LYCOS RETRIEVER 
Hysterectomies: United States
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Most (30%) of all hysterectomies in the United States are done to remove fibroid tumors. Fibroid tumors, or "fibroids" are non-cancerous (benign) growthsin the uterus. They can cause pelvic and lower-back pain and heavy orlengthy menstrual periods. Treatment of endometriosis is the reason for 20% of hysterectomies. In endometriosis, the cells of the uterine lining (the endometrium) begin growing outside the uterus. These outlying cells still respondto the hormones that control the menstrual cycle and bleed each month, justas they would if they were inside the uterus.
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Every 10 minutes, 12 hysterectomies are performed in the United States. That is over 600,000 per year, of which only 10% are due to cancer. This surgery most often does not correct the diagnosed problem and instead results in new afflictions. And, argues Dr. Stanley West, author of The Hysterectomy Hoax, nine out of ten hysterectomies are unnecessary.
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Approximately, 600,000 hysterectomies are performed in the United States annually. Vast majority of these hysterectomies are done for benign medical reasons. Hysterectomies may be performed using an abdominal, vaginal or laparoscopic approach. Using the abdominal or laparoscopic technique, the hysterectomy can be divided into two categories; total hysterectomy and subtotal hysterectomy. There is no indication for removal of cervix in most total Hysterectomies. Total hysterectomy is preferred over Subtotal Hysterectomy for prevention for future cervical cancer and menstrual bleeding.
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From 1994 through 1999, an estimated 3,525,237 hysterectomies were performed in the United States for women aged >15 years. The overall hysterectomy rate was 5.5 per 1,000 women per year (95% confidence interval [CI] = 5--5.9) during the 6-year study period (Table 1). Although statistically significant increases were observed in rates from 1994 through 1998 (p for trend = 0.04), the increase was limited, and the overall curve during this period was nearly flat. Rates appeared to decline in 1999 (Figure 1).
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The National Center for Health Statistics Hospital Discharge Survey for 1997 reports that 604,121 hysterectomies were done in the United States, of which 91.7% (554,118) were for benign conditions. Sixty-four and one-half percent (354,857) were done through the abdominal route and 35.5% (195,694) were done transvaginally. These vaginal hysterectomies were done without laparoscopic assistance in 81% of cases. Laparoscopic assistance was used in 19% (37,129) of cases when the route was vaginal.1
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The frequency with which hysterectomies are performed in the United States has been questioned in recent years. It has been suggested that a large number of hysterectomies are performed unnecessarily. The United States has the highest rate of hysterectomies of any country in the world. Also, the frequency of this surgery varies across different regions of the United States. Rates are highest in the South and Midwest, and are higher for African-American women. In recent years, although the number of hysterectomies performed has declined, the number of hysterectomies performed on younger women aged 30s and 40s is increasing, and 55% of all hysterectomies are performed on women ages 35รข€“49.
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