Vaginal hysterectomy is best, physicians group says

Hysterectomy is one of the most common surgeries performed in the United States, and doctors can use several methods to remove the uterus, including traditional, open surgery; laparoscopic hysterectomy; and vaginal hysterectomy.

The American College of Obstetricians and Gynecologists said today that vaginal hysterectomy is the superior choice for most women who are having the surgery for noncancerous reasons. The group concluded that, based on medical evidence, removing the uterus through a small incision in the vagina is the safest and most cost-effective method. This method causes the fewest complications and allows for quicker recovery, said the lead author of the statement, Dr. Cheryl B. Iglesia of Washington Hospital Center in Washington, D.C., who is chairwoman of the ACOG's Committee on Gynecological Practice.

The opinion should cause a fair bit of discussion in gynecologists' offices. Currently, 66% of cases involve standard abdominal hysterectomy, 22% vaginal hysterectomy and 12% laparoscopic hysterectomy.

Not every woman is a candidate for the vaginal surgery option, however.

"The paramount concern is that we provide the safest procedure for our patients," Iglesia said in a news release. "That being said, based on the national data, it's pretty clear that more hysterectomies in the U.S. could be performed using the less invasive approach than are currently being done."

The statement is published in the November issue of Obstetrics & Gynecology.

-- Shari Roan