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. 2011 Jul;108(30):508-14.
doi: 10.3238/arztebl.2011.0508. Epub 2011 Jul 29.

Hysterectomy in Germany: a DRG-based nationwide analysis, 2005-2006

Andreas Stang  1 , Ray M Merrill, Oliver Kuss
Affiliations

Hysterectomy in Germany: a DRG-based nationwide analysis, 2005-2006

Andreas Stang et al. Dtsch Arztebl Int. 2011 Jul.

Abstract

Background: Hysterectomy is among the more common surgical procedures in gynecology. The aim of this study was to calculate population-wide rates of hysterectomy across Germany and to obtain information on the different modalities of hysterectomy currently performed in German hospitals. This was done on the basis of nationwide DRG statistics (DRG = diagnosis-related groups) covering the years 2005-2006.

Methods: We analyzed the nationwide DRG statistics for 2005 and 2006, in which we found 305 015 hysterectomies. Based on these data we calculated hysterectomy rates for the female population. We determined the indications for each hysterectomy with an algorithm based on the ICD-10 codes, and we categorized the operations on the basis of their OPS codes (OPS = Operationen- und Prozedurenschlüssel [Classification of Operations and Procedures]).

Results: The overall rate of hysterectomy in Germany was 362 per 100 000 person-years. 55% of hysterectomies for benign diseases of the female genital tract were performed transvaginally. Bilateral ovariectomy was performed concomitantly in 23% of all hysterectomies, while 4% of all hysterectomies were subtotal. Hysterectomy rates varied considerably across federal states: the rate for benign disease was lowest in Hamburg (213.8 per 100 000 women per year) and highest in Mecklenburg-West Pomerania (361.9 per 100 000 women per year).

Conclusion: Hysterectomy rates vary markedly from one region to another. Moreover, even though recent studies have shown that bilateral ovariectomy is harmful to women under 50 who undergo hysterectomy for benign disease, it is still performed in 4% of all hysterectomies for benign indications in Germany.

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Figures

FIGURE
FIGURE
Hysterectomy with bilateral ovariectomy for benign diseases of the female genital organs in Germany, 2005–2006; columns: Absolute number (n) of women treated by hysterectomy with bilateral ovariectomy; curve: proportion (%) of hysterectomies with simultaneous bilateral ovariectomy. Altogether, 30 310 (12.36%) of 245 132 hysterectomies for which the ovariectomy status was clearly coded were accompanied by bilateral ovariectomy
eFigure
eFigure
Regional age-standardized hysterectomy rates (per 100 000) in Germany, 2005–2006
See this image and copyright information in PMC

Comment in

  • Hysterectomy is mostly unnecessary.
    Rott G. Rott G. Dtsch Arztebl Int. 2012 Mar;109(9):158; author reply 159-60. doi: 10.3238/arztebl.2012.0158a. Epub 2012 Mar 2. Dtsch Arztebl Int. 2012. PMID: 22461862 Free PMC article. No abstract available.
  • Data not correctly calculated.
    David M, Kentenich H. David M, et al. Dtsch Arztebl Int. 2012 Mar;109(9):158-9; author reply 159-60. doi: 10.3238/arztebl.2012.0158b. Epub 2012 Mar 2. Dtsch Arztebl Int. 2012. PMID: 22461863 Free PMC article. No abstract available.
  • Outpatient hysterectomies were not included.
    Klippel J. Klippel J. Dtsch Arztebl Int. 2012 Mar;109(9):159; author reply 159-60. doi: 10.3238/arztebl.2012.0159a. Epub 2012 Mar 2. Dtsch Arztebl Int. 2012. PMID: 22461864 Free PMC article. No abstract available.

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