Hysterectomy types in Estonia are still different from the Nordic countries

Objective To describe hysterectomy rates in different age groups, indications and proportion of surgery types over time. Design Nationwide register-based study. Setting Estonia. Population Women who had hysterectomies for benign indications from 2004 to 2011. Methods For each case, diagnosis according to ICD-10, type of surgery according to Nordic Medico-Statistical Committee, age, and time of operation were retrieved from the Estonian Health Insurance Fund database. Mid-year female population statistics were obtained from Statistics Estonia. Main outcome measures Rate of hysterectomies per 100 000 women, proportions of different operation types, and main indications for hysterectomies. Results The total number of hysterectomies was 12 336, with a yearly mean of 1542. The rate of hysterectomies per 100 000 women/year decreased between 2004 and 2011 from 239.1 to 204.9. The proportion of abdominal hysterectomies decreased from 86.0 to 56.1% and the proportion of laparoscopic hysterectomies increased from 6.3 to 34.7%, while the proportion of vaginal hysterectomies remained more or less stable (7.8–9.1%). Most hysterectomies (74.4%) occurred in the age group 35–54 years. The main indications for hysterectomies were leiomyoma (61.5%), female genital prolapse (9.0%) and endometriosis (8.8%). Conclusions Population rates and indications for hysterectomies in Estonia were similar to those in most Nordic countries, but the proportion of abdominal hysterectomies was higher and that of vaginal hysterectomy lower. The rates of laparoscopic and vaginal hysterectomies should be increased.