Hysterectomy: Necessity or Convenience - page 3
Extensive and/or frequent bleeding is not unusual in menopausal women - it is inconvenient and perhaps potentially life threatening, but not usually. Women have experienced it for hundreds of years,... Read More
Dec 28, '06Occupation: FNP Specialty: FNP, peds, epilepsy, mgt., occ. med., ed ; Joined: Mar '02; Posts: 1,821; Likes: 1,564I have a bad day or two a month, but other than being sure I have "supplies", am able to go the the bathroom every couple of hours, and wearing black, it's not too bad. My doc is encouraging me to think about it (my IM doc, not a gyn) but I'm not ready yet. I do understand that elective surgery is still risky.The benefit does not, currently, outweigh the risk, and I live in hope that my body will soon go into menopause.
That being said, most women I know who have had a hyst have been having severe bleeding and/or pain. Being basically incapacitated several days a month, becoming severely anemic and never feeling well, being unable to enjoy sex, and so forth are all very good reasons to have surgery, IMHO.
Dec 28, '06Joined: Apr '02; Posts: 4,738; Likes: 104Yes at times it is necessary. In the past it was overdone. I don't know statistics about how often it is used now. It should be done in last resort because it has a lot of complications (ask how many women who've had them that have incontinence problems).
Dec 29, '06Occupation: Teaching Specialty: ER ; Joined: Apr '06; Posts: 660; Likes: 114I'm a 35 year old mother of 1 who has had PCOS for several years, bled continuously, to the point of endometrial biopsies, etc. and wound up finding relief through "chemical menopause". I have been on year round, no break BCP for 3 years and it has been bliss (except for the 2 weeks I had a horrible intestinal virus that increased my GI transit time so much I didn't absorb my pills and started my first period in forever that like to have never stopped!). Unfortunately, my blood pressure has increased alot this last year, and we are weighing risks/benefits of BCP & high BP over age 35 versus hysterectomy. My family has a huge history of cardiac disease (mother w/ 2 MIs prior to age 50, double bypass at 51, father with MI at 46 - my chol > 270, 5 yo daughter w/ chol > 185). I'm pushing for the hysterectomy. It may not be immediately life-saving, but who's to say it won't save my life in the long run? In the mean time, I save lots of money on meds, and don't have to worry about starting a period that doesn't stop for ages (3 + months straight) and halts my life while it visits.
Dec 29, '06Joined: Apr '02; Posts: 38,771; Likes: 16,385That is for the doctor and patient to decide, not me. I just care for them in my GYN suites.
Dec 29, '06Joined: May '06; Posts: 435; Likes: 87I was eagerly awaiting a gastric bypass when the ultrasound that was required to show the health of my gallbladder showed instead, a large tumor growing on an ovary. Both my bypass surgeon & gynecologist were sure it was ovarian cancer but didn't share that bit of news with me. They lead me to believe we were dealing with fibroids. They told me that I'd have to postpone the gastric bypass & have a hysterectomy. I was shocked & soon subscribed to the belief that as men they didn't realize how important having a uterus was to women. I convinced the gynecologist to just do a laperoscopic exploratory.
Then I thought about it. What did a uterus mean to me at 52 years old? I had been eagerly waitng for menopause anyway so gave the gynecologist permission to take it out. Fortunately, it was a benign tumor so no further treatment was necessary. I'm minus a uterus, fallopian tubes, both ovaries & cervix and never for a minute have I missed any of them.
I do, however, have a friend who convinced her gynecologist to give her a hysterectomy because she was convinced that it would cure her migraines. I think she was just sickof the monthly bleeding & that was her excuse. She still has migraines & I understand had a bad time with HRT.
Dec 29, '06Joined: Oct '06; Posts: 1,256; Likes: 66So, for those of you who had this done, how long was the recovery?
Dec 29, '06Occupation: Re-retired Specialty: 42 year(s) of experience in NICU, Infection Control ; From: CA, US ; Joined: Dec '00; Posts: 12,426; Likes: 3,783My recovery (after a 3 hour surgery under an epidural) took 8 wks. It took a few months to get the hormones balanced, but I remember one day quite distinctly looking @ a bottle of Premarin and deciding that menopause probably wouldn't kill me, so [to myself] just stop whining about it, already!!
Dec 29, '06Occupation: Research Specialty: 28 year(s) of experience in Research, ED, Critical Care ; Joined: Nov '06; Posts: 154; Likes: 49[font=verdana, arial, helvetica, sans-serif][color=#660066]interesting posts. my thinking is that as we move closer to some type of universal health care system, there will be limitations. what is affordable and what is not. priorities will have to be set. the question remains: what healthcare is medically necessary versus convenient? many posters mention quality of life. quality of life is an issue possibly best defined individually. an example mentioned is dental health. in the us, teeth are a priority, because we want to have beautiful teeth. you can have ugly - healthy teeth - which is what you typically see in europe, unless an individual chooses to pay for beautiful teeth. don't everyone freak out here, there are plenty of americans without the resources for basic dental care, but many (me included) choose to pay for orthodontia etc....out of my own pocket. on the other hand, polio vaccinations prevent disease and catastrophic illness. there is no money to be made in this vaccine anymore (at least not high dollars) but it is clearly medically necessary for the individual and society as a whole. take it a step further. hip replacement for an active 65 year old versus hys for a 40 year old women bleeding heavily and cramping 10 days a month. i know i do not know where the line is. these will be the decisions we make as a society. who is responsible for the quality of your life? hopefully we are moving to evidence based care. electives (read choice in healthcare) will still be available, but the individual will pay for them - this is the sticky wicket.
[font=verdana, arial, helvetica, sans-serif][color=#660066]here is some info to follow up on questions - i thought it was interesting that only a few posts mentioned the potential dire complications of elective procedures.
[font=verdana, arial, helvetica, sans-serif][color=#660066]statistics
[font=verdana, arial, helvetica, sans-serif][color=#660066]every 10 minutes, 12 hysterectomies are performed in the united states. according to a report published by obstetrics and gynecology, 9 of them probably didn't meet the guidelines set out by the american college of obstetricians & gynecologists for hysterectomy.
- [font=verdana, arial, helvetica, sans-serif][color=#660066]~600,000 hysterectomies performed annually in the united states (~170,000 - ~300,000 due to uterine fibroids)
- [font=verdana, arial, helvetica, sans-serif][color=#660066]over 5 billion dollars spent annually on hysterectomies (medical expense of procedures only)
- [font=verdana, arial, helvetica, sans-serif][color=#660066]average time off from work to recover from a hysterectomy is 6 weeks (~144 million lost work hours)
- [font=verdana, arial, helvetica, sans-serif][color=#660066]~60% of all women undergoing hysterectomy have their ovaries removed (castration)
- [font=verdana, arial, helvetica, sans-serif][color=#660066]over 5 billion dollars spent on hormone replacement therapy annually
- [font=verdana, arial, helvetica, sans-serif][color=#660066]37% of all women undergo hysterectomy by age 60
- [font=verdana, arial, helvetica, sans-serif][color=#660066]myomectomy is performed less than 40,000 times a year in the u.s.
- [font=verdana, arial, helvetica, sans-serif][color=#660066]over 25,000 uterine artery embolizations have been performed worldwide since 1996.
- [font=verdana, arial, helvetica, sans-serif][color=#660066]for every 10,000 hysterectomies performed, 11 women die. (approximately 660 women die each year in the united states from complications of hysterectomy.)
[font=verdana, arial, helvetica, sans-serif][color=#660066]possibly as many as 80% of all women have uterine fibroids. while the majority usually have no symptoms, 1 in 4 end up with symptoms severe enough to require treatment. from: national uterine fibroids foundation i apologize that i cannot confirm the date span on the above data.
[color=#660066]a dated, but informative review is at: hysterectomy surveillance --- united states, 1994--1999
[color=#660066]there is a large volume of current, ongoing research about the many issues addressed in this forum. see: clinicaltrials.gov - information on clinical trials and human research studies: trial list