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Abstract
Although alternatives to hysterectomy for benign gynecological disease are now widely available, including the Mirena intrauterine system, endometrial ablation, uterine artery embolisation for fibroids, and pharmacological approaches, hysterectomy is the only definitive cure for abnormal uterine bleeding, improving quality of life and rating highest in satisfaction scores compared with the other modalities of treatment for dysfunctional uterine bleeding (Gimbel et al., 2005).
The vast majority of hysterectomies are performed via the abdominal route. Over the last decade or more, the issue of whether subtotal hysterectomy confers benefits over the total procedure has been hotly debated. The largest and most comprehensive trial comparing the effects of total and subtotal hysterectomy found no differences between the two operations with respect to bladder, bowel or sexual function up to one year after surgery (Thakar et al., 2002). The same results are confirmed again in the recent Cochrane review