In our area, one out of every 7 women over the age of 18 has had surgery to remove her uterus. That's 600 thousand procedures each year, a total that has not changed in a decade. The procedure can be life saving if there is cancer. But 90 percent of the time the reason is gynecological with problems like fibroids, endometriosis or abnormally heavy bleeding. So the solution becomes removal of the uterus and sometimes the ovaries and cervix as well. It is a major surgery with a long recovery and possibly long term effects.
"In New York State there is a brochure that is supposed to be handed out to every woman to whom the doctor recommends a hysterectomy" says journalist Peg Rosen. She writes about hysterectomies in this months issue of "MORE" magazine. Rosen says the law to make the brochure about alternatives available to women has been ignored, and she had to use the freedom of information act to find it out. Rosen also says that fewer than 20 of the four thousand practices in the entire state of New York had requested the alternatives brochure.
Dr. Jaques Moritz is a respected obstetrician gynecologist with decades of experience, and performs many minimally invasive gynecological procedures. "It's a shame that someone like myself who does a lot of these minimally invasive procedures doesn't know that there is a pamphlet that I'm supposed to be giving to these patients. So somewhere, the good idea didn't get followed up."
Peg Rosen says she "interviewed women who told me that when they did mention alternatives, their doctor's became annoyed."
Dr. Moritz feels doctors might not mention alternatives because they themselves do not know how to do some of the newer procedures like a laparoscopic hysterectomy or endometrial ablation. He says it's up to the woman herself to get, "a second opinion. I've been saying it over and over, you gotta do it."
Sandra Hernandez had a minimally invasive procedure to deal with a gynecological problem and says, "it's important to know all of your different options before going in and saying, ok just give me a hysterectomy."
The health department does have the brochure on line for downloading, but it hasn't been updated in 10 years. Women need to have complete informed consent before deciding to undergo a hysterectomy. Do careful research in order to find good alternatives, and remember, in some cases a hysterectomy might still be the best option. But get a second opinion from someone who does other procedures.
ON THE NET:
http://www.hersfoundation.org/index.html
http://www.fda.gov/fdac/features/2001/601_tech.html
http://www.acog.org/publications/patient_education/bp140.cfm
More alternatives to non-cancer related abdominal hysterectomies might include:
Laparascopic hysterectomy -- also known as peephole surgery
Endometrial ablation - treats the lining of the uterus.
Uterine artery embolization -- arteries to the uterus are blocked.
Myomectomy -- abdominal surgery to remove fibroid tumors, but preserves the uterus.
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