Abstract:

Surgical innovations have positively impacted the way hysterectomy procedures are performed by surgeons and the results experienced by patients. Patients with benign disease requiring a hysterectomy are no longer subjected to living with a large incisional scar that was common only 20 years ago. With the advent of minimally invasive surgery, surgeons can now provide hysterectomy patients with cosmetically pleasing results. To better understand the impact of surgical scars from hysterectomy incisions, 200 subjects answered a surgical incision questionnaire. Cosmetic issues (i.e., hysterectomy scars) were self-reported as important in 93% of subjects, of which 24% indicated this was extremely important. Of these same subjects, 11% indicated they were extremely bothered about their current scars. Subject interest in surgery without scars was 92% and 45% noted extreme interest. Concern about the surgical incision appearance was cited by 85% of subjects. Familiarity about incisions associated with the different hysterectomy procedures resulted in 26% of subjects who were not at all familiar. Low placed incision locations were considered cosmetically superior by 86% of the subjects. The least desirable incision location was above the belly button (69%) whereas the most desirable incision location was below the bikini line (68%). Discussion about the location, number, and incision size prior to surgery was cited to be important by 93% of subjects. Study subjects show there is value in discussing the number and placement of surgical incisions prior to surgery. Cosmesis of the surgical scars is a concern for many women, but most subjects knew little about the hysterectomy incision options. Based on these findings, surgeons can improve patient satisfaction scores by discussing incisional placement and surgical options prior to the procedure.

Authors:

Steven D. McCarus, MD, FACOG, Chief, Division of Gynecologic Surgery, Florida Hospital Celebration Health, Celebration, Florida, Assistant Professor of Obstetrics and Gynecology, Department of Medical Education, University of Central Florida College of Medicine, Orlando, Florida, Founder and Director, Mccarus Surgical Specialists for Women,  Orlando, Florida

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