Talk:Hysterectomy

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HERS and NPOV

This article appears to be under constant NPOV creep by HERS. I have removed one reference in the introduction to the article but I believe that it may need more clearing up from a NPOV pov. Elliehughes (talk) 15:25, 5 May 2011 (UTC) Ellie

Agreed. HERS folks, this issue has come up time and time again, and you have been asked to stop doing this time and time again. If you have any lingering doubt about the inappropriateness of inserting even one paragraph of HERS propaganda into this article's lead, let it cease lingering: The Wikipedia tenet of keeping articles factual and written from a Neutral Point of View (NPOV) is absolute and non-negotiable. This means that even if someone thinks it is vital that readers of a Wikipedia article know about the work of a lobbying site pushing a single agenda point concerning the article subject, inserting said website's agenda into the article's lead is not appropriate and is a blatant violation of NPOV. This article has a "See also" section, and an entry for the Hysterectomy Educational Resources and Services (HERS) Foundation already exists there. The information that HERSFoundation placed in the article's lead on 25 May 2011 belongs in that article, not this one. If someone wants to find that information, they can find it in the HERS article or on the HERS website. Please refrain from using this article as a soapbox to push your anti-hysterectomy agenda. Scarletsmith (talk) 04:04, 26 May 2011 (UTC)

Oldest discussion

I've added some major corrections and below are my rationale for them.

"removal of any parts of the female reproductive system" test

this is misleading as it implies that an unilateral ovary resection can be called a hysterectomy. The uterus HAS to be involved in a hysterectomy and the text has been changed to reflect this.

I changed this back, because it DOES say "colloquially yet incorrectly". It's not the explanation here that's misleading, it's the people who use it colloquially who are misleading, if not downright incorrect. Yet because it is used that way, I felt that an explanation here in which the usage is explained is warranted--people are coming here for basic info. Example: I've had women say to me that they've had two hysterectomies, and I've had to explain to them that it wasn't because of 2 uteruses, but because once was ovarian removal, once was uterine removal. And I've had women say they've had a hysterectomy and have no clue whatsoever what was removed. And I've had women say they've had a hysterectomy but they've really had just the ovaries removed. Such misunderstandings should be given an explanation.QuizzicalBee 14:41, 14 March 2007 (UTC)

'"The uterus is a hormone-responsive sex organ that is physically placed to support the bladder and bowel"'

this sounds as if the only role of the uterus was to support bladder and bowel. removed this part as someone interested in the anatomy and function of the uterus can look at the article for uterus

'"Removal of the uterus can interfere with blood supply to the ovaries, hence..."'

cause and effect problem. in this instance we are explaining the earlier menopause with blood supply disruption while other factors which predisposed these women to uterus problems could have also predisposed them to early menopause.

'"The uterus is a hormone-responsive sex organ that is physically placed to support the bladder and bowel. When only the uterus is removed women are at three times greater risk of cardiovascular disease--removal of the uterus often interferes with blood flow to the ovaries, so women who undergo hysterectomy reach menopause an average of 3.7 years sooner than the average age of natural menopause. When the ovaries are removed a woman is at a seven times great risk of cardiovascular disease. [2][3][4][5]As with other hormone-producing glands, the endocrine functions of the ovaries cannot be fully replicated by hormone replacement therapy. The ovaries produce dozens of hormones a woman needs throughout her entire life[6], released directly into the blood stream in a continuous fashion, in response to and as part of the complex endocrine system."'

repetitive with risks and one sentence mentions 3 times risk while another

(incorrectly) states seven times risk of cardiovascular diseases. moved this to Risks section and added the fact that despite a 3x inc risk, the risk has only increased to be on par with the male counterparts. (thats why its very rare for a premenopausal woman to have heart attacks)

'"The ovaries produce dozens of hormones a woman needs throughout her entire life[6], released directly into the blood stream in a continuous fashion, in response to and as part of the complex endocrine system."'

this is not completely true and is very misleading. in fact after menopause a woman no longer produces these hormones in significant quantities anymore. this is a physiological response signalling that she is too old to reproduce and that she has ran out of ovum (eggs) to be fertilized (a woman at puberty has about 3-400 ovum released at ~12 per year thats about 30 odd years of reproductive life). after this the ovaries as well as other sex organs (uterus, fallopian tubes, breasts) atrophies and become dysfunctional.

HRT is aimed not to restore a woman's fertility (as it cant when u've ran out of eggs to fertilize), but aimed to reduce the side effects of menopause and counter the effects of testosterone (yes women have male hormones in them, it's produced by the adrenal cortex) which causes facial hair growth, deepened voice etc etc.

I disagree--that is not true in the context of this article. We're talking about having the ovaries removed and therefore having surgical menopause before the time of the end of reproduction. Also, the ovaries DO continue to produce hormones throughout one's life, and they DO make a difference, even if some don't consider them to be 'significant.' It's up to you to prove they're not significant, rather than up to others to prove that a natural bodily function is signifiant. QuizzicalBee 14:41, 14 March 2007 (UTC)

It is true that the burden of proof is on me to show that it is not significant. After menopause there is still circulatory estrogen. But these estrogen is generally not being produced by the ovaries as at this stage, the ovaries have become resistant to follicle stimulating hormone (an inducer of the ovarian follicles to mature and produce estrogen). the ovaries become atrophic and no longer produce significant amounts that can overtly affect other sex organs such as the breast tissue and uterus. So, what i meant by "significant" is that they no longer secret enough estrogen to have the intended physiological effect on the body (i.e. uterus thickening). I probably should have not deleted the whole sentence, but stated that the estrogen secreted is only really important during a woman's reproductive life.

Also I do agree that there still are detectable levels of estrogen amongst other sex hormones in the body after menopause, but these are not produced by the ovaries, but other endocrine organs such as the adrenal cortex and adipose tissue (which only became a major endocrine organ recently). Hence I've changed "throughout her entire life" to "throughout her entire reproductive life".

Hi. I have to disagree with you here again--basically, our disagreement comes down to you saying that the ovaries and ovarian hormones are only significant for reproductive matters, and me saying no, they have many other significant effects and purposes in the body. Medical texts used to teach that the ovaries were only reproductive in function, minimizing any other effects, but it's simply true that ovarian hormones DO have many important effects in the body, and that the ovaries DO continue to produce hormones, albeit in small amounts, throughout one's life, which is why there are different hormone profiles for surgically menopausal and naturally menopausal women of the same age. The references section of this item lists sources to read. Teststerone is the main hormone produced, but there are others. It is therefore misleading to speak only of the reproductive functioning of the ovaries, uterus, etc. This attitude is becoming outdated, based on old ideas that after menopause, the uterus, ovaries, and breasts were just potential cancer causing organs and could safely be removed without repercussions of any kind. This may seem like a small matter, but it's actually quite important as an attitude towards which to approach women's bodies and health.QuizzicalBee 14:36, 15 March 2007 (UTC)

I've moved some parts around to give a better flow to the article and corrected some NPOV problems such as the overwhelming amount of "alarmist" statements involved.

--Av01d 12:05, 14 March 2007 (UTC)

---

This page seems to have a bit of NPOV trouble.

--Dfeuer 06:47, 25 December 2005 (UTC)

You make a fair point. The only two sentences I see that may not be NPOV are the last sentence of the last two paragraphs. Both of those are easily removable. Spamguy 07:35, 25 December 2005 (UTC)

"New treatment options have begun to decrease the number of hysterectomies performed in the United States, Canada, and Britain. Despite this, some women still undergo unnecessary surgery, as some are not given adequate access to good therapeutic alternatives."

It would be really good to cite a source for the first of these statements. The second absolutely needs a source to be NPOV, as it is essentially subjective.

--Dfeuer 21:23, 25 December 2005 (UTC)

This is still not NPOV, as suggested by the word "should" without a source. Who says women should consult with their doctors about this? Furthermore, alternatives are sometimes available, but not always.

--Dfeuer 21:44, 26 December 2005 (UTC)

Expand indications

The list of indications probably should be longer and more detailed. Off the top of my head, I know it should mention that hysterectomy is often requested by FTM transsexuals.

--Dfeuer 21:47, 26 December 2005 (UTC)

Is that a medical indication? JFW | T@lk 00:02, 27 December 2005 (UTC)

Yes, actually; during gender transition, removal of the ovaries and/or uterus helps prevent reproductive organ cancer, hormonally-related coronary artery disease, and some others. I've added them, as well as a breakout of the conditions that most indicate a need for hysterectomy (and fought off more HERS propaganda while doing so)... Scarletsmith 05:18, 12 June 2007 (UTC)

Just want to add that the section about FTM needs to be rephrased. It says "women" and then talks about trans men, who are not women. You could restate it a number of different ways to approach a good neutral balance, I don't really have the brain at the moment for it myself, since I run across a lot of articles that have problems like this, but a fix would be really appreciated. Thank you. — Preceding unsigned comment added by 70.177.143.15 (talk) 03:40, 27 June 2015 (UTC)

Etymology

Perhaps a discussion of the history/etymology of the term, "hysterectomy," would be in order. I don't personall6y have the expertise to add to the entry, but I think it might be interesting to know the way the term was used back in the days when "womens' hysteria" was said to come from the uterus. So was a "hysterectomy" an attempt by the (male-dominated) medical establishment to literally cut the hysteria out of a woman? I suspect that's the case, but I'd rather know for sure before making that claim.

The prefix "hyster" comes from the Greek word, "Hustera" (of course, this is the English spelling translation - the greek alphabet would have been used for the original word) meaning "womb". The terms "hysteria" or "hysterical" come from the 19th century medical assertions (possibly earlier) that extreme emotionalism, excessive pain perception, etc., seen as a few of the defining "weaknesses" of the female human, were rooted in the womb.

Women who underwent emergency cesarian sections, usually caused by undiagnosed, painful medical conditions such as endometriosis or even uterine cancer, often ended up having hysterectomies. If they survived the procedure, the women and doctors noted that most of their symptoms, severe pelvic pain (endometriosis), "hysteria" (PMS), etc. abated, thus hysterectomy was prescribed for women with "hysterical" symptoms. It was later that the term "hysteria" became synonymous with "imaginary" or "psychosomatic". There are certain misogynistic assumptions made by the medical establishment in this history, but hysterectomy was not solely a misogynistic procedure. After all, hysterectomy in order to excise uterine cancer is seen as perfectly reasonable.

All of the preceding commentary was gleaned from human biology and sexuality research during my university days. I'm not really interested in going back and doing a bibliography search for this stuff. It is an interesting topic for the discussion page though. Strike71 09:14, 30 December 2006 (UTC)

Recent Major Changes

QuizzicalBee 17:42, 11 December 2006 (UTC) What the? Did this page just suddenly change and become far shorter?

This article seems to have a very serious POV problem. It looks like its been "got at" by an activist of some sort Stuart Slade 14:25, 15 December 2006 (UTC)

I reverted way back to the version by User:BradBeattie of December 10. User:HERSFoundation made such a large number of changes at once that the diffs were useless. Furthermore, many of the changes did not obey the NPOV policy, and they did not properly cite their sources. I at first attempted to make minor edits to bring things back into line with Wikipedia standards, but decided it was not worth the trouble. HERSFoundation: if you would like to edit this article again, please keep individual changes small, and be sure they follow Wikipedia policies. --Dfeuer 21:52, 18 December 2006 (UTC)

I haven't looked in depth at the changes made by HERSFoundation, but the article on Oophorectomy was similarly altered by HERSFoundation and User:70.16.136.53. Stuart, I think you're right about the "activist of some sort" - namely the HERS Foundation (http://www.hersfoundation.com/). I don't think they're aware of "how we do things at Wikipedia," but they do have some information on their website, which if accurate and verifiable, could be useful to both articles. I've made similar comments at Talk:Oophorectomy. Jaksmata 15:58, 21 December 2006 (UTC)

QuizzicalBee 01:27, 25 December 2006 (UTC)The people who totally changed this before have come back and totally changed it again. They've slightly changed the text, but it is in essence the same, with similar NPOV problems like that hysterectomy is NEVER needed for fibroids. Something like that MUST be well-substantiated or it has no place here. It was also entirely unnecessary to completely remove the long-standing text in favor of completely new text, including removing all of the references which, frankly, better demonstrated the excesses of hysterectomy than the brief article that was inserted in its place. I'm entirely in support of HERS' mission, but they're not doing a good job by making these changes. I'm reverting it back, but incorporating MOST of what they had used. I just didn't include the parts without references and with NPOV problems. I hope this means we won't have these repeated reversion problems.

Mad props to QuizzicalBee for doing all that work. I think the description "intact women" could be a bit weasely. It'd be nice to find an alternative description. Dfeuer 08:21, 25 December 2006 (UTC)

The "hysterectomy is NEVER needed for fibroids" scare-text is back again, and once again I'm reworking it to remove PoV-creep. Never needed for fibroids? Ask my former sister-in-law, whose fibroid never did respond to any kind of non-surgical treatment and had to be removed because it had reached nearly 10 lbs. and was beginning to cause major difficulties with pressing on her bowels and bladder. There are procedures to make fibroids shrink (very good ones, in fact, that work on a lot of women), but because they are in essence a benign tumor on the uterus, they will never go completely away without surgery. That's the reality of the situation. Heck, there was an episode of Babies: Special Delivery that showed a woman with a 5+ lb. fibroid that was so large it was taking up crucial growing room for the baby. Although they were able to deliver the baby successfully through C-section, months later the fibroid was still not responding to conservative treatment and the woman required a hysterectomy to remove it. You could literally see it protruding from her skin. She said she was in a lot of pain during the pregnancy and couldn't wait for the pregnancy to be over so the doctors could finally address the massive fibroid. So, HERS folks, we know you feel strongly about this, but please don't just throw scare tactics into this article. Come talk to us here first and present your case, and let those of us who've spent a lot of time and energy working to make this article NPoV and informative help you find a way to word your factual information in such a way that it fits into the NPoV tone of the article. Thanks... Scarletsmith 05:29, 12 June 2007 (UTC)

OK, someone at HERS has just added a huge chunk of text--articles about the complications of Uterine Artery Embolization, with lengthy excerpts. This seems to likely be plagiarism, if the abstracts were from the journals and not written by the submitter. But it definitely is entirely outside of the realm of info needed for an article about HYSTERECTOMY. If they want to edit the article on Uterine Artery Embolization, they can do so, but for now, I'm reverting back to the previous entry. Also, don't just copy and paste materials from some other source, like the HERS web page--all of the new material on UAE was from: http://www.uterinearteryembolization.com/journal.html. You need to rewrite the materials for Wikipedia.

The claims of negative cardiovascular effects added by HERSFoundation seem to be backed only by two studies, one of them from the 1960s. It would be great if someone could do the reading to find out what more recent studies have said on the matter, or even try to find out how the studies were received at the time. Dfeuer 06:31, 27 December 2006 (UTC)

There are a lot of recent studies that show the negative cardiovascular effects--I'll add some later today. I also reverted the changes you (Dfeuer) just made, because I didn't feel that emphasizing that surgical menopause and menopause are different biological processes was non-NPOV. I guess I'd have to say that I find it kind of weasely to use the same words to refer to two different things--but technically, those are actually the usual, accepted words. I mean, I can definitely see the point that we should use the conventional terms "menopause" and "surgical menopause," but the use is problematic nevertheless, so using them while making a point of mentioning that there is a distinction is a good idea, I feel. I also felt that the oophorectomy-only stuff should stay in there, simply because hysterectomy IS conventionally used to refer to removal of ANY organs of the female reproductive system, and I've heard many women use it this way. That's weasely too, to use the same word euphemistically to refer to several different things. What makes me want to include it, though, is that I believe it extremely likely that people looking for info on oophorectomy WILL first look at the "hysterectomy" page. I'll see if I can rephrase any of this to be more NPOV, though.QuizzicalBee 15:50, 27 December 2006 (UTC)

We are writing an encyclopedia, not a paper to present at a conference. We should therefore use the generally accepted medical terms, whether or not we personally like them. It is absolutely obvious that surgical menopause is not the same as natural menopause, and there is no need to harp on it. There are enough links to the oophorectomy article (including one I just added) in this article that anyone who comes to Hysterectomy looking for information on oophorectomy will have absolutely no trouble finding it. Dfeuer 20:02, 29 December 2006 (UTC)

I have moved some of the info QuizzicalBee added to Hysterectomy into Oophorectomy.Dfeuer 20:11, 29 December 2006 (UTC)

I came upon this article last week while doing some research. This entry reads as an anti-hysterectomy manifesto. In addition, the current article is USA-centric in its use of statistics and is no longer NPOV - it cannot be used as a fact-gathering tool due to the obvious bias, that is, complete repudiation of the idea that hysterectomy is ever a valid medical procedure. After reading the history of the page and talk:Hysterectomy as well, it is obvious to me that a lot of really good work by WP editors has been subverted to the cause of the HERS foundation, which seems to be the reduction or elimination of hysterectomy as a medical choice. Please, may I revert this article yet again to the December 10 User:BradBeattie pre-HERS foundation edited version (I agree with Dfeuer that this is a good starting-point) so we can have a fresh go at adding new facts and data free of bias? I can't help but feel that users who comes across this page as it is may lose faith in the WP mission.

A "Controversy" heading addition would be an improvement too, outlining the history of the anti-hysterectomy movement and providing a place for their POV in an appropriate venue for an encyclopedia. Incidentally, I am not anti-'anti-hysterectomy'. I believe all well-researched, cited, factual evidence should be considered objectively. However, the POV of the HERS foundation is demonstrably not objective in that I could not find any acknowledgment on their website or in their literature that the experience of hysterectomy can be positive (ie, life-saving, life-improving, etc.) in some cases, though not all. Since there are many women who consider their hysterectomies a "new lease on life" and the like (such views are commonly expressed on hysterectomy support group message boards along with diminished quality of life complaints), the radical, one-sided HERS foundation perspective can be dismissed as unreflective of medical realities. Strike71 20:59, 2 January 2007 (UTC)

I agree with Strike71 that the article as it is now has very serious problems. However, I do not agree with the suggested remedy, although adding a "Controversy" section might not be a bad idea. The best way to address this kind of bias is typically not to remove arguments but to add them. In my view, the following steps would be most productive (not in any particular order):

• Check all references added by HERS foundation to ensure they are good references and that information from them is not used out of context.
• Look for (preferably more recent) research coming to different conclusions, as well as published responses to the cited studies criticizing their methodology.
• Make the anti-hysterectomy arguments as concise as possible without losing content.
• Add more information about the benefits of hysterectomy (I too have seen women write about how much happier they became after necessary hysterectomies that doctors initially refused to perform, and I have heard from FTMs who have found it very difficult to find doctors willing to perform a desired hysterectomy.)

Unfortunately, I don't think I have the time right now to do a whole lot of this work, but I will try to do some. Dfeuer 09:18, 3 January 2007 (UTC)

After consideration, I agree with Dfeuer that substantial removal of "Anti-hysterectomy" data will probably only incite repeated excisement of changes and reversions back to the most extreme of the HERSfoundation material. Therefore, I'm going to dip my toe in the controversy and start making some additions as per Dfeuer's suggestions, which I think are reasonable and well thought out.

Hope it all turns out, but I'm sure I'll be notified if my additions are not "up to spec". I'm new at this but will do my best... 216.231.42.198 04:19, 13 January 2007 (UTC)

As a woman who had a bilateral ovariohysterectomy 5+ years ago and never regretted it, daughter of a woman who had a single oophrectomy with hysterectomy (who regretted not having doctors remove her other ovary) 25+ years ago, and granddaughter of a woman who had bilateral ovariohysterectomy 40+ years ago and never regretted it, I have finally added a "Benefits" section with full references and real scientific studies that prove that oophrectomy and ovariohysterectomy can, in fact, be beneficial to women with certain conditions:

• Women with BRCA1 and BRCA2 mutated genes, which are genetic triggers for breast cancer (adding hysterectomy with prophylactic oophrectomy further reduces the risk)
• Women whose intractable pelvic pain and/or reproductive issues do not respond to non-surgical or limited surgical intervention

Hopefully, this will both aid in keeping the tone NPOV and give a way to counter all the HERS propaganda in here. Scarletsmith 19:23, 7 June 2007 (UTC)

Improperly formatted references

I removed the following from the references section. It needs to be put in the right format to be readable. I'm way too tired to do that now, but as it was, it turned the references section into an unreadable mess. Some checking into the quality of these sources would be very helpful as always.

The vagina is shortened and made into a closed pocket and there is a loss of support to the bladder and bowel.[verification needed]

The following is the requested verification:

Rock, John A. et al  Total Abdominal Hysterectomy: Surgical Technique Te Lindes's Operative Gynecology Ninth Edition p.809-828
Zeigerman, Joseph H.  Length of the Vagina After Total Abdominal Hysterectomy Obstetrics & Gynecology 1955 Vol. 6 No. 5 p.519-521
Parys, B.T. et al  Bladder Dysfunction after Simple Hysterectomy: Urodynamic and Neurological Evaluation  Eur Urol 1990; 17: 129-133
Parys, B.T. et al  The Effects of Simple Hysterectomy on Vesicourethral Function British Journal of Urology 1989, 64, 5940599
Cruikshank, Stephen H. et al  The functional anatomy  of the urethra: Role of the pubourethral ligaments Am J Obstet Gynecol Vol 17 No. 6 p.1200-1205
Varma, J.S. Autonomic Influences on Colorectal Motility and Pelvic Surgery 1992 World J. Surg. 16, 811-819
Roe, AM et al Slow Transit Constipation, Comparison between Patients with or without Previous Hysterectomy 1988 Digestive Diseases and Sciences Vol. 33, No. 9 p.1159-1163
van Dam, JH et al Changes in Bowel Function After Hysterectomy 1997 Dis Colon Rectum Vol 40 No 11 p.1342-1347
Wiersma, Tj et al Hysterectomy: the Anorectal Pitfall 1997 Scan J Gastroenterol p.3-7

—The preceding unsigned comment was added by Dfeuer (talk • contribs) 09:23, 20 January 2007 (UTC).

Properly formatted references

Here are the refs list above, properly formatted in Cite.php format and ready for re-insertion as needed:

• Rock JA, Jones HW (eds.) (2003). Total Abdominal Hysterectomy in: TeLinde's Operative Gynecology (9th ed. ed.). Lippincott Williams & Wilkins. pp. pp. 809-28. ISBN 0781728592. {{cite book}}: |author= has generic name (help); |edition= has extra text (help); |pages= has extra text (help)

• Zeigerman JH (1955). "Length of the vagina after total abdominal hysterectomy". Obstet Gynecol. 6 (5): 519–21. PMID 13266268.

• Parys B, Woolfenden K, Parsons K (1990). "Bladder dysfunction after simple hysterectomy: urodynamic and neurological evaluation". Eur Urol. 17 (2): 129–33. PMID 2311638.{{cite journal}}: CS1 maint: multiple names: authors list (link)

• Parys B, Haylen B, Hutton J, Parsons K (1989). "The effects of simple hysterectomy on vesicourethral function". Br J Urol. 64 (6): 594–9. PMID 2627634.{{cite journal}}: CS1 maint: multiple names: authors list (link)

• Cruikshank S, Kovac S (1997). "The functional anatomy of the urethra: role of the pubourethral ligaments". Am J Obstet Gynecol. 176 (6): 1200–3, discussion 1203-5. PMID 9215174.

• Varma J (1992). "Autonomic influences on colorectal motility and pelvic surgery". World J Surg. 16 (5): 811–9. PMID 1462613.

• Roe A, Bartolo D, Mortensen N (1988). "Slow transit constipation. Comparison between patients with or without previous hysterectomy". Dig Dis Sci. 33 (9): 1159–63. PMID 3409802.{{cite journal}}: CS1 maint: multiple names: authors list (link)

• van Dam J, Gosselink M, Drogendijk A, Hop W, Schouten W (1997). "Changes in bowel function after hysterectomy". Dis Colon Rectum. 40 (11): 1342–7. PMID 9369110.{{cite journal}}: CS1 maint: multiple names: authors list (link)

• Wiersma T, Werre A, den Hartog G, Thies J, Tytgat G, Mulder C (1997). "Hysterectomy: the anorectal pitfall. A guideline for evaluation". Scand J Gastroenterol Suppl. 223: 3–7. PMID 9200299.{{cite journal}}: CS1 maint: multiple names: authors list (link)

-- MarcoTolo 02:10, 20 February 2007 (UTC)

HERS Foundation description

I just reverted a change HERS Foundation made to the description I wrote of the organization. I formulated my description after looking through the materials available on the HERS Foundation website: It seems to be primarily an advocacy site rather than an informative one (see for example the facts page on the site). There's nothing wrong with advocacy, but the fact that HERS Foundation wants to be seen in a certain way is not justification for a slanted description on Wikipedia. The claim that the organization is an international one is seriously weakened by the fact that at least since 2002 (the earliest information I could find in the Internet Archive) their conferences have all occurred in the United States. Similarly, their IRS Form 990 for 2005 lists all "officers, directors, trustees, and key employees", including the president, chair, secretary, and treasurer, as residing in the United States. Information on Wikipedia must be verifiable. I will add back the fact that HERS Foundation is a non-profit, as that could be verified through their IRS filing. Dfeuer 10:02, 20 January 2007 (UTC)

HERS posters have been particularly egregious about POV pushing. We may have to request a no-anonymous-user lock for this article if it keeps up. Scarletsmith 22:32, 1 June 2007 (UTC)

Hysterectomy vs. oophorectomy

I added back in the mention of oophorectomy on this page, because most women do not know the difference, and very often medical professionals will use the term "hysterectomy" when referring to hysterectomy with oophorectomy. It is therefore important to clarify the difference here. The vast majority of information about oophorectomy is on the oophorectomy page, but some differentiation of oophorectomy and hysterectomy is necessary on the hysterectomy page because that's how the term is used, and this is the page that a lot of people will come to to learn about getting ovaries removed, at least initially. Furthermore, since in the vast majority of cases of hysterectomy, the ovaries are also removed, it makes sense to make the distinctions clear on this page. —The preceding unsigned comment was added by QuizzicalBee (talk • contribs) 02:31, 31 January 2007 (UTC).

Belated addition of external links cleanup

• Posted this explanation on my talk page the other day - copying here as more appropriate...

As for the external links, going through the list of what I removed, the support groups are either listed or have similar sites available at the Open Directory Project (the dmoz links), the FTM guide link was/is broken, and the BBC link seemed to duplicate much of the information available at the ODP. After looking at the preview of the surgical hysterectomy video, it seemed much more like an infomercial than educational. As a general rule, I try to follow the most basic of the WP:EL guidelines: external links should only be added if they directly add pertinent, relevant information that is unavailable and/or cannot be added to the article itself. As an aside, I've also begun using the {{dmoz}} template to direct folks to another, WP-like resource, particularly when it comes to health-related support groups. This lets readers see a wider range of options without turning Wikipedia into a giant linkfarm. -- MarcoTolo 01:40, 25 February 2007 (UTC)

-- MarcoTolo 00:00, 27 February 2007 (UTC)

Fixed FTM links. Scarletsmith 22:33, 1 June 2007 (UTC)

I would like to recommend adding back the link to http://www.hystersisters.com to the external links listing. In the early days of this hysterectomy page of wiki, the website was listed as a resource as it should be. Yes, it is listed in DMOZ but the listing is under support groups and not under the proper heading of simply hysterectomy. As the largest resource online for patients and doctors for hysterectomy, it would be a good thing to provide in the wiki listing, especially in light of the balance it provides for the anti-hysterectomy propaganda of HERS. (No, hystersisters.com is not "pro-hysterectomy" as we are a balance for our visitors....We regularly must edit/remove posts by HERS as well at hystersisters.com). Further, if I can be a benefit to this article, I'd be happy to provide additional information, research, stats, articles, as the editors of this page need. Hystersisters 20:40, 5 August 2007 (UTC) Kathy Kelley (Hystersisters.com)

Thanks for coming here, Kathy, and I agree with your addition to the links. Also, I'm not sure who keeps removing the FTM guide links, but they need to be here as well (as hysterectomy is an important issue in the transman community). Welcome to the page! Scarletsmith 17:07, 6 August 2007 (UTC)

I'm still not sure that hystersisters.com meets the definition of an appropriate external link per the guideline. I don't doubt the usefulness or validity of the site as a whole - it seems to provide a valuable services for its target group - but I'm not seeing how a site that seems to basically be a support group is an appropriate link for an encyclopedia. I do consider this particular site to be a borderline-case for inclusion, but I'd like to hear the rationale(s) explicitly for this one. (NB: Prior inclusion is not a good basis - Wikipedia's standards increase as articles (and the site) mature).) -- MarcoTolo 00:55, 7 August 2007 (UTC)

I personally think that hystersisters meets the guidelines under items 3 & 4 of "What should be linked:

Sites that contain neutral and accurate material that cannot be integrated into the Wikipedia article due to copyright issues, amount of detail (such as professional athlete statistics, movie or television credits, interview transcripts, or online textbooks) or other reasons.

Sites with other meaningful, relevant content that is not suitable for inclusion in an article, such as reviews and interviews.

I also think prior inclusion is a useful guideline to follow; just because articles mature does not automatically render past content irrelevant. But that's just my opinion. Scarletsmith 14:56, 7 August 2007 (UTC)

My concerns are mostly that the site content appears to be mostly anecdotal in nature (at least based on what I found during browsing) - which would tend to suggest that it falls under the "discussion forum" section of links to be avoided. That said, since I feel this is a borderline case I'll suspend my objection at this point. -- MarcoTolo 17:16, 7 August 2007 (UTC)

as of hystersisters it may be unfair but it is much easier to include links to advocacy/activist sites such as HERS (as long as it is clearly visibly it is activist and they are halfway notable) than to external sites that claim to contain medical information - here the strict rules of WP:MEDRS apply. Looking at hystersisters the site had forums that can be certainly very helpful but upon first glance the medical information did appear neither up to date nor especially noteworthy. Richiez (talk) 09:18, 20 June 2010 (UTC)

I would like to request that hystersisters.com be added to the external links at the bottom of the article. HysterSisters.com isn't just a large community. We have a medical advisory team, regularly use doctors for our Ask the Doctor - articles and videos. We have kept all articles up to date for diagnosis, surgical choices and news within the medical community. Additionally, we produce educational videos with doctors answering members questions. I believe the missing ingredient you didn't find when I made the request a few years ago - has been added - with medical authority but still with patient education in mind. Hystersisters is a recognized patient education brand - partnering patients with great information while they partner with their doctors. I believe it is a great resource for this article. Thank you for your consideration. Hystersisters (talk) 17:57, 7 November 2013 (UTC)Kathy Kelley

Category:Human reproduction

I propose removing this article from Category:Human reproduction. I have proposed narrowing the scope of that category at Category talk:Human reproduction. Please comment on the category talk page. Lyrl ^Talk _C 15:02, 17 March 2007 (UTC)

HERS Foundation Editors Pushing POV

To those editors who keep coming in and inserting the HERS Foundation website as an informational site, please stop. It smacks of POV-creep. Scarletsmith 02:14, 17 May 2007 (UTC)

Seriously, HERS folks, this isn't funny. Please stop using this entry as your own personal opinion board. Particularly, users coming in via 68.236.x.x addresses with no user name, stop doing this. Get a Wiki user ID and put your name out there if you really feel so strongly about this issue. Scarletsmith 02:42, 30 May 2007 (UTC)

Strongly seconded. Wikipedia articles must be from a neutral point of view. The recent HERS Foundation additions have blatantly pushed a POV - keep it out of the encyclopedia, please. At the very least, please discuss changes like this on the talk page before adding them. -- MarcoTolo 03:20, 30 May 2007 (UTC)

To Norawcoffey, thanks for taking on the task of getting a Wiki account and participating with us on this article. We appreciate your willingness to participate properly in the process. Please come here to discuss any changes that may push the tone of the article toward a PoV position (a.k.a. "PoV-creep") before posting them. I think we've got a good NPoV article for right now; let's all work hard to keep it that way. Scarletsmith 02:24, 12 June 2007 (UTC)

I'm sorry if I offended anyone by not signing before making my previous posts. I did, however, at your recommendation, sign in before posting a comment a few days ago on the Talk Page, also as you suggested, but my comments don't appear to be posted. If you have any suggestions on how to communicate with you on this page I would appreciate it. Thanks, Nora W. Coffey

Nora (and any other posters pushing a particular organization's view on this subject): While we all have our own personal views on many subjects, according to Jimbo Wales, founder of Wikipedia, "Neutral Point of View is absolute and non-negotiable." This means you must make every effort to keep your additions as neutrally worded as possible. If you need help with creating neutral wording for any additions to this article, please come here first. The editors here are very diligent about knocking back PoV-creep, as we are required to be; please meet us halfway and work with us. Thanks... Scarletsmith 23:18, 18 July 2007 (UTC)

Hysterectomy

I just posted this comment at the end of the last post, but perhaps this is the proper format. I thought I'd give it a try, so my apologies in advance of it is duplicated.

I'm sorry if I offended anyone by not signing before making my previous posts. I did, however, at your recommendation, sign in before posting a comment a few days ago on the Talk Page but my comments are not posted. If you have any suggestions on how to communicate with you on this page I would appreciate it. Please let me know if there's something else I should be doing to post here. Thanks, Nora W. CoffeyNorawcoffey 03:35, 26 June 2007 (UTC)

Castration

To Nora W. Coffey: Please, stop deliberately introducing PoV creep into this article. There is already a perfectly valid NPoV sentence in the opening section that refers to removal of ovaries as being a form of castration. There does not need to be any more references to "castration" added to that section. I can appreciate that you feel strongly about this issue, but Wikipedia requires that articles maintain a Neutral Point of View even in regard to issues one feels strongly about.

This is NPoV wording: "Additionally, the removal of otherwise healthy ovaries is a form of castration because it involves removal of the female gonads, which many opponents and even some supporters of hysterectomy do not support."

This is PoV-creep: "During a hysterectomy, in the last decade, an average of 73% of surgeons removed ovaries and fallopian tubes in a surgery called bilateral salpingo-oophorectomy (sometimes called ovariohysterectomy) and female castration."

This is the same sentence with PoV-creep removed: "During a hysterectomy, in the last decade, an average of 73% of surgeons removed ovaries and fallopian tubes during the same operation, a procedure known technically as bilateral salpingo-oophorectomy and less formally as ovariohysterectomy."

Please work with those of us who have put in a lot of effort to keep this page as NPoV as possible. Don't deliberately add inflammatory text and/or PoV-creep. Thanks.... Scarletsmith 18:32, 18 July 2007 (UTC)

Question

After reading some of this, a women's goes under changes rather radically. But, why does this not happen to animals? For example, when female cat or dog is spaded (or whatever the word is), that changes dont seem as apparent. From my experience, my cat got spaded, nad it appears the main thing that happened to her is that she gained weight. I'm asking out of curiousity(sic), but it would be interesting for a mention of this in the article. THROUGH FIRE, JUSTICE IS SERVED! 01:14, 30 July 2007 (UTC)

It is a good question, and was addressed in this article at one point several edits back. (Veterinarians suggest spaying cats and dogs not only to keep the population down, but because it substantially reduces mammary cancer risk, particularly if done before the first heat cycle.) The fact that spaying--hysterectomy plus bilateral salpingo-oophorectomy--reduces mammary cancer in animals is significant, particularly because bilateral oophorectomy also significantly reduces breast cancer in humans, particularly women who have BRCA1/BRCA2 genetic mutation, and accompanying hysterectomy allows hormonal treatments to be estrogen-based rather than mixed-hormone-based which further reduces breast cancer risk. My mother, who had a serious breast cancer risk due to strong family history, stopped developing breast tumors after her uterus and one of her ovaries were removed. I too have stopped developing breast tumors post-hysterectomy/oophorectomy. Yeah, it's anecdotal in our cases. But it's also an example of the same scenario first spotted in spayed domestic animals. Scarletsmith 04:07, 30 July 2007 (UTC)

WikiProject class rating

This article was automatically assessed because at least one WikiProject had rated the article as start, and the rating on other projects was brought up to start class. BetacommandBot 16:28, 10 November 2007 (UTC)

Question: the article states that having a hysterectomy drastically changes a woman's hormone balance. I did not have the courage to actually CHANGE this in the article, but for the best of my medical knowledge this isn't the case unless an oophorectomy has taken place also...The uterus is not a major hormone-producing organ in itself.

Unsourced statement removed

I have removed the following statement as it has been marked "citation needed" for several months:

• Many women also find that their sex drive is reduced or eliminated after hysterectomy, especially if an oophorectomy was part of the procedure.

If anyone can find a source for this statement, feel free to re-add it. —Angr ^{If you've written a quality article...} 19:53, 27 December 2007 (UTC)

Misleading statement

I never realised this was quite such a controversial issue, I've never come across the kind of disputes over hysterectomies that seem to be playing out right here. All that aside though, I have a problem with the final paragraph of the introduction.

• Both the uterus and the ovaries have important life-long functions in the maintenance of a woman's health, and there is never an age or a time when the uterus and ovaries are not essential to health and well-being.[3] Additionally, the removal of otherwise healthy ovaries is a form of castration because it involves removal of the female gonads[4], which many opponents and even some supporters of hysterectomy[5] do not support

I know there has been talk about some of this already but it really ends up being a paragraph about ovaries in the introduction to a page about hysterectomy which seems odd to me. I also dispute the line that uterus and ovaries are 'essential to health and well-being'. This suggests that a woman who has had either her ovaries or her uterus removed can be neither healthy nor happy and this is plainly not true. The second sentence which people seem to have found ok in the past, I find unnecessarily negative. I know there are some strong opinions out there about it, but if it needs to be included at all in the intro to a hysterectomy page, perhaps it could be made a little less accusatory? eg. The practise remains controversial to some advocacy groups who are opposed to oophorectomy (and if REALLY needed, which I don't think it is) as they consider the procedure to amount to castration. McPat (talk) 13:13, 6 November 2008 (UTC)

Ok, I've reworded it a bit. I left the note about POV editing there.McPat (talk) 09:55, 16 November 2008 (UTC)

Poor quality "indications" section

The last paragraph of the Indications section is poor. It is unclear exactly how it relates to hysterectomy, and also links directly to a specific product. The link is broken, but the domain is that of a "natural nutrition" company. I don't know enough to replace it, but if nobody can do better perhaps it should just be removed. —Preceding unsigned comment added by 86.45.82.53 (talk) 01:23, 3 January 2009 (UTC)

Heavy Bias on this page

I'm concerned about the heavy bias this page now demonstrates with HERS foundation so prominently displayed in multiple ways. HERS is passionately anti-hysterectomy and will stop at nothing to get their message out. Are they now the editors of this page? Inappropriate use of wiki which should remain a non-biased resource. I see HysterSIsters.com was removed from the wiki again. HysterSisters.com represents a balance view of the issues. Neither anti-hysterectomy nor pro-hysterectomy, it provides resources and support for women gathering information and making decisions - and helps them through the process - even helping them with alternatives to hysterectomy, hormone therapy options, and offering resources for minimally invasive surgery methods. - Kathy Kelley (hystersisters.com)

As someone who has never visited the page before and has no relation to medicine or the procedure (my mother is receiving it late next week so I thought I'd read up a bit) the article reads very heavily against the operation - so much so that I read the talk page to determine what level of consensus there was regarding the expressed viewpoint. I'm not in a position to judge the accuracy of the claims but it really feels like it's saying "There are no situations in which a hysterectomy is a good idea". PhiRatE (talk) 05:22, 26 November 2009 (UTC)

It could sure use a lot of improvement. Imho it is generally better to be overly cautious and describe the risks, the long term effects are very frequently underestimated. The alternatives section looks like it needs some structuring tooRichiez (talk) 13:27, 23 January 2010 (UTC)

I agree on the heavy bias. I was looking for information about the procedure, not anyone's opinion on it. I was not looking to be talked out of a hysterectomy and I'm on annoyed that it was attempted through a wiki article. The opinion on whether it's right for me will come from my doctor, not some wiki activists. Maybe the article needs a fresh set of eyes because I know little on the topic and I was struck by the bias. GrrrlRomeo (talk) 07:03, 7 March 2011 (UTC)

Help is always welcome - even if it is only critique, but then it needs to be more precise. Its a huge chunk for the few editors, the past POV wars don't seem to be a problem most of the time. Richiez (talk) 19:58, 7 March 2011 (UTC)

Benefits

the section title is slightly strange, but there are other problems, I am moving two fragments to this place as I consider them in not very good shape and "difficult to salvage"

Women with a risk of breast cancer, especially those with BRCA1 or BRCA2 gene mutations, have been shown to have a significantly reduced risk of developing breast cancer after prophylactic oophorectomy. In addition, removal of the uterus in conjunction with prophylactic oophorectomy allows estrogen-only hormone replacement therapy (HRT) to be prescribed to aid the individual through their transition into surgical menopause, instead of estrogen-progestin HRT, which has a slightly increased risk of breast cancer as compared with post-menopausal non-hysterectomized women taking HRT.

The problems with above:

• BRCA1/2 is very complex, the various prophylactic strategies and surgeries are probably better explained in the specific BRCA article.
• HRT is a very protracted subject in itself, could be mentioned here. However *if* we want to mention it here it should be at least also mentioned that:
  • hysterectomy does on average cause premature menopause which necessitates earlier HRT which may be an inconvenience or have other adverse effects
  • hormonal effects of oophorectomy before age 45 cause significantly increased long term mortality

Other paragraph:

One of the conditions most cited by women who have complex pelvic and reproductive issues is pain. This is particularly true for women who have other conditions that amplify pain, such as fibromyalgia and chronic fatigue syndrome. Removal of a condition that is causing pain has a dramatic effect on reducing the overall pain levels of a person with such disorders; for many women with such pain conditions, a hysterectomy is preferable to the continual pain which adds to the burden of their already painful lives, even though the loss of hormones post-surgery may initially contribute to an increase in the symptoms of their disorder.

the merrits of the above paragraph are not quite clear to me. Who says that "Removal of a condition" is a synonym to hysterectomy. Richiez (talk) 23:30, 22 January 2010 (UTC)

BRCA mutation has been created and I hope over time it will grow to give a good overview if cancer preventions strategies and other issues. Richiez (talk) 09:31, 20 June 2010 (UTC)

Robotic hysterectomy

Hello wandals, I would be delighted to leave the following fragment verbatim in the article:

The fastest-growing technique is robotic hysterectomy, which as the name implies is a form of robotic surgery. It uses the da Vinci Surgical System which is manufactured by Intuitive Surgical corporation. It has the same advantages as laparoscopic hysterectomy, such as smaller incisions, less scarring, less pain, less blood loss, shorter hospital stay, and less chance of infection, but is much easier to perform because the surgeon uses a comfortable ergonomic computer console to control the articulating robotic arms of the device. Surgeons who find laparoscopic hysterectomy to be too challenging are very likely to grasp robotic surgery.

This fragment makes it appear like robotic surgery:

• it is some overhyped buzzword technique pushed by commercial interests
• is best suited for "challenged" surgeons who would be otherwise unable to do any surgery at all and who will be under tremendous economic pressure to perform hysterectomies after taking big loans to buy expensive equipment from "Intuitive Surgical"

It is wikipedia policy not to tolerate advertisement even if the formulation is so clumsy to be amusing and directly damaging to the advertisers intentions. Richiez (talk) 22:52, 25 January 2010 (UTC)

Reworded - Richiez (talk) 13:04, 26 February 2010 (UTC)

Vanity citation

Just for the record it is trivial to find out where a particular IP is geolocated. Regarding http://en.wikipedia.org/w/index.php?title=Hysterectomy&diff=340562730&oldid=340519621 there is a remarkable coincidence between the location from where this edit was done with the location where the cited article was authored. Richiez (talk) 20:38, 28 January 2010 (UTC)

Skill of surgeons who perform robotic surgery

All surgeons who perform robotic surgery are indeed able to perform surgery without a robot. For example, it is not unheard of for robotic surgeries to convert to open surgeries using the same surgeon for both techniques. Robotic surgery is growing in popularity due to the fact that most GYN surgeons are not interested in performing total laparoscopic hysterectomy using conventional laparoscopy. Lisa11777 (talk) 01:23, 29 January 2010 (UTC)

"Robotic surgery" is not a buzz word

If anyone can think of a better term for robotic surgery, I am open to suggestions. Lisa11777 (talk) 01:23, 29 January 2010 (UTC)

It was not "robotic surgery" I was complaining about, phrases like "fastest growing", "worlds greatest" etc should be avoided as far as possible in medical articles. Anything that looks like advertisement. Richiez (talk) 23:45, 14 February 2010 (UTC)

Decision to use a surgical robot

Generally speaking, surgeons who use robots do so because they choose to, not because their hospital pressures them to. Surgeons do not purchase robots; hospitals do. It is usually the surgeon who pressures the hospital to purchase one. Furthermore, many GYN surgeons are very fortunate to already have access to a robot which was originally purchased for use by urological surgeons for robotic prostatectomy. Lisa11777 (talk) 01:53, 29 January 2010 (UTC)

removed material from Alternatives

This section should ideally have a short overview and where possible head-to-head comparison to hysterecomy.

The part about UAE was more detailed than the separate article, placing the material here maybe its of soem use later.Richiez (talk) 00:23, 15 February 2010 (UTC)

Death from embolism, or septicemia (the presence of pus-forming or other pathogenic organisms, or their toxins, in the blood or tissues) resulting in multiple organ failure. Infection from tissue death of fibroids, leading to endometritis (infection of the uterus) resulting in lengthy hospitalization for administration of intravenous antibiotics. Misembolization from microspheres or polyvinyl alcohol (PVA) particles flowing or drifting into organs or tissues where they were not intended to be, causing damage to other organs or other parts of the body. Ovarian damage resulting from embolic material migrating to the ovaries. Loss of ovarian function, infertility, and loss of orgasm. Failure of embolization surgery- continued fibroid growth, regrowth within four months. Menopause - iatrogenic, abnormal, cessation of menstruation and follicle stimulating hormones elevated to menopausal levels. Post-Embolization Syndrome (PES) - characterized by acute and/or chronic pain, temperatures of up to 102 degrees, malaise, nausea, vomiting and severe night sweats. Foul vaginal odor coming from infected, necrotic tissue which remains inside the uterus. Hysterectomy due to infection, pain or failure of embolization. Severe, persistent pain, resulting in the need for morphine or synthetic narcotics. Hematoma, blood clot at the incision site. Vaginal discharge containing pus and blood, bleeding from incision site, bleeding from vagina, fibroid expulsion (fibroids pushing out through the vagina), unsuccessful fibroid expulsion (fibroids trapped in the cervix causing infection and requiring surgical removal), life threatening allergic reaction to the contrast material, and uterine adhesions.

00:23, 15 February 2010 (UTC)

Recent change

I remove material recently added as most of it appeared to violated WP:MEDRS, either relying on primary studies or outdated materials >10 years old. Yobol (talk) 20:20, 2 May 2012 (UTC)

PMID 20352368 does add some very interesting data. Richiez (talk) 21:35, 2 May 2012 (UTC)

Good source, will incorporate. Yobol (talk) 21:41, 2 May 2012 (UTC)

Possible new source

I've just removed this URL from the article, since the addition was badly formatted and caused a "cite error". It might be useful to the regular editors here: "Supracervical hysterectomy versus total abdominal hysterectomy: perceived effects on sexual function" http://www.biomedcentral.com/1472-6874/2/1 -- John of Reading (talk) 21:02, 7 June 2012 (UTC)

un necessary????

This isn't really a chat site, I can see that. But I felt strongly to make this comment. I'm not suggesting that the person who started this site about hysterectomy believes that lots of hysterectomies are unnecessary. But whoever does believe that, can I just ask you something... Have you ever been seriously injured in some kind of accident, where you are bleeding? The life blood is literally being drained away from you. When this happens, a person tends to feel a bit weak, don't they? Need I say more? To some people that happens every month, only it's not called a serious injury, it's called a period. Hysterectomies are a God send, and thank you to the medical world for making them available! — Preceding unsigned comment added by 120.144.50.118 (talk) 05:33, 30 July 2012 (UTC)

Incidence table

Found data on incidence from Germany ( http://www.aerzteblatt.de/int/archive/article/99715 ) and more countries (http://www.vitadidonna.it/salute/medicina-e-salute/4187-patologie-dellutero-e-pregiudizio-scientifico-isterectomia.html), I think it is time to convert the data to table form to keep it compact.. and before doing that think a bit how to organize the table best. From first glance at available data that could be total/y, incidence/y/100000, % at age 60+, cause/indication, % of oophorectomies, % of vaginal/abdominal/laparoscopic procedures. Where data is available for several years or sub-populations (by age, status etc) it could go into several columns though that would obsolete the age 60+ table row. Richiez (talk) 15:34, 31 July 2012 (UTC)

Problems with additions to chronic pain section

Multiple issues with the attempts to add discussion of "vaginal vault excision" surgery to this section. First, the material are primary sources, which runs against WP:MEDRS and WP:WEIGHT. The material is also a therapeutic discussion, not appropriate for the side effects section. Finally, the material is not primarily about hysterectomy, but with the treatment of chronic pelvic pain, which is not the primary subject of this article. Yobol (talk) 20:03, 13 January 2013 (UTC)

Mostly agree, this change is not ready yet. It seems to be just one out of many possible causes of dyspareunia after hysterectomy and the more prevalent causes (perhaps hormonal changes) should be discussed first. Just how prevalent are persistent "pathologies at the top of vagina"? Seems pretty rare to me. Richiez (talk) 23:02, 13 January 2013 (UTC)

Adding the SWAN study concerning CVD risk after hysterectomy

Any objections to including the 2013 SWAN study reported in J American College of Cardiology, concerning CVD risk associated with hysterectomy? The study involved multivariable analyses of 3,302 pre-menopausal women followed for 11 years, and concluded there were no significantly increased risks.Ronsword (talk) 02:58, 18 July 2014 (UTC)

Have noticed your post here much too late. The SWAN study has a small number of cases and the results seem contrary to older and bigger studies. Causality is hard to prove, the association on the other hand seems pretty well documented. The borderline significant trends observed in patients over 50 in the Ingelson study are intriguing. Richiez (talk) 16:48, 30 July 2014 (UTC)

Why not include a reference to the SWAN study simply as current information coming down the pike - for example: "in one of the most recent studies involving 3,302 pre-menopausal women, the following results were noted"? The study was considered worthy enough to publish in J American College of Cardiology, and it is one of the most recent. However, if there are some methodological issues that several editors agree should be clarified, then we can certainly point those issues out (e.g., "however, the study is, by comparison to previous studies, small").Ronsword (talk) 21:47, 2 August 2014 (UTC)

With 183 cases and just a few lab values as "endpoints" this can only serve as pilot study (PMID 23684687) - soft endpoints have failed in many large trials. Many dozens of similar studies exist examining many other aspects. There are several much larger studies available, it is not easy to interpret them and also there won't be obviously any randomised double blind studies but so far my impression is that there is some effect. We might pick Ingelson, PMID 23635669, PMID 21518944 and try to report the differing results but for me this is hindered by lack of hard data on many issues. Eg PMID 21518944 does not seem to have a control group wo hysterectomy which is a problem because it is well known that ovarian conservation is frequently misreported and even with ovarian conservation the actual function of the ovaries is substantially affected with very high rates of subsequent premature ovarian failure. Richiez (talk) 10:54, 9 August 2014 (UTC)

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Accuracy of table- Advantages and disadvantages of different hysterectomy techniques

Hello, I am going through a newer version of a Cochrane Review to update this article https://www.ncbi.nlm.nih.gov/pubmed/26264829

I find the whole section on comparison of surgical techniques quite hard to read. There is a lot of information presented in a segmented fashion, and there is a table at the end of the section that does not reflect all the evidence listed in paragraphs.

Comparison of Techniques

The whole table is presently referenced as info from a 2010 paper, Hysterectomy#cite_note-pmid20539807-79

I may have time this week to re-do this table and use the information presently cited in the wikipedia article, plus adding in the newer 2015 Cochrane Review. If I do re-do the table, should I remove the information that is presented in the paragraphs (once it is inserted in the table)?

I will be reading through the full-text version of the 2015 review in a day or so to update the article.

If you have any feedback or suggestions, I would appreciate them.

Thanks, JenOttawa (talk) 03:00, 3 January 2017 (UTC)

even once it is inserted in the table, it might be best to leave some "general information" in the paragraph for subsection Comparison of techniques...IMO--Ozzie10aaaa (talk) 22:47, 3 January 2017 (UTC)

I agree, thanks! JenOttawa (talk) 00:41, 4 January 2017 (UTC)

Thanks again for all your feedback on all my editing Ozzie10aaaa. I am tackling the table this week. On closer inspection, it is paraphrased from a retrospective single institution study table, in the discussion of https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883234/table/T2/. I am assuming that it should be entirely re-done, and only results from reviews should be included? Thanks. JenOttawa (talk) 14:52, 10 January 2017 (UTC)

• Wikipedia:Identifying reliable sources (medicine)#Assess evidence quality per the first triangle diagram, one can see retrospective is "lower" than review, so I would therefore agree w/ you, a review is best--Ozzie10aaaa (talk) 15:35, 10 January 2017 (UTC)

Great. thanks Ozzie10aaaa. Here is what I have so far. Rather than deleting the whole table, I have found references and added in info from multiple reviews. I don't have time today to go through all the points in the table and find citations. I added "citation needed" tags to the information that i have not looked into yet. Do you think I should go ahead and make this edit, or wait until I have time to verify more of the "citation needed" tags?

Summary- Advantages and disadvantages of different hysterectomy techniques

Technique	Benefits	Disadvantages
Abdominal hysterectomy	No limitation by the size of the uterus Combination with reduction and incontinence surgery possible No increase in post-surgical complications compared with vaginal	Longest recovery period and return to normal activities May have a higher risk of bleeding compared with laparoscopic surgery Vaginal or Laparoscopic technique preferred for people who are obese
Vaginal hysterectomy	Shortest operation time Short recovery period and discharge from hospital Less pain medication and lower hospital costs compared with laparoscopic technique Lowest cost	Limited by the size of the uterus and previous surgery Limited ability to evaluate the fallopian tubes and ovaries
Laparoscopic supracervical hysterectomy (subtotal hysterectomy)	Unclear if subtotal approach leads to a reduction in pelvic organ prolapse in the long-term No evidence that this technique improves sexual function or reduces operative risk of urinary or bowel damage Faster return to normal activities	Women must have regular cervical cancer screening following surgery Possibility of cyclical bleeding following subtotal approach
Laparoscopic-assisted vaginal hysterectomy (LAVH)	Possible with a larger uterus, depending on the surgeon's skills Combination with reduction operations are possible	Higher cost than vaginal approach Malignancies can only be removed by this approach if they are intact Not suggested for people with cardiopulmonary disease
Total laparoscopic hysterectomy	Short inpatient treatment duration compared with abdominal Allows the possibility to diagnose and treat other pelvic diseases Quicker return to normal activities compared with abdominal Associated with a high quality of life in the long term, compared with abdominal	Increased length of surgery Less bleeding, fevers, infections compared with abdominal surgery Requires a high degree of laparoscopic surgical skills May have a higher risk of bladder or uterer injury
Single-port laparoscopic hysterectomy / mini laparoscopic hysterectomy	No significant clinical improvements compared with conventional laparoscopic hysterectomy Improved cosmetic outcomes compared with conventional laparoscopic hysterectomy More research required
Robotic-assisted hysterectomy	Similar complication rate compared with conventional laparoscopic May result in shorter hospital stays More research required	Longer surgical times Increased cost More research required

JenOttawa (talk) 15:43, 10 January 2017 (UTC)

IMO, I would wait to have the citations needed ...BTW your doing great work, I'm happy to know such a positive editor(and I'm certain all wikiproject Medicine feels the same), thank you--Ozzie10aaaa (talk) 15:55, 10 January 2017 (UTC)

Thanks for the quick feedback Ozzie10aaaa. It has been nice getting to know the community and I appreciate the support. Have a great week!JenOttawa (talk) 16:01, 10 January 2017 (UTC)

I have found most of the references for this table. Ozzie10aaaa, I am having trouble finding quality sources with evidence (for or against) combining cosmetic abdominoplasty procedures with hysterectomies. For now I have left these as "citation needed" tags. If there are no high quality sources, I will delete this info. Thanks again! JenOttawa (talk) 19:24, 12 January 2017 (UTC)

yes, agree, remember per MEDRSWikipedia:Identifying reliable sources (medicine)#Books to look at textbooks as well[1]...--Ozzie10aaaa (talk) 19:58, 12 January 2017 (UTC)

Great, thanks Ozzie10aaaa. I am not used to referencing from textbooks, but they would be helpful for descriptions of techniques in this case. Through google I see lots of reference to the option of having the cosmetic procedure done at the same time as a hysterectomy. The present wording is not "for" or "against" having cosmetic procedures done at the same time as a hysterectomy, it only states that this may be possible with certain surgical approaches.

I appreciate the reminder about MEDRS and remembering to include books. JenOttawa (talk) 20:57, 12 January 2017 (UTC)

always glad to help, thank you--Ozzie10aaaa (talk) 21:36, 12 January 2017 (UTC)

References

Primary research eVal study

I feel that the following should be removed from the comparison of techniques, unless these times are reviewed elsewhere more recently. The reference is outdated and is primary research. ref 69 = 2003 eVALuate study, two parallel randomised trials- https://www.ncbi.nlm.nih.gov/pubmed/14711749

"Time required for completion of surgery in the eVAL trial is reported as following:[69] abdominal 55.2 minutes average, range 19-155 vaginal 46.6 minutes average, range 14-168 laparoscopic (all variants) 82.5 minutes average, range 10-325 (combined data from both trial arms)"

If you have any feedback, please let me know. Thanks. JenOttawa (talk) 15:10, 10 January 2017 (UTC)

I believe you are correct in your assessment, and would support...(however it would be good to get a few more opinions...IMO / I moved your comment at talk/med Wikiproject for greater visibility[2])--Ozzie10aaaa (talk) 10:41, 11 January 2017 (UTC)

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Foundations 2 2019, Group 3c Goals

-more detailed list of indications -origin/history of “hysterectomy” -updated data on hysterectomy -address bias against hysterectomy from HERS Ellenberkley (talk) 05:43, 31 July 2019 (UTC)

UCSF Foundations II Course Wikipedia Project Group 3c

Proposed changes: -expand medical uses to include updated indications such as gender confirmation for transgender (trans) males -expand alternative options to include other treatments to try first such as "kegel exercises" for uterine prolapse -add section on the origin/history of "hysterectomy" to provide background information on the procedure -updated data on hysterectomy utilization and outcomes to align with current standards of care Ellenberkley (talk) 21:35, 1 August 2019 (UTC)

Foundations 2 2019, Group 3B Peer Review

Group 3b peer review Respond to peer review prompts on the ARTICLE talk page, following the statement made the group about its planned edits.

1. All group members should respond to the following prompts, with specific examples:

· Do the group’s edits improve the article as described in the Wikipedia peer review “Guiding framework”?

-- Yes, group 3c's edits expanded heavily on the medical uses of hysterectomy besides as a last resort for disease states, such as trans people undergoing hysterectomy to treat body dysphoria and to prevent future gynecologic problems. --Dannymrowr (talk) 20:59, 5 August 2019 (UTC)

-- The group's edits improve the article by adding significant background and information about the medical uses for a hysterectomy. Additionally, they expanded on uterine prolapse as an alternative to a hysterectomy. --Mparagas18 (talk) 21:20, 5 August 2019 (UTC)

-- They added a significant amount of information about hysterectomy and expanded on its medical uses. -- Brendado425 (talk) 21:32, 5 August 2019 (UTC)

-- Edits provide a balanced and neutral addition to 'Medical Uses' and are connected to a reliable secondary source. -- Alexuang (talk) 16:30, 6 August 2019 (UTC)

· Has the group achieved its overall goals for improvement?

-- Yes, group 3c's goal was to expand on the medical uses section, and the section has been expanded on substantially to cover as many bases as possible --Dannymrowr (talk) 20:59, 5 August 2019 (UTC)

-- The group achieved its goals of expanding the medical uses and uterine prolapse sections.--Mparagas18 (talk) 21:20, 5 August 2019 (UTC)

-- Yes, they acheieved their overall goals for improvement. -- Brendado425 (talk) 21:32, 5 August 2019 (UTC)

-- Proposed changes achieved:

"-expand medical uses to include updated indications such as gender confirmation for transgender (trans) males

-expand alternative options to include other treatments to try first such as "kegel exercises" for uterine prolapse" -- Alexuang (talk) 16:30, 6 August 2019 (UTC)

2. Each group should divide up the prompts below so that a different person responds to each question. Please sign your comments with your name and account name so that you receive credit.

· Person A: Does the draft submission reflect a neutral point of view? If not, specify…

-- Yes, no opinions were stated and the information was presented as purely factual information with proper citation --Dannymrowr (talk) 20:59, 5 August 2019 (UTC)

· Person B: Are the points included verifiable with cited secondary sources that are freely available? If not, specify…

-- Yes, they are consistent with womenshealth.gov. Consider adding citation for the section on 'Medical Uses' after "Such conditions and/or indications include, but are not limited to:" Alexuang (talk) 21:10, 5 August 2019 (UTC)

· Person C. Are the edits formatted consistent with Wikipedia’s manual of style? If not, specify… -- Yes, the edits are formatted consistent with Wikipedia's manual of style.-- Brendado425 (talk) 21:07, 5 August 2019 (UTC)

· Person D. Is there any evidence of plagiarism or copyright violation? If yes, specify…

-- No, all information added was properly referenced, and direct copying or close paraphrasing were not evident.--Mparagas18 (talk) 21:11, 5 August 2019 (UTC)