More Hysterectomies, More Inappropriate Reasons
WebMD News Archive
"We've known for some time that there are some percentage of
hysterectomies that probably are unnecessary and therefore probably wouldn't
meet rigid criteria for hysterectomy. The message from this article is that 76%
did not meet ACOG criteria preoperatively [before surgery] for hysterectomy,
but that doesn't mean that all of those patients shouldn't have had
hysterectomy or that hysterectomy wasn't appropriate," Trupin says.
Broder and colleagues say a lack of research showing the risks and benefits
of hysterectomies may be making some doctors unsure about when a hysterectomy
is or is not appropriate. They also suggest that since a hysterectomy is viewed
as relatively safe, many doctors and patients may feel that the benefits
outweigh the risks even when all the standard criteria are not met.
Trupin says the relationship between doctor and patient plays a big role in
deciding how quickly to proceed to hysterectomy, but says the high percentage
of patients in this study who did not receive a biopsy of the uterus beforehand
is troubling. In addition to ruling out cancer, the biopsy gives other
important information that helps guide the surgery so that more surgery won't
be needed in the future to correct something that is missed or shows up
unexpectedly during the hysterectomy.
The message for women with pain and bleeding is to ask questions about their
options and to make sure they are satisfied with the reasons their doctors are
recommending a hysterectomy, says Trupin. "You want to be sure that, in
your individual case, you are being checked thoroughly enough to be sure you
are getting the right operation and, in the process of being checked more
thoroughly, you may uncover things that can be treated medically rather than
surgically," she says.
- A hysterectomy, or surgical removal of the uterus, can be recommended to
treat severe bleeding and pain caused by infection, cancer, fibroids,
endometriosis, or prolapse.
- In a recent study, 70% of hysterectomies performed did not meet an expert
panel's criteria for having the procedure.
- Patients should ensure that they are being checked thoroughly to rule out
other causes of pain that may be treated nonsurgically.