3808:"Hysterectomy-a comparison of approaches" 3747: 3613: 3568: 3456: 3251: 3183: 3015: 2771: 2593: 2552: 2511: 2501: 2417: 2351: 2291: 2234: 2185: 2082: 2050: 2033: 2023: 1879: 1787: 1614: 1525: 1506:Current Obstetrics and Gynecology Reports 831: 775:, which reported the following findings: 456:Urinary incontinence and vaginal prolapse 5798:) is being considered for deletion. See 5489:"Rate of Hysterectomies Puzzles Experts" 5391:Journal of Minimally Invasive Gynecology 5323: 4518:Journal of Minimally Invasive Gynecology 4485:Journal of Minimally Invasive Gynecology 3889: 3094: 2398:Journal of Minimally Invasive Gynecology 715: 600: 592: 473:Adhesion formation and bowel obstruction 189: 5586: 5507: 5062:"Robot-assisted surgery in gynaecology" 5008:"Robot-assisted surgery in gynaecology" 3140: 3001: 2995: 1896: 1090:No limitation by the size of the uterus 872: 538:. The wound can be allowed to close by 522:, and then coverage by a thin layer of 14: 6328: 5486: 4701: 3479: 3395: 3112:The Global Library of Women's Medicine 2443:Obstetrical & Gynecological Survey 2440: 557: 429:Several other studies have found that 404:Effects on sexual life and pelvic pain 5894: 5287:Archives of Gynecology and Obstetrics 5055: 5053: 5051: 5001: 4999: 4997: 4995: 4993: 4991: 4989: 4987: 4815:Archives of Gynecology and Obstetrics 4173: 4171: 3945:American Academy of Family Physicians 3912:American Academy of Family Physicians 3897:American Academy of Family Physicians 3282: 2883:Journal of Obstetrics and Gynaecology 1927: 1734: 1694:Journal of Obstetrics and Gynaecology 1339:National Center for Health Statistics 605:Sutured uterus wound after myomectomy 5749:10.1080/j.1600-0412.2001.080003267.x 5463:"Hysterectomy rates falling: report" 3636: 3105: 2662:Journal of Bone and Mineral Research 1267:May result in shorter hospital stays 995:End of a laparoscopical hysterectomy 620:are highly effective at controlling 303:: to remove either a severe case of 5921:Tests and procedures involving the 5566:. Taylor & Francis. p. 3. 4973:. U.S. Food and Drug Administration 4675:The New England Journal of Medicine 3861:The New England Journal of Medicine 3708:Citing: "Wertheim's hysterectomy". 3509:10.1016/j.contraception.2010.02.011 3410:10.1016/j.contraception.2007.01.003 3328:Ginecologia y Obstetricia de Mexico 3276: 3060:Journal of Gastrointestinal Surgery 2057:Burks FN, Santucci RA (June 2014). 924: 698: 651:Levonorgestrel intrauterine devices 639: 618:Levonorgestrel intrauterine devices 417:Premature menopause and its effects 24: 5840:, "FTM Gender Reassignment Surgery 5614:Deutsches Ärzteblatt International 5204:Clinical Obstetrics and Gynecology 5048: 4984: 4472: 4168: 3812:Deutsches Ärzteblatt International 3297:10.1111/j.1471-0528.1980.tb04559.x 2455:10.1097/01.OGX.0000083225.90017.01 1595:Clinical Obstetrics and Gynecology 1158:Faster return to normal activities 846:transverse (Pfannenstiel) incision 493: 25: 6377: 5802:to help reach a consensus. › 5781: 3988:Pillarisetty LS, Mahdy H (2022). 3004:Seminars in Reproductive Medicine 2484:Dalal PK, Agarwal M (July 2015). 2317:Journal of Ultrasound in Medicine 1917:, American Urogynecologic Society 1639:"Hysterectomy | Transgender Care" 1344: 1190:Higher cost than vaginal approach 612: 5702:Geburtshilfe und Frauenheilkunde 5553: 5528: 5510:"Are Hysterectomies Too Common?" 5480: 5455: 4934:10.1016/j.fertnstert.2011.05.095 4733:Debodinance P (April 2001). "". 4360:International Journal of Surgery 4056:Langenbeck's Archives of Surgery 3143:Williams gynecology, 2nd edition 2717:10.1111/j.1743-6109.2006.00246.x 2582:American Journal of Epidemiology 2236:10.1111/j.1471-0528.2005.00696.x 1789:10.1111/j.1471-0528.2004.00174.x 1434:Expert Review of Medical Devices 1357:The number of hysterectomies in 1324: 1203:Total laparoscopic hysterectomy 1018:recovery times and fewer costs. 988: 976: 964: 952: 940: 164:gynecological surgical procedure 5274: 5195: 5159:Journal of Gynecologic Oncology 5146: 4959: 4726: 4715:from the original on 2010-07-17 4666: 4538: 4505: 4431: 4396: 4347: 4298: 4269: 4220: 4043: 4014: 3981: 3848: 3799: 3764: 3715: 3699: 3674: 3649: 3630: 3585: 3544: 3523: 3473: 3424: 3346: 3319: 3240:International Journal of Cancer 3227: 3200: 2917: 2739: 2477: 2434: 2308: 2259: 2134: 2099: 2063:Therapeutic Advances in Urology 1999: 1812: 1728: 916:Total laparoscopic hysterectomy 773:benign gynecological conditions 588: 477:The formation of postoperative 185: 126:is the surgical removal of the 5441:10.1002/14651858.CD004993.pub3 5078:10.1002/14651858.CD011422.pub2 5024:10.1002/14651858.CD011422.pub2 4632:10.1002/14651858.CD003677.pub5 4512:Moawad G, Robinson JK (2012). 4245:10.1002/14651858.CD003677.pub6 3785:10.1002/14651858.CD004993.pub3 3606:10.1002/14651858.CD005073.pub4 3449:10.1002/14651858.CD000329.pub4 3185:10.1001/archinternmed.2010.425 2705:The Journal of Sexual Medicine 2284:10.1002/14651858.CD001501.pub5 1631: 1582: 1566: 1542: 1493: 1468: 1262:Robotic-assisted hysterectomy 622:dysfunctional uterine bleeding 413:(painful sexual intercourse). 27:Surgical removal of the uterus 13: 1: 5787: 4417:10.1016/S1074-3804(96)80129-0 4281:Foundation for Women's Cancer 4154:10.1016/j.bpobgyn.2010.12.005 4116:10.1016/j.bpobgyn.2010.11.003 3530:Parker WH, Parker RL (2002). 3367:10.1016/s0140-6736(07)60462-0 3172:Archives of Internal Medicine 2852:10.1016/S0140-6736(07)61635-3 2809:10.1016/S0140-6736(00)02577-0 2360:Annual Review of Sex Research 1833:10.1016/s0002-9378(85)80067-3 1389: 5560:Khastgir G, Studd J (1998). 5216:10.1097/GRF.0000000000000149 4883:10.1371/journal.pone.0050058 4026:www.oxfordwomenshealth.co.nz 3740:10.1097/SPV.0b013e3181cec343 2490:Indian Journal of Psychiatry 2012:Journal of Clinical Medicine 1977:10.1097/gme.0b013e31803c56a4 1942:10.1097/AOG.0b013e3182083189 1749:10.1097/AOG.0b013e31821646e1 1607:10.1097/GRF.0000000000000318 1294: 947:Uterus prior to hysterectomy 815: 636:lining or uterine fibroids. 7: 6366:Surgical removal procedures 6310:Gynecologic ultrasonography 6040:Uterine artery embolization 5838:Hudson's FTM Resource Guide 5487:Kolata, Gina (1988-09-20). 4781:10.1136/bmj.37984.623889.F6 4687:10.1056/NEJM199608153350712 1706:10.1080/0144361031000098352 1377: 1227:Increased length of surgery 959:Laparoscopical hysterectomy 673:Uterine artery embolization 504:pelvic inflammatory disease 391:hormone replacement therapy 367: 10: 6382: 5923:female reproductive system 5403:10.1016/j.jmig.2013.01.009 5260:10.1016/j.ajog.2012.06.050 4531:10.1016/j.jmig.2012.08.620 4498:10.1016/j.jmig.2010.08.381 4373:10.1016/j.ijsu.2018.12.013 4323:10.1016/j.ajog.2011.08.026 4068:10.1007/s00423-021-02404-5 3480:Pesmen C (July 27, 2007). 2981:10.1016/j.ajog.2008.01.012 2938:10.1016/j.ijgo.2010.01.025 2619:Osteoporosis International 2410:10.1016/j.jmig.2011.01.012 1575:Uterine fibroids: Overview 1365: 1352: 1260: 1238: 1201: 1173: 1145: 1114: 1083: 643: 362:infundibulopelvic ligament 290:developmental disabilities 29: 6300: 6277:Female genital mutilation 6262: 6197: 6132: 6109: 6081: 6053: 6008: 5999: 5961: 5938: 5929: 5848: 5671:10.1080/13645700510034010 5626:10.3238/arztebl.2010.0353 5359:10.1016/j.ogc.2016.04.005 5299:10.1007/s00404-015-3680-7 5171:10.3802/jgo.2011.22.4.253 4827:10.1007/s00404-014-3347-9 4196:10.1136/bmj.330.7506.1478 3824:10.3238/arztebl.2010.0353 3072:10.1007/s11605-010-1189-8 2895:10.1080/01443610500235170 2486:"Postmenopausal syndrome" 2329:10.7863/jum.2005.24.2.169 1930:Obstetrics and Gynecology 1737:Obstetrics and Gynecology 1518:10.1007/s13669-017-0187-1 1384:List of surgeries by type 1299: 514:. Typically, both confer 460:Urinary incontinence and 384:The average onset age of 342:Risks and adverse effects 110: 96: 82: 72: 56: 44: 39: 6356:Sterilization (medicine) 5815:MedlinePlus Encyclopedia 5800:templates for discussion 5508:Masters C (2006-07-01). 4411:(4, Supplement): S1–S2. 2554:10.1093/eurheartj/ehq477 2503:10.4103/0019-5545.161483 2124:"Abdominal hysterectomy" 2075:10.1177/1756287214526767 1446:10.1586/17434440.5.4.437 1001:Comparison of techniques 896:together and called the 860:. This technique allows 711: 534:when there is a risk of 278:(trans) male affirmation 222:Heavy menstrual bleeding 30:Not to be confused with 6287:Clitoral hood reduction 6254:Vaginal transplantation 5751:(inactive 2024-09-01). 4921:Fertility and Sterility 3710:A Dictionary of Nursing 3682:"Complete Hysterectomy" 2674:10.1002/jbmr.5650100419 1912:: an initiative of the 1860:Menopause International 1121:Shortest operation time 1085:Abdominal hysterectomy 741:Wertheim's hysterectomy 488:small bowel obstruction 313:obstetrical haemorrhage 256:BRCA1 or BRCA2 mutation 5595:Wort & Bild Verlag 5540:labblog.uofmhealth.org 3990:"Vaginal Hysterectomy" 3404:(6 Suppl): S152–S154. 3026:10.1055/s-0028-1082394 2541:European Heart Journal 2496:(Suppl 2): S222–S232. 2187:10.1210/jcem.85.2.6405 1872:10.1258/mi.2008.008016 1313:hysterectomies due to 1286:More research required 1270:More research required 1248:More research required 832:Abdominal hysterectomy 769:vaginal vault prolapse 721: 606: 598: 329:PMS and menstrual pain 195: 6346:Gynecological surgery 6315:Hysterosalpingography 5932:Gynecological surgery 5714:10.1055/s-2007-965243 5131:10.1001/jama.2013.186 2631:10.1007/s001980170062 1550:"Uterine Adenomyosis" 1280:Longer surgical times 1116:Vaginal hysterectomy 1010:, or the need for an 760:Subtotal hysterectomy 719: 644:Further information: 604: 596: 520:incision and drainage 193: 6101:Endometrial ablation 5563:Hysterectomy and HRT 5254:(3): 174.e1–174.e7. 3874:10.1056/NEJMoa013336 2975:(5): 572.e1–572.e6. 873:Vaginal hysterectomy 730:Radical hysterectomy 633:endometrial ablation 564:renal cell carcinoma 526:followed by sterile 395:endometrial ablation 254:in conjunction with 245:Reproductive system 6351:Reproductive system 6152:Cervical conization 6035:Pelvic exenteration 5953:Salpingoophorectomy 4874:2012PLoSO...750058S 3361:(9566): 1027–1038. 3120:10.3843/GLOWM.10032 2846:(9597): 1494–1499. 2025:10.3390/jcm10225335 1971:(3 Pt 2): 580–585. 1827:(7 Pt 1): 803–808. 1319:menstrual disorders 1070: 684:(PVA) material (an 558:Other rare problems 540:secondary intention 6169:Cervical screening 6124:Uterine myomectomy 6096:Endometrial biopsy 5830:2017-09-14 at the 5494:The New York Times 3141:Hoffman B (2012). 2595:10.1093/aje/kwi295 1643:transcare.ucsf.edu 1068: 812:are still needed. 806:cervical dysplasia 750:Total hysterectomy 722: 607: 599: 544:butterfly stitches 508:incisional abscess 196: 176:irregular bleeding 6361:Surgical oncology 6323: 6322: 6249:Vaginal wet mount 6193: 6192: 6164:Cervical cerclage 6073:Vacuum aspiration 5888: 5887: 5590:Apotheken Umschau 5573:978-1-85317-408-7 5542:. 23 January 2018 3867:(17): 1318–1325. 3253:10.1002/ijc.23750 3178:(22): 2011–2016. 3066:(10): 1619–1628. 2803:(9229): 535–539. 2764:10.1159/000211951 2752:Neuroepidemiology 1926:, which cites: * 1337:According to the 1292: 1291: 858:caesarean section 682:polyvinyl alcohol 575:ectopic pregnancy 309:placenta percreta 247:cancer prevention 121: 120: 16:(Redirected from 6373: 6140: 6117: 6089: 6061: 6013: 6006: 6005: 5915: 5908: 5901: 5892: 5891: 5846: 5845: 5775: 5774: 5768: 5760: 5732: 5726: 5725: 5697: 5691: 5690: 5654: 5648: 5647: 5637: 5605: 5599: 5598: 5584: 5578: 5577: 5557: 5551: 5550: 5548: 5547: 5532: 5526: 5525: 5523: 5522: 5505: 5499: 5498: 5484: 5478: 5477: 5475: 5474: 5459: 5453: 5452: 5424: 5415: 5414: 5386: 5371: 5370: 5342: 5321: 5320: 5310: 5278: 5272: 5271: 5242: 5236: 5235: 5199: 5193: 5192: 5182: 5150: 5144: 5143: 5133: 5109: 5100: 5099: 5089: 5057: 5046: 5045: 5035: 5003: 4982: 4981: 4979: 4978: 4963: 4957: 4956: 4946: 4936: 4912: 4906: 4905: 4895: 4885: 4853: 4847: 4846: 4821:(6): 1215–1220. 4809: 4803: 4802: 4792: 4760: 4751: 4750: 4730: 4724: 4723: 4721: 4720: 4705: 4699: 4698: 4670: 4664: 4663: 4653: 4643: 4611: 4554: 4553: 4542: 4536: 4535: 4533: 4509: 4503: 4502: 4500: 4476: 4470: 4469: 4459: 4435: 4429: 4428: 4400: 4394: 4393: 4375: 4351: 4345: 4344: 4334: 4302: 4296: 4295: 4293: 4292: 4283:. Archived from 4273: 4267: 4266: 4256: 4224: 4218: 4217: 4207: 4175: 4166: 4165: 4137: 4128: 4127: 4099: 4090: 4089: 4079: 4062:(3): 1303–1309. 4047: 4041: 4040: 4038: 4037: 4028:. Archived from 4018: 4012: 4011: 4009: 4008: 3985: 3979: 3978: 3976: 3974: 3969:on June 24, 2012 3968: 3962:. Archived from 3960:Consumer Reports 3953: 3941:Consumer Reports 3937: 3931: 3930: 3928: 3926: 3921:on June 24, 2012 3920: 3914:. Archived from 3905: 3893: 3887: 3886: 3876: 3852: 3846: 3845: 3835: 3803: 3797: 3796: 3768: 3762: 3761: 3751: 3719: 3713: 3703: 3697: 3696: 3694: 3693: 3678: 3672: 3671: 3669: 3668: 3661:womenshealth.gov 3653: 3647: 3646: 3634: 3628: 3627: 3617: 3600:(12): CD005073. 3589: 3583: 3582: 3572: 3548: 3542: 3541: 3527: 3521: 3520: 3492: 3486: 3485: 3477: 3471: 3470: 3460: 3428: 3422: 3421: 3393: 3387: 3386: 3350: 3344: 3343: 3323: 3317: 3316: 3280: 3274: 3273: 3255: 3246:(9): 2213–2216. 3231: 3225: 3224: 3215:(11): 999–1003. 3204: 3198: 3197: 3187: 3163: 3157: 3156: 3138: 3132: 3131: 3103: 3092: 3091: 3055: 3046: 3045: 3019: 2999: 2993: 2992: 2964: 2958: 2957: 2921: 2915: 2914: 2878: 2872: 2871: 2835: 2829: 2828: 2792: 2786: 2785: 2775: 2743: 2737: 2736: 2700: 2694: 2693: 2657: 2651: 2650: 2614: 2608: 2607: 2597: 2573: 2567: 2566: 2556: 2532: 2526: 2525: 2515: 2505: 2481: 2475: 2474: 2438: 2432: 2431: 2421: 2382: 2376: 2375: 2355: 2349: 2348: 2312: 2306: 2305: 2295: 2263: 2257: 2256: 2238: 2214: 2208: 2207: 2189: 2165: 2156: 2155: 2153: 2152: 2138: 2132: 2131: 2120: 2114: 2103: 2097: 2096: 2086: 2054: 2048: 2047: 2037: 2027: 2003: 1997: 1996: 1960: 1954: 1953: 1925: 1924: 1922: 1900: 1894: 1893: 1883: 1851: 1845: 1844: 1816: 1810: 1809: 1791: 1767: 1761: 1760: 1743:(5): 1175–1178. 1732: 1726: 1725: 1689: 1683: 1682: 1680: 1679: 1674:on July 27, 2011 1659: 1653: 1652: 1650: 1649: 1635: 1629: 1628: 1618: 1586: 1580: 1579: 1570: 1564: 1563: 1561: 1560: 1546: 1540: 1539: 1529: 1497: 1491: 1490: 1488: 1487: 1480:womenshealth.gov 1472: 1466: 1465: 1429: 1423: 1422: 1420: 1419: 1405: 1315:uterine fibroids 1071: 1067: 992: 980: 968: 956: 944: 925:Other techniques 744: 743: 699:Uterine prolapse 678:uterine fibroids 646:Uterine fibroids 640:Uterine fibroids 462:vaginal prolapse 305:placenta praevia 282:gender dysphoria 237:Uterine prolapse 229:Uterine fibroids 180:uterine fibroids 168:cesarean section 114:edit on Wikidata 106: 92: 68: 67: 49: 37: 36: 21: 18:Wertheim surgery 6381: 6380: 6376: 6375: 6374: 6372: 6371: 6370: 6326: 6325: 6324: 6319: 6302:Medical imaging 6296: 6258: 6189: 6133: 6128: 6110: 6105: 6082: 6077: 6054: 6049: 6045:Transplantation 6009: 5995: 5963:Fallopian tubes 5957: 5934: 5925: 5919: 5889: 5884: 5883: 5857: 5832:Wayback Machine 5803: 5784: 5779: 5778: 5762: 5761: 5733: 5729: 5698: 5694: 5655: 5651: 5620:(20): 353–359. 5606: 5602: 5585: 5581: 5574: 5558: 5554: 5545: 5543: 5534: 5533: 5529: 5520: 5518: 5506: 5502: 5485: 5481: 5472: 5470: 5461: 5460: 5456: 5435:(4): CD004993. 5425: 5418: 5387: 5374: 5343: 5324: 5279: 5275: 5243: 5239: 5200: 5196: 5151: 5147: 5110: 5103: 5072:(4): CD011422. 5058: 5049: 5018:(4): CD011422. 5004: 4985: 4976: 4974: 4965: 4964: 4960: 4913: 4909: 4854: 4850: 4810: 4806: 4775:(7432): 129–0. 4761: 4754: 4731: 4727: 4718: 4716: 4707: 4706: 4702: 4671: 4667: 4626:(8): CD003677. 4612: 4557: 4550:medlineplus.gov 4544: 4543: 4539: 4510: 4506: 4477: 4473: 4436: 4432: 4401: 4397: 4352: 4348: 4303: 4299: 4290: 4288: 4275: 4274: 4270: 4239:(8): CD003677. 4225: 4221: 4176: 4169: 4138: 4131: 4100: 4093: 4048: 4044: 4035: 4033: 4020: 4019: 4015: 4006: 4004: 3986: 3982: 3972: 3970: 3966: 3951: 3938: 3934: 3924: 3922: 3918: 3903: 3894: 3890: 3853: 3849: 3818:(20): 353–359. 3804: 3800: 3779:(4): CD004993. 3769: 3765: 3720: 3716: 3704: 3700: 3691: 3689: 3680: 3679: 3675: 3666: 3664: 3655: 3654: 3650: 3645:. wdxcyber.com. 3635: 3631: 3590: 3586: 3549: 3545: 3528: 3524: 3493: 3489: 3478: 3474: 3443:(2): CD000329. 3429: 3425: 3394: 3390: 3351: 3347: 3324: 3320: 3281: 3277: 3232: 3228: 3205: 3201: 3164: 3160: 3153: 3139: 3135: 3106:Duff P (2009). 3104: 3095: 3056: 3049: 3017:10.1.1.628.2706 3000: 2996: 2965: 2961: 2922: 2918: 2879: 2875: 2836: 2832: 2793: 2789: 2744: 2740: 2701: 2697: 2658: 2654: 2615: 2611: 2574: 2570: 2533: 2529: 2482: 2478: 2439: 2435: 2383: 2379: 2356: 2352: 2313: 2309: 2278:(1): CD001501. 2264: 2260: 2215: 2211: 2166: 2159: 2150: 2148: 2140: 2139: 2135: 2122: 2121: 2117: 2107:Ureteral Trauma 2104: 2100: 2055: 2051: 2004: 2000: 1961: 1957: 1936:(2 Pt 1): 404. 1920: 1918: 1914:ABIM Foundation 1910:Choosing Wisely 1901: 1897: 1852: 1848: 1817: 1813: 1768: 1764: 1733: 1729: 1690: 1686: 1677: 1675: 1660: 1656: 1647: 1645: 1637: 1636: 1632: 1587: 1583: 1572: 1571: 1567: 1558: 1556: 1548: 1547: 1543: 1498: 1494: 1485: 1483: 1474: 1473: 1469: 1430: 1426: 1417: 1415: 1407: 1406: 1397: 1392: 1380: 1368: 1355: 1347: 1327: 1302: 1297: 1003: 996: 993: 984: 981: 972: 969: 960: 957: 948: 945: 927: 918: 906: 884: 875: 834: 818: 798:cervical cancer 739: 738: 714: 706:kegel exercises 701: 648: 642: 615: 591: 560: 499:Wound infection 496: 494:Wound infection 475: 458: 426:are preserved. 419: 406: 379: 370: 344: 188: 160:fallopian tubes 144:fallopian tubes 117: 102: 88: 63: 62: 52: 35: 28: 23: 22: 15: 12: 11: 5: 6379: 6369: 6368: 6363: 6358: 6353: 6348: 6343: 6338: 6321: 6320: 6318: 6317: 6312: 6306: 6304: 6298: 6297: 6295: 6294: 6292:Vestibulectomy 6289: 6284: 6279: 6274: 6268: 6266: 6260: 6259: 6257: 6256: 6251: 6246: 6241: 6236: 6231: 6230: 6229: 6227:husband stitch 6219: 6214: 6209: 6203: 6201: 6195: 6194: 6191: 6190: 6188: 6187: 6181: 6176: 6166: 6161: 6160: 6159: 6149: 6143: 6141: 6130: 6129: 6127: 6126: 6120: 6118: 6107: 6106: 6104: 6103: 6098: 6092: 6090: 6079: 6078: 6076: 6075: 6070: 6064: 6062: 6057:Uterine cavity 6051: 6050: 6048: 6047: 6042: 6037: 6032: 6027: 6022: 6016: 6014: 6003: 5997: 5996: 5994: 5993: 5991:Tubal reversal 5988: 5983: 5981:Tubal ligation 5978: 5973: 5967: 5965: 5959: 5958: 5956: 5955: 5950: 5944: 5942: 5936: 5935: 5930: 5927: 5926: 5918: 5917: 5910: 5903: 5895: 5886: 5885: 5882: 5881: 5870: 5858: 5853: 5852: 5850: 5849:Classification 5843: 5842: 5834: 5822: 5811: 5783: 5782:External links 5780: 5777: 5776: 5743:(3): 267–272. 5727: 5708:(6): 628–632. 5692: 5665:(3): 145–159. 5649: 5600: 5593:. Baierbrunn: 5579: 5572: 5552: 5527: 5500: 5479: 5454: 5416: 5397:(4): 424–434. 5372: 5353:(3): 463–478. 5322: 5293:(4): 723–738. 5273: 5237: 5210:(4): 732–739. 5194: 5165:(4): 253–259. 5145: 5124:(7): 689–698. 5101: 5047: 4983: 4958: 4927:(2): e90–e96. 4907: 4868:(11): e50058. 4848: 4804: 4752: 4741:(2): 151–159. 4725: 4700: 4681:(7): 512–513. 4665: 4555: 4537: 4504: 4471: 4450:(3): 370–375. 4430: 4395: 4346: 4317:(4): 284–288. 4297: 4268: 4219: 4190:(7506): 1478. 4167: 4148:(2): 115–132. 4129: 4110:(2): 133–152. 4091: 4042: 4013: 3980: 3932: 3899:(April 2012). 3888: 3847: 3798: 3763: 3714: 3698: 3686:www.cancer.gov 3673: 3657:"Hysterectomy" 3648: 3643:Women's Health 3629: 3584: 3563:(3): 258–261. 3543: 3540:on 2007-06-09. 3522: 3487: 3472: 3423: 3388: 3345: 3334:(6): 349–352. 3318: 3291:(5): 363–365. 3275: 3226: 3199: 3158: 3152:978-0071716727 3151: 3133: 3093: 3047: 3010:(4): 356–368. 2994: 2959: 2916: 2889:(5): 469–475. 2873: 2830: 2787: 2738: 2711:(3): 408–418. 2695: 2668:(4): 650–654. 2652: 2625:(8): 630–638. 2609: 2588:(9): 879–886. 2568: 2547:(6): 745–750. 2527: 2476: 2449:(9): 615–623. 2433: 2404:(3): 288–295. 2377: 2350: 2323:(2): 169–174. 2307: 2258: 2229:(7): 956–962. 2209: 2180:(2): 645–651. 2157: 2142:"Hysterectomy" 2133: 2115: 2098: 2069:(3): 115–124. 2049: 1998: 1955: 1895: 1866:(3): 111–116. 1846: 1811: 1782:(7): 688–694. 1762: 1727: 1700:(3): 252–254. 1684: 1668:Washington, DC 1654: 1630: 1601:(4): 738–757. 1581: 1565: 1541: 1492: 1476:"Hysterectomy" 1467: 1440:(4): 437–445. 1424: 1413:ihpi.umich.edu 1394: 1393: 1391: 1388: 1387: 1386: 1379: 1376: 1367: 1364: 1354: 1351: 1346: 1345:United Kingdom 1343: 1332:Nora W. Coffey 1326: 1323: 1301: 1298: 1296: 1293: 1290: 1289: 1288: 1287: 1284: 1283:Increased cost 1281: 1278: 1273: 1272: 1271: 1268: 1263: 1259: 1258: 1257: 1256: 1251: 1250: 1249: 1246: 1241: 1237: 1236: 1235: 1234: 1231: 1228: 1223: 1222: 1221: 1218: 1215: 1212: 1209: 1204: 1200: 1199: 1198: 1197: 1194: 1191: 1186: 1185: 1184: 1181: 1176: 1172: 1171: 1170: 1169: 1166: 1161: 1160: 1159: 1156: 1153: 1148: 1144: 1143: 1142: 1141: 1138: 1133: 1132: 1131: 1128: 1125: 1122: 1117: 1113: 1112: 1111: 1110: 1107: 1104: 1099: 1098: 1097: 1094: 1091: 1086: 1082: 1081: 1080:Disadvantages 1078: 1075: 1053:morcellation. 1047: 1046: 1043: 1040: 1002: 999: 998: 997: 994: 987: 985: 982: 975: 973: 970: 963: 961: 958: 951: 949: 946: 939: 926: 923: 917: 914: 905: 902: 883: 880: 874: 871: 867:abdominal wall 833: 830: 817: 814: 791: 790: 787: 784: 780: 764: 763: 757: 747: 713: 710: 700: 697: 655:levonorgestrel 641: 638: 614: 613:Heavy bleeding 611: 590: 587: 559: 556: 495: 492: 474: 471: 457: 454: 435:bone fractures 418: 415: 405: 402: 378: 375: 369: 366: 343: 340: 339: 338: 332: 326: 316: 296: 285: 272: 259: 242: 233: 225: 219: 210: 187: 184: 119: 118: 111: 108: 107: 100: 94: 93: 86: 80: 79: 76: 70: 69: 60: 54: 53: 50: 42: 41: 26: 9: 6: 4: 3: 2: 6378: 6367: 6364: 6362: 6359: 6357: 6354: 6352: 6349: 6347: 6344: 6342: 6339: 6337: 6334: 6333: 6331: 6316: 6313: 6311: 6308: 6307: 6305: 6303: 6299: 6293: 6290: 6288: 6285: 6283: 6280: 6278: 6275: 6273: 6270: 6269: 6267: 6265: 6261: 6255: 6252: 6250: 6247: 6245: 6244:Hymenorrhaphy 6242: 6240: 6237: 6235: 6232: 6228: 6225: 6224: 6223: 6220: 6218: 6217:Culdocentesis 6215: 6213: 6210: 6208: 6205: 6204: 6202: 6200: 6196: 6185: 6182: 6180: 6177: 6174: 6170: 6167: 6165: 6162: 6158: 6155: 6154: 6153: 6150: 6148: 6145: 6144: 6142: 6139: 6137: 6131: 6125: 6122: 6121: 6119: 6116: 6114: 6108: 6102: 6099: 6097: 6094: 6093: 6091: 6088: 6086: 6080: 6074: 6071: 6069: 6066: 6065: 6063: 6060: 6058: 6052: 6046: 6043: 6041: 6038: 6036: 6033: 6031: 6028: 6026: 6023: 6021: 6018: 6017: 6015: 6012: 6007: 6004: 6002: 5998: 5992: 5989: 5987: 5984: 5982: 5979: 5977: 5976:Salpingectomy 5974: 5972: 5969: 5968: 5966: 5964: 5960: 5954: 5951: 5949: 5946: 5945: 5943: 5941: 5937: 5933: 5928: 5924: 5916: 5911: 5909: 5904: 5902: 5897: 5896: 5893: 5880: 5876: 5875: 5871: 5869: 5865: 5864: 5860: 5859: 5856: 5851: 5847: 5841: 5839: 5835: 5833: 5829: 5826: 5823: 5821: 5817: 5816: 5812: 5810: 5806: 5801: 5797: 5796: 5791: 5786: 5785: 5772: 5766: 5758: 5754: 5750: 5746: 5742: 5738: 5731: 5723: 5719: 5715: 5711: 5707: 5703: 5696: 5688: 5684: 5680: 5676: 5672: 5668: 5664: 5660: 5653: 5645: 5641: 5636: 5631: 5627: 5623: 5619: 5615: 5611: 5604: 5596: 5592: 5591: 5583: 5575: 5569: 5565: 5564: 5556: 5541: 5537: 5531: 5517: 5516: 5511: 5504: 5496: 5495: 5490: 5483: 5468: 5464: 5458: 5450: 5446: 5442: 5438: 5434: 5430: 5423: 5421: 5412: 5408: 5404: 5400: 5396: 5392: 5385: 5383: 5381: 5379: 5377: 5368: 5364: 5360: 5356: 5352: 5348: 5341: 5339: 5337: 5335: 5333: 5331: 5329: 5327: 5318: 5314: 5309: 5304: 5300: 5296: 5292: 5288: 5284: 5277: 5269: 5265: 5261: 5257: 5253: 5249: 5241: 5233: 5229: 5225: 5221: 5217: 5213: 5209: 5205: 5198: 5190: 5186: 5181: 5176: 5172: 5168: 5164: 5160: 5156: 5149: 5141: 5137: 5132: 5127: 5123: 5119: 5115: 5108: 5106: 5097: 5093: 5088: 5083: 5079: 5075: 5071: 5067: 5063: 5056: 5054: 5052: 5043: 5039: 5034: 5029: 5025: 5021: 5017: 5013: 5009: 5002: 5000: 4998: 4996: 4994: 4992: 4990: 4988: 4972: 4968: 4962: 4954: 4950: 4945: 4940: 4935: 4930: 4926: 4922: 4918: 4911: 4903: 4899: 4894: 4889: 4884: 4879: 4875: 4871: 4867: 4863: 4859: 4852: 4844: 4840: 4836: 4832: 4828: 4824: 4820: 4816: 4808: 4800: 4796: 4791: 4786: 4782: 4778: 4774: 4770: 4766: 4759: 4757: 4748: 4744: 4740: 4736: 4729: 4714: 4710: 4704: 4696: 4692: 4688: 4684: 4680: 4676: 4669: 4661: 4657: 4652: 4647: 4642: 4637: 4633: 4629: 4625: 4621: 4617: 4610: 4608: 4606: 4604: 4602: 4600: 4598: 4596: 4594: 4592: 4590: 4588: 4586: 4584: 4582: 4580: 4578: 4576: 4574: 4572: 4570: 4568: 4566: 4564: 4562: 4560: 4551: 4547: 4541: 4532: 4527: 4523: 4519: 4515: 4508: 4499: 4494: 4490: 4486: 4482: 4475: 4467: 4463: 4458: 4453: 4449: 4445: 4441: 4434: 4426: 4422: 4418: 4414: 4410: 4406: 4399: 4391: 4387: 4383: 4379: 4374: 4369: 4365: 4361: 4357: 4350: 4342: 4338: 4333: 4328: 4324: 4320: 4316: 4312: 4308: 4301: 4287:on 2018-11-07 4286: 4282: 4278: 4272: 4264: 4260: 4255: 4250: 4246: 4242: 4238: 4234: 4230: 4223: 4215: 4211: 4206: 4201: 4197: 4193: 4189: 4185: 4181: 4174: 4172: 4163: 4159: 4155: 4151: 4147: 4143: 4136: 4134: 4125: 4121: 4117: 4113: 4109: 4105: 4098: 4096: 4087: 4083: 4078: 4073: 4069: 4065: 4061: 4057: 4053: 4046: 4032:on 2023-10-17 4031: 4027: 4023: 4017: 4003: 3999: 3995: 3991: 3984: 3965: 3961: 3957: 3950: 3946: 3942: 3936: 3917: 3913: 3909: 3902: 3898: 3892: 3884: 3880: 3875: 3870: 3866: 3862: 3858: 3851: 3843: 3839: 3834: 3829: 3825: 3821: 3817: 3813: 3809: 3802: 3794: 3790: 3786: 3782: 3778: 3774: 3767: 3759: 3755: 3750: 3745: 3741: 3737: 3733: 3729: 3725: 3718: 3711: 3707: 3702: 3687: 3683: 3677: 3662: 3658: 3652: 3644: 3640: 3637:Jelovsek FR. 3633: 3625: 3621: 3616: 3611: 3607: 3603: 3599: 3595: 3588: 3580: 3576: 3571: 3566: 3562: 3558: 3554: 3547: 3539: 3535: 3534: 3526: 3518: 3514: 3510: 3506: 3502: 3498: 3497:Contraception 3491: 3483: 3476: 3468: 3464: 3459: 3454: 3450: 3446: 3442: 3438: 3434: 3427: 3419: 3415: 3411: 3407: 3403: 3399: 3398:Contraception 3392: 3384: 3380: 3376: 3372: 3368: 3364: 3360: 3356: 3349: 3341: 3337: 3333: 3329: 3322: 3314: 3310: 3306: 3302: 3298: 3294: 3290: 3286: 3279: 3271: 3267: 3263: 3259: 3254: 3249: 3245: 3241: 3237: 3230: 3222: 3218: 3214: 3210: 3203: 3195: 3191: 3186: 3181: 3177: 3173: 3169: 3162: 3154: 3148: 3144: 3137: 3129: 3125: 3121: 3117: 3113: 3109: 3102: 3100: 3098: 3089: 3085: 3081: 3077: 3073: 3069: 3065: 3061: 3054: 3052: 3043: 3039: 3035: 3031: 3027: 3023: 3018: 3013: 3009: 3005: 2998: 2990: 2986: 2982: 2978: 2974: 2970: 2963: 2955: 2951: 2947: 2943: 2939: 2935: 2931: 2927: 2920: 2912: 2908: 2904: 2900: 2896: 2892: 2888: 2884: 2877: 2869: 2865: 2861: 2857: 2853: 2849: 2845: 2841: 2834: 2826: 2822: 2818: 2814: 2810: 2806: 2802: 2798: 2791: 2783: 2779: 2774: 2769: 2765: 2761: 2757: 2753: 2749: 2742: 2734: 2730: 2726: 2722: 2718: 2714: 2710: 2706: 2699: 2691: 2687: 2683: 2679: 2675: 2671: 2667: 2663: 2656: 2648: 2644: 2640: 2636: 2632: 2628: 2624: 2620: 2613: 2605: 2601: 2596: 2591: 2587: 2583: 2579: 2572: 2564: 2560: 2555: 2550: 2546: 2542: 2538: 2531: 2523: 2519: 2514: 2509: 2504: 2499: 2495: 2491: 2487: 2480: 2472: 2468: 2464: 2460: 2456: 2452: 2448: 2444: 2437: 2429: 2425: 2420: 2415: 2411: 2407: 2403: 2399: 2395: 2391: 2388:, Frangos E, 2387: 2381: 2373: 2369: 2365: 2361: 2354: 2346: 2342: 2338: 2334: 2330: 2326: 2322: 2318: 2311: 2303: 2299: 2294: 2289: 2285: 2281: 2277: 2273: 2269: 2262: 2254: 2250: 2246: 2242: 2237: 2232: 2228: 2224: 2220: 2213: 2205: 2201: 2197: 2193: 2188: 2183: 2179: 2175: 2171: 2164: 2162: 2147: 2143: 2137: 2129: 2125: 2119: 2113: 2109: 2108: 2102: 2094: 2090: 2085: 2080: 2076: 2072: 2068: 2064: 2060: 2053: 2045: 2041: 2036: 2031: 2026: 2021: 2017: 2013: 2009: 2002: 1994: 1990: 1986: 1982: 1978: 1974: 1970: 1966: 1959: 1951: 1947: 1943: 1939: 1935: 1931: 1916: 1915: 1911: 1906: 1899: 1891: 1887: 1882: 1877: 1873: 1869: 1865: 1861: 1857: 1850: 1842: 1838: 1834: 1830: 1826: 1822: 1815: 1807: 1803: 1799: 1795: 1790: 1785: 1781: 1777: 1773: 1766: 1758: 1754: 1750: 1746: 1742: 1738: 1731: 1723: 1719: 1715: 1711: 1707: 1703: 1699: 1695: 1688: 1673: 1669: 1665: 1658: 1644: 1640: 1634: 1626: 1622: 1617: 1612: 1608: 1604: 1600: 1596: 1592: 1585: 1577: 1576: 1569: 1555: 1554:Yale Medicine 1551: 1545: 1537: 1533: 1528: 1523: 1519: 1515: 1511: 1507: 1503: 1496: 1481: 1477: 1471: 1463: 1459: 1455: 1451: 1447: 1443: 1439: 1435: 1428: 1414: 1410: 1404: 1402: 1400: 1395: 1385: 1382: 1381: 1375: 1373: 1363: 1360: 1350: 1342: 1340: 1335: 1333: 1325:United States 1322: 1320: 1316: 1311: 1307: 1285: 1282: 1279: 1276: 1275: 1274: 1269: 1266: 1265: 1264: 1261: 1254: 1253: 1252: 1247: 1244: 1243: 1242: 1239: 1232: 1229: 1226: 1225: 1224: 1219: 1216: 1213: 1210: 1207: 1206: 1205: 1202: 1195: 1192: 1189: 1188: 1187: 1182: 1179: 1178: 1177: 1174: 1167: 1164: 1163: 1162: 1157: 1154: 1151: 1150: 1149: 1146: 1139: 1136: 1135: 1134: 1129: 1126: 1123: 1120: 1119: 1118: 1115: 1108: 1105: 1102: 1101: 1100: 1095: 1092: 1089: 1088: 1087: 1084: 1079: 1076: 1073: 1072: 1066: 1062: 1058: 1054: 1051: 1044: 1041: 1038: 1037: 1036: 1033: 1030: 1026: 1022: 1019: 1015: 1013: 1009: 1008:endometriosis 991: 986: 979: 974: 967: 962: 955: 950: 943: 938: 937: 936: 933: 930: 922: 913: 911: 901: 899: 894: 889: 888:gynecologists 879: 870: 868: 863: 859: 855: 851: 847: 843: 839: 829: 825: 822: 813: 811: 807: 804:to check for 803: 799: 794: 788: 785: 781: 778: 777: 776: 774: 770: 761: 758: 755: 751: 748: 745: 742: 735: 731: 728: 727: 726: 718: 709: 707: 696: 694: 689: 687: 683: 679: 675: 674: 669: 667: 662: 660: 656: 652: 647: 637: 634: 629: 627: 623: 619: 610: 603: 595: 586: 584: 580: 576: 571: 569: 565: 555: 553: 549: 545: 541: 537: 533: 529: 525: 521: 517: 513: 509: 505: 500: 491: 489: 485: 480: 470: 466: 463: 453: 450: 448: 444: 439: 436: 432: 427: 423: 414: 412: 401: 398: 396: 392: 387: 382: 374: 365: 363: 358: 355: 351: 348: 336: 333: 330: 327: 324: 322: 317: 314: 310: 306: 302: 301: 297: 293: 291: 286: 283: 279: 277: 273: 270: 266: 265: 260: 257: 253: 252:breast cancer 249: 248: 243: 240: 238: 234: 231: 230: 226: 223: 220: 217: 215: 211: 208: 206: 205:Endometriosis 202: 201: 200: 192: 183: 181: 177: 173: 172:endometriosis 169: 165: 161: 157: 153: 149: 148:salpingectomy 145: 141: 137: 133: 129: 125: 115: 109: 105: 101: 99: 95: 91: 87: 85: 81: 77: 75: 71: 66: 61: 59: 55: 48: 43: 38: 33: 19: 6239:Colpocleisis 6179:Cervicectomy 6134: 6111: 6083: 6068:Hysteroscopy 6055: 6025:Hysterectomy 6024: 6020:Genitoplasty 6010: 5971:Falloposcopy 5948:Oophorectomy 5872: 5861: 5837: 5820:Hysterectomy 5813: 5805:Hysterectomy 5793: 5765:cite journal 5740: 5736: 5730: 5705: 5701: 5695: 5662: 5658: 5652: 5617: 5613: 5603: 5589: 5582: 5562: 5555: 5544:. Retrieved 5539: 5530: 5519:. Retrieved 5513: 5503: 5492: 5482: 5471:. Retrieved 5469:. 2010-05-27 5457: 5432: 5428: 5394: 5390: 5350: 5346: 5290: 5286: 5276: 5251: 5247: 5240: 5207: 5203: 5197: 5162: 5158: 5148: 5121: 5117: 5069: 5065: 5015: 5011: 4975:. Retrieved 4970: 4961: 4924: 4920: 4910: 4865: 4861: 4851: 4818: 4814: 4807: 4772: 4768: 4738: 4734: 4728: 4717:. Retrieved 4703: 4678: 4674: 4668: 4623: 4619: 4549: 4540: 4521: 4517: 4507: 4488: 4484: 4474: 4447: 4443: 4433: 4408: 4404: 4398: 4363: 4359: 4349: 4314: 4310: 4300: 4289:. Retrieved 4285:the original 4280: 4271: 4236: 4232: 4222: 4187: 4183: 4145: 4141: 4107: 4103: 4059: 4055: 4045: 4034:. Retrieved 4030:the original 4025: 4016: 4005:. Retrieved 3993: 3983: 3971:. Retrieved 3964:the original 3955: 3947:(May 2012). 3935: 3923:. Retrieved 3916:the original 3907: 3891: 3864: 3860: 3850: 3815: 3811: 3801: 3776: 3772: 3766: 3734:(1): 49–57. 3731: 3727: 3717: 3709: 3701: 3690:. Retrieved 3688:. 2011-02-02 3685: 3676: 3665:. Retrieved 3663:. 2017-02-21 3660: 3651: 3642: 3632: 3597: 3587: 3560: 3556: 3546: 3538:the original 3532: 3525: 3503:(1): 41–55. 3500: 3496: 3490: 3475: 3440: 3436: 3426: 3401: 3397: 3391: 3358: 3354: 3348: 3331: 3327: 3321: 3288: 3284: 3278: 3243: 3239: 3229: 3212: 3208: 3202: 3175: 3171: 3161: 3142: 3136: 3111: 3063: 3059: 3007: 3003: 2997: 2972: 2968: 2962: 2932:(1): 27–30. 2929: 2925: 2919: 2886: 2882: 2876: 2843: 2839: 2833: 2800: 2796: 2790: 2758:(1): 32–40. 2755: 2751: 2741: 2708: 2704: 2698: 2665: 2661: 2655: 2622: 2618: 2612: 2585: 2581: 2571: 2544: 2540: 2530: 2493: 2489: 2479: 2446: 2442: 2436: 2401: 2397: 2386:Komisaruk BR 2380: 2363: 2359: 2353: 2320: 2316: 2310: 2275: 2271: 2261: 2226: 2222: 2212: 2177: 2173: 2149:. Retrieved 2146:www.acog.org 2145: 2136: 2127: 2118: 2105: 2101: 2066: 2062: 2052: 2018:(22): 5335. 2015: 2011: 2001: 1968: 1964: 1958: 1933: 1929: 1919:, retrieved 1908: 1898: 1863: 1859: 1849: 1824: 1820: 1814: 1779: 1775: 1765: 1740: 1736: 1730: 1697: 1693: 1687: 1676:. Retrieved 1672:the original 1657: 1646:. Retrieved 1642: 1633: 1598: 1594: 1584: 1574: 1568: 1557:. Retrieved 1553: 1544: 1512:(1): 34–41. 1509: 1505: 1495: 1484:. Retrieved 1482:. 2017-02-21 1479: 1470: 1437: 1433: 1427: 1416:. 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