Long-term outcomes following laparoscopic supracervical hysterectomy


Dr M Lieng, Department of Gynaecology and Obstetrics, Ullevål University Hospital, Kirkeveien 166, N-0407 Oslo, Norway. Email m.lieng@online.no


Objective  Evaluation of long-term outcomes following laparoscopic supracervical hysterectomy (LSH).

Design  Retrospective postal questionnaire.

Setting  Norwegian university teaching hospital.

Population  A total of 315 consecutive patients.

Methods  A questionnaire sent to all patients who underwent a LSH during 2004 and 2005.

Main outcome measures  Persistent vaginal bleeding and pelvic pain, patient acceptability of such symptoms and patient satisfaction following LSH.

Results  A total of 240 women (78%) completed the questionnaire. About 24% reported experiencing vaginal bleeding up to 3 years following their hysterectomy, although this was rated as minimal in 90% of cases, resulting in a mean bothersome score of 1.1 (SD 2.0) on a 10-point visual analogue scale (VAS). Women operated on by less experienced surgeons were more likely to report vaginal bleeding following surgery (P = 0.02). About 74% of women reported having menstrual pain prior to surgery, with a mean score of 6.8 (SD 2.1) (10-point VAS). Up to 3 years following surgery, 38% continued to experience menstrual pain, although this was significantly less intense with a mean score of 3.5 (SD 2.2) (P < 0.01). While all women reported a decrease in the amount of pain experienced following the hysterectomy, those having a hysterectomy because of endometriosis reported significantly higher levels of menstrual/cyclical pain after surgery compared with women who had a hysterectomy for other reasons (P < 0.01). Ninety per cent of women reported being satisfied with their surgery.

Conclusion  Although vaginal bleeding and pelvic pain are frequently observed following LSH, these symptoms are significantly reduced and patient satisfaction is high.