Hysterectomy: More Harm Than Good or Innocent Bystander?

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As physicians, and particularly as surgeons, we recognize our responsibility to evaluate the potential harm posed by our interventions. Although primum non nocere does not actually appear in the Hippocratic Oath, its sentiment does: “I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing.”1 The article by Kocaay et al2 asks a critically important question regarding a widely performed operation and a vastly underrecognized potential consequence: does hysterectomy increase a woman’s risk of developing a pelvic floor disorder? Hysterectomy is the second most common surgical procedure performed on adult women.3 The majority of women with pelvic floor disorders do not seek care, so without studies like this one, we are unlikely to uncover potential harms of hysterectomy. This study is particularly valuable because of its focus on symptoms related to bowel dysfunction, which are least likely to be disclosed by patients.

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