Objective: Analysis of representation in surgical approaches and techniques to hysterectomy (abdominal hysterectomy, vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy) in our clinic. The evolution of indications, diagnosis and operating approaches from 1989 to 2002 were analysed. Design: Retrospective study. Setting: Department of Obstetric and Gynecology, University Hospital, Olomouc. Methods: Retrospective analysis of medical documentation (operating protocols). Results: 3079 hysterectomies were performed in years 1989-2002. Type of hysterectomy in years 1989-1993: abdominal approach 97% (diagnosis: uterine leiomyomas 57%, malignant tumors 28%), vaginal hysterectomy 3% (diagnosis: descensus uteri only). Type of hysterectomy in years 1989-1993: abdominal approach 42% (diagnosis: malignant tumors 65%, uterine leiomyomas 28%), vaginal hysterectomy 48% (diagnosis: uterine leiomyomas 56%, descensus uteri 25%), Laparoscopically assisted vaginal hysterectomy (LAVH) 10%. Conclusion: Decreased number of abdominal hysterectomies in women with non oncological diagnosis since 1989 to 2002 and increase of vaginal hysterectomies and LAVH was noted. This abdocomplies with the contemporary trends of minimally invasive surgery.

        Key words: abdominal hysterectomy, vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy