Frequency of hysterectomy as a treatment for benign uterine pathology: the problem of long-term postoperative outcomes

Approximately 90% of hysterectomies (HE) are performed for benign uterine conditions, with uterine myoma accounting for one-third of the indications.The objective: to assess the frequency of HE and its long-term effects on hormonal and metabolic homeostasis. A systematic analysis of available sources from the last 10 years was conducted to evaluate the frequency of HE as a treatment for benign uterine pathology and its long-term postoperative outcomes. The search for scientific articles and publications was carried out in databases such as PubMed, Scopus, Web of Science, and Google Scholar. Inclusion criteria: original articles, literature reviews, meta-analyses, and guidelines from leading professional associations. Exclusion criteria: publications without full-text availability, non-English articles (excluding Ukrainian sources), and studies focusing solely on malignant uterine diseases. A qualitative analysis was performed to determine the frequency of HE, the main indications for surgery in benign conditions were studied, the long-term outcomes of HE were evaluated, including the risks of early menopause, pelvic organ dysfunction, psychosocial effects, and quality of life in patients. Bibliographic tools such as Mendeley and EndNote were used to organize references. This approach enabled to structure available data, identify research gaps, and formulate key conclusions regarding the frequency of HE and its postoperative consequences.HE is one of the most common gynecological surgeries, especially for uterine fibroids, adenomyosis, abnormal bleeding, and prolapse. While the method remains effective, the procedure is associated with significant postoperative complications such as pelvic floor dysfunction, hormonal imbalances, chronic pelvic pain syndrome, pelvic organ prolapse, and ovarian dysfunction. The risks of complications are exacerbated by factors such as obesity, diabetes mellitus, connective tissue dysplasia, anatomical and functional pelvic floor disorders. Genetic studies highlight the role of gene polymorphisms affecting collagen and elastin metabolism in the development of pelvic organ prolapse after HE. Reducing complications requires personalized approaches, including preoperative risk assessment, advanced surgical techniques, individualized rehabilitation and preventive programs. Informing patients about potential surgical outcomes and measures to avoid risks is an important element of ensuring quality of life after surgery. HE is an effective treatment for benign uterine pathology, but it is associated with significant postoperative complications such as pelvic organ prolapse and hormonal and metabolic disorders. Women undergoing HE before menopause are particularly vulnerable due to an increased risk of cardiovascular diseases, osteoporosis, and reduced quality of life. Key risk factors include hormonal imbalance, ovarian ischemia, circulation disorders, psychological factors, as well as genetic predisposition and comorbidities. To improve the prognosis outcomes individualized rehabilitation programs, hormonal therapy, and further research of genetic predictors are needed to develop effective prevention and treatment strategies.