In cases of benign disease, vaginal hysterectomy is preferred approach

The vaginal route is preferable to the open abdominal route and to the laparoscopic technique for hysterectomy for benign disease, according to a recent American College of Obstetrics and Gynecology (ACOG) committee opinion.

Of the 600,000 hysterectomies performed in the United States each year, 40.7% are performed to treat fibroids, 17.7% to treat endometriosis, and 14.5% to treat uterine prolapse.

A review of available evidence led the committee to conclude that, for the majority of women, the vaginal approach provides better outcomes, faster recovery, fewer complications, and greater cost-efficacy than the other 2 options.

Currently in the United States, about 66% of hysterectomies for benign disease are performed abdominally, about 22% are performed vaginally, and about 12% are performed laparoscopically.

ACOG Committee Opinion No. 444: Choosing the route of hysterectomy for benign disease. Obstet Gynecol. 2009;114(5):1156-1158.