A comparative study of the cosmetic appeal of abdominal incisions used for hysterectomy

Objective To assess the cosmetic appeal of abdominal incisions used for hysterectomy. Design A comparative study. Setting St James's University Hospital, Leeds Participants One hundred women, including 50 consecutive women attending a gynaecology clinic for the first time and 50 hospital staff. Results Sixty-eight percent of women preferred a Pfannenstiel incision as the incision of first choice, while 31% chose the laparoscopic assisted vaginal hysterectomy incisions (LAVH). When women who had undergone previous abdominal surgery were compared with women with no previous surgery, there was a significant difference in their choice (80% Pfannenstiel, 18% LAVH compared with 54% Pfannenstiel, 45% LAVH). Conclusions In gynaecological surgery there is already a cosmetically-favoured incision. One cannot assume that if a gynaecologist uses a minimally invasive surgical technique at hysterectomy that this will be cosmetically acceptable to the woman. Gynaecologists should not use cosmetic appeal in counselling women for LAVH and should concentrate on the other proven benefits of minimally invasive surgery.