Too Many Hysterectomies A Concern
" The number of hysterectomies in this country," said Dr. Ernst Bartsich, a gynecologist with New York Hospital/Weill, "is unacceptably high.
" What I mainly want to do is call attention to the unacceptably high number of hysterectomies performed. You have 600,000 hysterectomies performed per year for benign reasons, we're not talking about cancer.
" There is no justification for that. We have alternative methods available. They are in place, they aren't new; I'm not talking about revolutionary procedures. These are established procedures, they are part of the training program for residents for the past 15 years and yet the number of hysterectomies performed has remained at 600,000. That is three times the rate of any industrialized nation. That is a rate of one out of three women aged 60 or 62 and one out of two women aged 65.
" Absolutely this is too high.
" The American College of Obstetrics and Gynecology and the National Institute of Health and Human
Services has reviewed this and they find that 75% are not justified. In three quarters of the cases there is no justification for doing this and yet they are done, and done and done again.
" So the profession is entrenched in the traditional approach and you cannot get them to change. Our residents are trained. They are proficient in the alternative methods. A resident does not graduate successfully from any training program in the country unless they are trained in these alternatives. And yet they don't do them.
" Certainly if cancer is involved there is no argument a hysterectomy is necessary. But for the most part fibroids are benign. The most common reason for a hysterectomy is fibroids. The symptoms are bleeding and pain and endometriosis. Again, most fibroids are benign. Why do a hysterectomy and take a normal, healthy organ out?
" Why not just remove the fibroids? There are ways to do that which are less invasive, less
complicated, and even less expensive and yet it remains standard practice to do a hysterectomy.
" When fibroids cause symptoms, it depends on where they are and what size they grow. Certain fibroids can be removed laproscopically or there's robotic surgery. Some can be removed from the abdomen and some can be removed vaginally but still without a hysterectomy. This is minimally invasive surgery.
" So what's so bad about a hysterectomy? Number one it's a big operation and a long operation. There are more complications. You risk bladder injuries, bowel injures, urethra injuries. These injuries increase dramatically with a hysterectomy.
" A hysterectomy is more expensive. It requires a long hospital stay. Fertility, of course, is compromised.
" Also don't underestimate the psychological effects. Even if a woman doesn't want to get pregnant anymore, or can't get pregnant anymore, she is now dealing with hormonal changes. There can be impaired sexual function, regarding lubrication and pelvic support.
" Women are not always informed as much as we think they should be, or could be. There's a lack of information out there.
" Doctors have to inform their patients about the alternatives. There is a medical, legal issue here of whether a patient has given an informed consent. Has she been informed of alternative treatments, including the option of not having any treatment.
So more about what a fibroid is.
" The fibroid is a benign tumor. We don't know actually what causes them. It's nothing to do with diet or exercise or drinking coffee or not drinking coffee. 60% of women have fibroids, some don't even know they have fibroids.
But should they become large enough to cause pain in the back, abdomen and pelvis, bloating and very heavy menstrual bleeding, or grow to be as large as a grapefruit and begin interfering with other organs, it's time to explore different treatment options. When you remove the fibroids you restore the integrity of the uterus.
" It's amazing how little women are actually informed about their options. It is the medical profession's responsibility, but if they don't live up to their responsibility, women need to step forward and ask about other options besides a hysterectomy.
For more information:
http://www.about.com/womenshealth
http://www.cdc/reproductivehealth
