A recent survey published in the American Journal of Obstetrics and Gynecology (August 2003) offered surprising insights. It found that most doctors opted for total versus partial (or subtotal) hysterectomy for their patients when surgically treating non-cancerous conditions such as fibroid tumors. Also, most did not discuss the positive and negative points of each alternative with their patients. In addition, many of the doctors who opted for subtotal hysterectomy over total hysterectomy did so without consulting their patients.| Take Action |
Important questions to ask before having a hysterectomy:
What type of hysterectomy will I have – a total abdominal hysterectomy or a minimally invasive procedure?
Is a minimally invasive procedure appropriate for my condition?
Will my ovaries or any reproductive organs besides my uterus be removed?
How long will it take to recover and when can I resume my normal activities?
How many of these procedures has the surgeon performed in the past year?
Are there any non-surgical treatments available for handling my problem?
What are the consequences to my health if I don’t get the procedure done?
What are the side effects of a hysterectomy? |
Dr. Nadine Zekam and colleagues at Georgetown University (Washington, D.C.) conducted the study. Surveys were mailed to 1,647 gynecologists in the Washington, D.C. metropolitan area, with slightly over 50 percent responding. Dr. Zekam found that sixty-five percent of the doctors responding said that they rarely discussed the pros and cons of total versus subtotal hysterectomy with their patients. By contrast, only twenty percent said that they did, with fifteen percent giving no indication either way. The gender of a patient’s physician appeared to have no influence on the results.
Hysterectomy is the second most common abdominal operation in the US. About 600,000 hysterectomies are performed every year according to the Centers for Disease Control and Prevention. Total hysterectomy involves the removal of the cervix as well as the womb, or uterine cavity. Many doctors prefer it to subtotal hysterectomy because it eliminates the risk of cervical cancer, offering an obvious advantage for at-risk women. However, subtotal hysterectomy has advantages of its own. The procedure leaves the cervix intact, which can prevent future urinary, digestive, and sexual complications. In addition, a subtotal hysterectomy reduces the length and scope of recovery.
Extensive comparative research on the advantages and risks of total versus partial hysterectomy has not yet been completed. But preliminary findings led Dr. Zekam and her team to argue that patients should be made aware of the known positive and negative outcomes of both procedures. In addition, she recommends that patients understand the risks involved with each type of procedure and make an informed decision by consulting with their doctors.
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