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Hysterectomy is the surgical removal of the uterus; it is a permanent solution for women with abnormal uterine bleeding. Hysterectomy should be regarded as the last resort to treat this problem. Less invasive alternatives should be tried in the first instance, such as the use of pharmaceutical agents including levonorgestrel-releasing intrauterine system, tranexamic acid, non-steroidal anti-inflammatory drugs, combined oral contraceptives, high-dose progestogen treatment and endometrial ablation.1 These treatment options are highly effective in the absence of significant structural and histological abnormalities.2 This Cochrane Review assesses which type of hysterectomy is associated with the best outcomes: vaginal hysterectomy …
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.