Hysterectomy. The very word evokes emotions and reactions unlike any other surgical procedure. For many women, hysterectomy symbolizes the end to fertility, femininity, sexuality, and even their very identity. For others, hysterectomy is the procedure that liberates them from pain, bleeding, and cancer.
Almost half a million hysterectomies are performed annually in the United States, and almost one-third of women will ultimately lose their uterus. But is hysterectomy always necessary?
Evidence of Unnecessary Surgery
A study published this week in the American Journal of Obstetrics and Gynecology reported that 20 percent of women who underwent hysterectomies performed for benign conditions were not offered options other than removal of their uterus. In addition, in many cases, what the surgery found did not support the pre-operative diagnosis.
Clearly, many hysterectomies are appropriate and beneficial, but there are still too many women who have unnecessary surgery or who are not offered less invasive alternatives.
Surgical technology has grown exponentially in the past 15 years, and I originally wrote The Essential Guide to Hysterectomy as a source for women to learn about uterus-sparing alternatives to hysterectomy, such as uterine lining ablation, hysteroscopic myomectomy, and uterine artery embolization. The University of Michigan study confirms my assertion: Too many women are still not offered those options. I feel more strongly than ever that women need to empower themselves with information about these procedures, ask about them, and in some cases find a doctor who will provide them if their own can not.
For women who do their own research to find out about hysterectomy, it can be really frustrating. Most books and articles on hysterectomy are extremely one-sided. The message is either “Never have a hysterectomy under any circumstances, your life will be ruined,” or “You’re having a hysterectomy . . . here’s what to bring to the hospital!”
Of interest: I did a survey of more than 2,000 women about their hysterectomy experience and 85 percent reported that they were glad they had undergone surgery. The majority of the 15 percent who wish they had not had a hysterectomy stated that they were upset that they had not been offered any alternative.
Minimally Invasive Alternatives to Hysterectomy
The issues go beyond the decision to have a hysterectomy, of course. I often meet with patients who would benefit from a hysterectomy but whose doctors did not offer options such as laparoscopic hysterectomy and/or preservation of the ovaries and cervix. Too many women end up with a large incision and a long recovery when they may well have been candidates for a minimally invasive alternative.
It’s clear to me that more information a woman has prior to surgery, the better the choices she will make, and the better her long-term outcome will be.
It is critical that women are presented current treatment options in a balanced, objective, and scientific manner, so that those looking for alternatives won’t feel they are being sold a procedure they are trying to avoid, and women who desire a hysterectomy will know what to expect.
It is time to take the “hysteria” out of hysterectomy and empower women making this critical decision.