Subtotal laparoscopic hysterectomy x total laparoscopic hysterectomy for imediate and late postoperative outcomes: a randomized controlled trial

Abstract

Hysterectomy is the most performed gynecological surgery in the world, and several minimally invasive approaches has been developed to improve postoperative period of women, such as laparoscopy. Preservation of the uterine cervix during hysterectomy (subtotal or supracervical hysterectomy) is a controversial step regarding its interference on sexual function or genital prolapse after surgery. There are few studies comparing subtotal hysterectomy versus total hysterectomy, and no study comparing these approaches laparoscopically. The aim of this research is to realize a study with women scheduled for hysterectomy due to benign gynecological conditions that will remove the cervix or not during surgery. It is proposed a randomized, factorial, controlled trial, single-blinded for the postoperative research evaluator of patients from Brigham & Womens Hospital, one the biggest minimally invasive surgical centers in the world, with enrollment starting January 2014. Primary endpoint is precocious return to activities. Secondary endpoints are: operative time, blood loss, intraoperative complications, postoperative pain, quality of life, sexual function, presence of genital prolapse, urinary symptoms. It is expected that with these results, we may be able to guide gynecological surgeons to council their patients if there is (or not) any benefits to remove the uterine cervix during hysterectomy. (AU)