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.