Population-based hysterectomy rates in Germany from 2005 through 2006

Objectives: Population-based hysterectomy (HE) rates in Germany have not been estimated until now. The aim of this study was to provide German-wide and regional HE rates based on the national DRG hospitalization file. Study Design: DRG data of the years 2005 and 2006 covering 36.3 million hospitalisations all over Germany were used to calculate HE rates stratified by region, indication group, and surgical approach. We used ICD-10 codes and surgical procedures codes (OPS) to classify HEs. Results: Overall 305,015 HE were undertaken during the study period (3.6 out of 1,000 women). HE rates varied considerably across Federal States. After correction for the population at risk by the estimated prevalence of HE in the general population, this rate increased to 4.3 out of 1,000 women (19% increase). Only about 6% of all HEs were either performed by LAVH or laparoscopic procedures. The majority of HE for benign indications were performed as vaginal HEs (55%). Overall, 23% of all HEs included bilateral oophorectomy. Five percent all HEs due to benign diseases of the genital tract were subtotal HEs. The proportion of subtotal HEs in this group was highest for HEs undertaken as laparoscopic HE (64%). Conclusions: HE is one of the most frequent surgical procedures in gynecology. The international comparison of population-wide HE rates related to benign diseases of the genital tract of the recent years shows that Sweden has the lowest HE rate and the United States and Australia have the highest rates. Germany has a rate between these extremes.