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Choosing a route of hysterectomy for benign disease

Mark D Walters, MD
Section Editor
Howard T Sharp, MD
Deputy Editor
Kristen Eckler, MD, FACOG


Hysterectomy can be performed vaginally, abdominally, laparoscopically, or with robot-assisted laparoscopy. Hysterectomy can also be performed by combining two of these four routes, such as in laparoscopically-assisted vaginal hysterectomy or laparoscopic hysterectomy combined with a mini-laparotomy to remove the uterine specimen from the peritoneal cavity. Hysterectomy has been associated with improvements in physical and mental quality-of-life measures, body image, and aspects of sexual activity, with few differences among surgical routes [1,2].

This topic review will review the data and clinical issues that impact selection of hysterectomy route. Topics on specific hysterectomy techniques are reviewed separately. (See "Vaginal hysterectomy" and "Laparoscopic hysterectomy" and "Abdominal hysterectomy" and "Prophylactic vaginal apex suspension at the time of hysterectomy".)


There are five broad diagnostic categories of indications for hysterectomy:

Uterine leiomyomas

Abnormal uterine bleeding


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Literature review current through: Mar 2017. | This topic last updated: Apr 19, 2017.
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