An NHS trust has apologised to 119 women over fears unnecessary operations were carried out by a former hospital gynaecologist.
A report has found major concerns about the care received by 50 patients of ex-consultant Daniel Hay between 2015 and 2018.
A further 69 cases were ruled to be of some worry, a review overseen by NHS England (NHSE) said.
Lawyers acting on behalf of some of the patients said they were "particularly concerned that life-changing procedures appear to have been conducted without some women being able to make informed decisions about their care".
The executive medical director at University Hospitals of Derby and Burton NHS Foundation Trust (UHDB) made a "full and unreserved apology" as the interim findings were published.
The trust had contacted nearly 400 women after reports that some of Mr Hay's patients suffered "serious harm".
Got a story? Email webews@mirror.co.uk.
A total of 327 cases were reviewed, including 181 gynaecology procedures and 36 obstetrics cases.
The care of 110 women, who attended outpatient appointments at Ripley Hospital, was also investigated.
The review of Mr Hay's care found examples of poor documentation, insufficient information on the rationale for clinical decision making, and some operations added to the waiting list that were not necessary or could have been avoided.
Detailing some of the areas for concern, the report said: "The interim report, independently written by NHSE, highlights considerable concerns about decision making and the choice of surgery that was undertaken.
"The rationale for surgery is often absent or not clear in the clinical notes and treatment plans did not describe non-surgical options prior to embarking on surgery.
"The standard of documentation is poor, and the assessors took the view that what was not documented was not done."
Mr Hay has since left the trust and has performed no operations since 2018.
The interim report made seven recommendations to the trust, including inviting women to a review of their care, reviewing its measures so information is shared and staff do not work as individuals, and so other employees feel they are able to raise concerns about the standard of care.
Dr Magnus Harrison, executive medical director at UHDB, said: "I want to make a full and unreserved apology to all those women who have identified as being harmed.
"When colleagues initially raised concerns in the latter half of 2018 and right through to today we have worked diligently to piece together a picture of the care they received under this consultant in an open and transparent way.
"I want to make clear that the standard of care these women received was far below that which we strive to provide and for that I am very sorry.
"The interim report sets out some immediate recommendations and these are either currently under way or will start shortly.
"One of the recommendations is for each patient to be offered the opportunity to discuss their care.
"We have now been in touch with all the women who we believe harm is likely to have occurred as a result of a major gynaecological operation and many of these women have now spoken to us in person.
"We will continue to contact all the women involved through 2021 to offer them the opportunity to discuss their care with us.
"There is still much work to do but the interim report of investigation demonstrates that it was the right decision to formally investigate the work of this consultant.
"I want to thank the patients who have already shared their experiences with us, which I know must be extremely difficult for them.
"I also want to thank my colleagues in our gynaecology and obstetrics service for initially raising their concerns and for the support they have given these patients since.
"This has not been an easy task, complicated by an absence of clear patient documentation, and the Covid-19 pandemic.
"We will share the full report in 2022 and implement its recommendations in full."
Tim Annett, medical negligence lawyer at Irwin Mitchell who represents women affected by gynaecology care, said: "The findings of the report, including the standard of care women received and how operations were apparently carried out without other less invasive options being fully considered first, mirrors the first-hand accounts women have told us as part of our investigations.
"Patient safety should be the fundamental priority. We're particularly concerned that life-changing procedures appear to have been conducted without some women being able to make informed decisions about their care.
"Our clients continue to live with the physical and psychological effects of what happened to them and understandably continue to have concerns about their care.
"We're determined to provide the care and support our clients need to get through this difficult time.
"It's also vital that lessons are learned from the issues identified by the review to improve patient safety for others."
The full report findings are due next year.
