Our Summary

This research paper is looking at how hysterectomies (surgery to remove the uterus) are performed in Norway. From 2008 to 2018, the researchers found that most of these operations were done using minimally invasive techniques, which cause less pain and have shorter recovery times. The amount of these types of surgeries increased from 41% to 73% during that ten-year period. They also found that 15% of hysterectomies in 2018 were done with the help of a robot.

Additionally, the study found that more than half of the surgeries included a salpingectomy, which is the removal of the fallopian tubes, when the reason for the surgery was not cancer.

The paper concludes that doctors in Norway generally follow international guidelines for these surgeries. However, the use of minimally invasive techniques varies greatly between different health trusts (organizations that provide health care services).

FAQs

  1. What percentage of hysterectomies in Norway were performed using minimally invasive techniques between 2008 and 2018?
  2. How often were robots used in assisting hysterectomies in Norway in 2018?
  3. What is the variation in the use of minimally invasive techniques for hysterectomies among different health trusts in Norway?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hysterectomy is to discuss with their healthcare provider the possibility of using minimally invasive techniques for the surgery, as these techniques typically result in less pain and faster recovery times. Additionally, patients should inquire about the option of including a salpingectomy (removal of the fallopian tubes) during the surgery, especially if the reason for the hysterectomy is not cancer. It is important for patients to have a thorough discussion with their healthcare provider about the different options available and to ensure they are receiving the best possible care based on current guidelines and practices.

Suitable For

Patients who are typically recommended for a hysterectomy include those with:

  1. Uterine fibroids: Non-cancerous growths in the uterus that can cause heavy menstrual bleeding, pelvic pain, and other symptoms.

  2. Endometriosis: A condition where tissue similar to the lining of the uterus grows outside of the uterus, leading to pain and other symptoms.

  3. Adenomyosis: A condition where the lining of the uterus grows into the muscle wall, causing heavy menstrual bleeding, pain, and other symptoms.

  4. Uterine prolapse: A condition where the uterus slips down into or protrudes out of the vagina, often causing discomfort and urinary incontinence.

  5. Chronic pelvic pain: Persistent pain in the pelvic region that does not respond to other treatments.

  6. Abnormal uterine bleeding: Heavy or irregular menstrual bleeding that does not improve with other treatments.

  7. Gynecologic cancers: Hysterectomy may be recommended as part of treatment for cancers such as endometrial, cervical, or ovarian cancer.

  8. Pre-cancerous conditions: Hysterectomy may be recommended for patients with pre-cancerous conditions of the uterus, cervix, or ovaries.

It is important for patients to discuss their individual medical history and symptoms with their healthcare provider to determine if a hysterectomy is the best treatment option for them.

Timeline

Before a hysterectomy, a patient typically undergoes several steps, including consultation with a gynecologist to discuss the reasons for the surgery, pre-operative testing to evaluate the patient’s overall health, and possibly hormonal therapy to shrink the uterus before surgery. The patient will also receive information on the procedure, potential risks and benefits, and post-operative care.

After a hysterectomy, the patient can expect a recovery period that may involve pain management, restricted activity, and follow-up appointments with their healthcare provider. Depending on the type of hysterectomy performed (such as minimally invasive or traditional surgery), the recovery time may vary. Patients may also experience emotional changes, such as relief from symptoms that led to the surgery or feelings of loss related to the removal of the uterus.

Overall, the timeline for a patient undergoing a hysterectomy includes pre-operative preparation, the surgery itself, and a post-operative recovery period with follow-up care to ensure a successful outcome.

What to Ask Your Doctor

  1. What are the different types of hysterectomy procedures available and which one is most suitable for my condition?
  2. What are the potential risks and complications associated with a hysterectomy?
  3. What is the expected recovery time and what can I do to promote healing after the surgery?
  4. Will a hysterectomy affect my hormone levels and what are the potential long-term effects on my health?
  5. Are there alternative treatments or therapies that I should consider before opting for a hysterectomy?
  6. Will I still experience menopause symptoms after a hysterectomy and how can they be managed?
  7. How often do you perform hysterectomies and what is your experience with the specific procedure recommended for me?
  8. What is the success rate of the chosen procedure and what factors could affect the outcome of the surgery?
  9. Will I need any additional procedures, such as a salpingectomy, during the hysterectomy?
  10. How will my fertility be affected by a hysterectomy and are there any options for preserving my fertility before the surgery?

Reference

Authors: Johanson ML, Dögl M, Lieng M. Journal: Tidsskr Nor Laegeforen. 2020 Oct 7;140(14). doi: 10.4045/tidsskr.20.0167. Print 2020 Oct 13. PMID: 33070594