Hysterectomy as treatment for dysfunctional uterine bleeding

The surgical treatment of patients with dysfunctional uterine bleeding (DUB ) is discussed in this chapter, including indications, techniques and compl ications. Hysterectomy is the definitive treatment for DUB; in most studies it has a higher rate of patient satisfaction than does hysteroscopic endom etrial ablation. The vaginal or laparoscopic approach should be selected in this group of patients with small uteri, while laparotomy is seldom indica ted. In general, the indications for vaginal hysterectomy and endometrial a blation differ from those of laparoscopic hysterectomy. Ablation and vagina l hysterectomy are done for hypermenorrhoea, while laparoscopic hysterectom y is best when pathology is present, usually adhesions, endometriosis or fi broids.