{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T20:53:04Z","timestamp":1780865584208,"version":"3.54.1"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,12,18]],"date-time":"2013-12-18T00:00:00Z","timestamp":1387324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The objective of this study was to assess the cost\u2010effectiveness of hysterectomy performed for benign indications. Hysterectomy remains the most common major gynecological operation in the Western world. Rates of hysterectomy have not declined as expected with the introduction of new treatment options. Furthermore, use of laparoscopic techniques varies widely within the Nordic countries. We designed a systematic review in a University Central Hospital. The sample included all published studies regarding the cost\u2010effectiveness of hysterectomy performed for benign indications (<jats:italic>n<\/jats:italic>\u00a0=\u00a01666). Medline, Cochrane Library, PsycINFO, CINAHL, and Nursing databases were searched. Inclusion criteria were the availability of pre\u2010 and post\u2010intervention health\u2010related quality of life measures (<jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>oL) and data on costs.<jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>oL, costs, and cost\u2010effectiveness of treatment were the main outcome measures. Studies (<jats:italic>n<\/jats:italic>\u00a0=\u00a024) focused on treatment of symptomatic fibroids (<jats:italic>n<\/jats:italic>\u00a0=\u00a08), treatment of heavy menstrual bleeding (<jats:italic>n<\/jats:italic>\u00a0=\u00a010), various surgical techniques (<jats:italic>n<\/jats:italic>\u00a0=\u00a05) and the effect of various indications for hysterectomy (<jats:italic>n<\/jats:italic>\u00a0=\u00a02). Follow\u2010up periods varied from 4\u00a0months to over 10\u00a0years.<jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">RAND<\/jats:styled-content>\u201036 or<jats:styled-content style=\"fixed-case\">EQ<\/jats:styled-content>\u20105D measures and societal cost perspective were most commonly used. Only 11 studies used individual patient data.<jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>oL following hysterectomy was generally good but costs were high. The cost\u2010effectiveness depended on indication, age, and duration of follow\u2010up. The cost\u2010effectiveness of hysterectomy has been surprisingly poorly studied. Conclusions are difficult to draw due to different study designs, indications, follow\u2010up times, and<jats:styled-content style=\"fixed-case\">HRQ<\/jats:styled-content>oL instruments used. Rates of hysterectomy have declined less than expected with the introduction of new treatment modalities. Costs of surgery are high. Laparoscopic hysterectomy seems to be the least cost\u2010effective, although further data from original patient cohorts with long\u2010term follow\u2010up are needed.<\/jats:p>","DOI":"10.1111\/aogs.12299","type":"journal-article","created":{"date-parts":[[2013,11,4]],"date-time":"2013-11-04T06:30:58Z","timestamp":1383546658000},"page":"225-232","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Cost\u2010effectiveness of hysterectomy for benign gynecological conditions: a systematic review"],"prefix":"10.1111","volume":"93","author":[{"given":"Kristiina","family":"Pynn\u00e4","sequence":"first","affiliation":[{"name":"University of Helsinki Helsinki Finland"},{"name":"Department of Obstetrics and Gynecology Lohja Hospital Lohja Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piia","family":"Vuorela","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Porvoo Hospital Porvoo Finland"},{"name":"Finnish Medical Society Duodecim Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Lodenius","sequence":"additional","affiliation":[{"name":"Finnish Medical Society Duodecim Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorma","family":"Paavonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Helsinki University Central Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risto P.","family":"Roine","sequence":"additional","affiliation":[{"name":"Hospital District of Helsinki and Uusimaa Administration\/Research and Development Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pirjo","family":"R\u00e4s\u00e4nen","sequence":"additional","affiliation":[{"name":"Hospital District of Helsinki and Uusimaa External Evaluation Unit Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,12,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0957-5847(03)00008-8"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01199.x"},{"key":"e_1_2_9_4_1","unstructured":"BrummerT.Hysterectomy for benign indications in Finland. 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