RATES OF HYSTERECTOMY FOR UTERINE MYOMAS AND MYOMECTOMY IN THE UNITED STATES, 1979 – 2001

L.J. Burrows, L.A. Meyn, A.M. Weber

Woodland Physicians Associates, Inc., Bloomfield, CT

OBJECTIVE: To describe the rates of hysterectomy for uterine myomas and myomectomy performed in the United States over time and to evaluate any differences by patient characteristics. 

MATERIALS AND METHODS: Data from the National Hospital Discharge Survey were analyzed from 1979 to 2001 for the diagnosis of uterine myoma as well as procedure codes for myomectomy and various types of hysterectomy using the ICD-9-CM classification system. The numbers of surgical procedures were inflated to national averages using specifically designated hospital weights. Age-adjusted rates of procedures were calculated by the direct method of rate adjustment. Postoperative complications were tabulated. Separate multivariable logistic regression models were developed to identify factors independently associated with extended length of stay and postoperative complications.

RESULTS: The total number of hysterectomies for myomas and myomectomies performed from 1979 to 2001 was 6,091,700 and 500,000, respectively. Overall, hysterectomies were performed twelve times as often as myomectomies. The average age of women undergoing hysterectomy and myomectomy was 45.2 +/- 9.4 and 35.6 +/- 8.0 years, respectively. The adjusted rate of hysterectomy per 1,000 women remained stable at 2.4 in 1979 and 2.3 in 2001 (P = 0.2). The adjusted rate of myomectomy per 1,000 women was 0.11 in 1979 and 0.21 in 2001, an almost two-fold increase; however, this was not statistically significant (P = 0.2). Black women were hospitalized with a diagnosis of uterine myoma more often than white women (age-adjusted rate 4.8 per 1000 women, compared to 2.2 per 1000, respectively).  In addition, black women had a higher rate of hysterectomy for myomas (3.3 versus 1.8 per 1000 women) and a higher rate of myomectomy (0.4 versus 0.1 per 1000 women). Complications with hysterectomy for myomas and myomectomy occurred with similar frequency.

CONCLUSIONS: The rate of hysterectomy for uterine myoma has remained constant while the rate of myomectomy has almost doubled over a 23-year period from 1979 to 2001.  Black women undergo hysterectomy for myoma and myomectomy at higher rates than white women.

Key Words: hysterectomy, myomectomy, myoma

Disclosure – Nothing to disclose.