Hysterectomy vs Alternative method

[denim]

CNN.com link

Hundreds of thousands of women go to gynecologists each year with a common condition known as uterine fibroid tumors. When it's severe, a majority of them get the same recommendation: a hysterectomy, or removal of the uterus.

In recent years, a less invasive procedure, known as uterine artery embolization or UAE, has been growing in popularity. Yet some patients, and even some gynecologists, say many gynecologists aren't telling their patients about the alternative.

A study presented at a medical conference in 2002 found that of 100 UAE patients at Chicago's Northwestern Memorial Hospital, 79 had learned about the procedure from a source other than a gynecologist. A survey by Yale University School of Medicine in 2003 found that 13 of 21 UAE patients had learned about the procedure from the Internet.

"It's sad," says Juergen Eisermann, a gynecologist who is medical director of the South Florida Institute for Reproductive Medicine. "We do a disservice not to mention all the options."

In the large majority of cases, UAE brings relief from uterine fibroid tumors, and it has a much shorter recovery time than hysterectomies. These tumors aren't cancerous, but their growth can be debilitating. UAE involves cutting off the blood supply to the tumors, causing them to shrink.

Some gynecologists blame the failure to inform patients about UAE on the fact that gynecologists generally don't perform the procedure. Instead, members of a specialty known as interventional radiology do UAE. When gynecologists lose the chance to perform a hysterectomy, they also lose the roughly $2,000 fee the gynecologist might have earned.

"When you are sitting in a gynecologist's office, and they know that their livelihood is depending on the services that they provide, they are less likely to refer you" to another specialist, says Ruth Shaber, a gynecologist who heads women's health at Kaiser Permanente, Northern California, a large health-maintenance organization.

Gynecologists in the U.S. perform about 200,000 hysterectomies a year for fibroids, meaning that $400 million in annual fees is at stake. Women who may have uterine problems almost always go to, or are referred to, gynecologists, the medical profession's experts on the uterus.

UAE isn't a perfect solution. It isn't recommended for women who want to have children. Studies have shown that as many as 20% of patients who undergo it experience further fibroid symptoms after three years, and the procedure is too new for doctors to know whether that percentage will rise with time. "It's difficult to strongly recommend a procedure without long-term data," says Howard Sharp, a University of Utah gynecologist who is vice chairman of the American College of Obstetrics and Gynecology's gynecologic practice committee.

About 15,000 women with fibroids have UAE performed annually in the U.S. But many don't hear about UAE from gynecologists. "My gynecologist didn't say a word about UAE," says Collette Styles, whose heavy bleeding from fibroids last year prompted her to visit Thermutus McKenzie, an Atlanta gynecologist. After Dr. McKenzie recommended hysterectomy, says Ms. Styles, who is 36 years old, she got on the Internet and learned about UAE. "I didn't want anybody cutting on me. I didn't want anybody removing my uterus," she says.

After undergoing UAE in January, she left the hospital the same day, sporting a Band Aid. She returned to work as a flight attendant one week later, free of fibroid troubles, she says. A hysterectomy could have grounded her for as long as eight weeks. Dr. McKenzie didn't return phone calls or written requests for comment.

Note that the article is much longer than my quote.

I seem to recall that there was a thread on fibroids in the Ladies Lounge, so this might be relevant to some there.

[lurkette]

Thanks for the info!

I have fibroids, and when the time comes to treat them I'd much rather have this prodecure (which hopefully, by then, will be better-established and more widely practiced) than a hysterectomy, which comes with all kinds of complications.

A strange note: Even though they don't recommend the procedure for women who want to have children, how do they think they'd have kids with a missing uterus?!? Seems like a better option to me. Even though I don't want to have kids myself.

[denim]

Originally Posted by lurkette

A strange note: Even though they don't recommend the procedure for women who want to have children, how do they think they'd have kids with a missing uterus?!?

I was wondering about that myself.

[ShaniFaye]

I go today to see if my fibroids have come back...they were being treated with a medication therapy because I was too "young" for them to want to give me a hysterectomy....stupidly I stopped going to be checked when check ups showed the meds were working and now I think Im back in the same boat I was in before...which means for me going back off the caffiene and back on the pills again....I will have to remember this when my test results come back

[lurkette]

ShaniFaye - sorry to hear about the damn fibroids. They're a pain. I'm on a constant dose of b/c pills to manage pain caused by a fibroid, and the accursed thing's still growing. It's about the size of my ovary now. :-/

Hope your results come back the way you want 'em.