Mental retardation: a controversial indication for hysterectomy.

Some mentally retarded women, particularly those severely affected, may benefit from hysterectomy. Although the contraceptive effect of hysterectomy frequently may be useful, this procedure should be performed only in those women for whom menstrual hygeine is (or is anticipated to be) a major problem. A recommendation from a pediatrician or other physician who has an established relationship with the patient is a prerequisite to surgery. Likewise, informed written consent from the women's legal guardian must include a review of the risks and benefits of and alternatives to the proposed surgery. Our experience suggests that, for selected women with severe mental retardation, hysterectomy, albeit controversial, may improve the quality of life.