INTRODUCTION
Hysterectomy is the most frequently performed gynecologic surgery
worldwide (1). In the United States, approximately 450,000
hysterectomies are performed annually (2). Currently, surgical
approaches to hysterectomy include laparoscopic, vaginal, and abdominal
routes. Advantages and disadvantages of each of these techniques have
been analyzed in meta-analysis and systematic reviews (3-7).
Based on those reviews, scientific societies have issued guidelines and
recommendations in order to choose the appropriate surgical approach for
each patient (8,9). While the most recent recommendations by the
American College of Obstetricians and Gynecologists (ACOG) emphasize
that the choice of surgical approach to hysterectomy should take into
account the patient, her values and preferences, the final decision may
be biased by the surgeon’s preferences (10).
For instance, the Entwistle study showed that less than half of women
undergoing hysterectomy had been informed of the advantages and
disadvantages of the different types of hysterectomies, and 26% to 65%
considered that they had been given little information about the
procedure. (11) Strikingly, one in every 5 patients underwent surgery
not knowing the type of surgical approach (12). The Skea study, 76% of
patients attending the medical appointment to schedule their
hysterectomy expected a shared decision-making regarding the surgical
approach (13)
Currently, few studies have reported on patient preferences regarding
surgical approach to hysterectomy (14). Therefore, this study was
designed to identify variables that women perceive as being most
important when it comes to deciding type of surgical approach to
hysterectomy, and thus identify the technique that best accommodates to
their preferences.