LYCOS RETRIEVER 
Hysterectomies: Women
built 636 days ago
Nearly 50 percent of doctors said they routinely performed total hysterectomies even when women had benign uterine diseases like uterine fibroids. Thirty to 70 percent of all women are estimated to have uterine fibroids-particularly women in their 30s and 40s and African American women. A study published in Obstetrics and Gynecology in February showed mifepristone's promise as a non-surgical way to shrink fibroids. Mifepristone... known as RU 486 or the "abortion pill," was shown to shrink uterus sizes 50 percent after six months of treatment. While further studies are needed, they are hopeful that the shrinking of fibroids with mifepristone will 1) help protect against infertility 2) allow some women to avoid a hysterectomy and 3) reduce complications should surgery still be required.
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Genital prolapse — Which accounts for 10 to 15% of all hysterectomies. This is a condition in which the pelvic ligaments supporting the uterus, bladder and rectum are severely stretched or injured (often due to previous pregnancies and deliveries) so that these organs protrude down or out of the vagina. Prolapse causes a sensation of pulling or pressure and can ... create problems with urination and/or bowel movements. A pessary can be inserted to hold up the organs, but many women don’t like the way it feels or the fact that it had to be periodically removed and cleansed. The definitive treatment for a prolapsed uterus is hysterectomy. Additional types of surgery may be needed for bladder or rectal prolapse.
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The women who had hysterectomies experienced greater improvements in mental health, sexual desire and functioning, sleep, and overall satisfaction with health. Most of the improvement was evident within 6 months. By the end of the study, half of the women originally assigned to medical treatment had elected to undergo hysterectomies, and their improvements were similar to those of women who were assigned to have hysterectomies at the outset.
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Uterine leiomyoma, endometriosis, and uterine prolapse were the most frequent diagnoses for women undergoing hysterectomy and accounted for 73% of all hysterectomies during 1994--1999. The percentage of hysterectomies with a diagnosis of uterine leiomyoma was 68% among black women, 33% in white women, and 45% among women of other races (Table 3). Women in the >55-year age group had higher numbers of diagnoses of hyperplasia, cancer, and uterine prolapse, whereas women in the age groups from 30 through 54 years had higher numbers of cases of leiomyomata and endometriosis (Table 4). From 1994 through 1999, the percentage of cancer as a primary diagnosis for hysterectomy significantly decreased by 20% (p for trend = 0.01), and uterine leiomyoma increased significantly by 11% (p for trend = 0.02) (Figure 4). The percentage of uterine leiomyoma as a primary diagnosis for hysterectomy increased 10.2% among white women (p for trend = 0.20), 7.8% among black women (p for trend = 0.08), and 23% among women of other races (p for trend = 0.42).
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About 600,000 hysterectomies are performed annually in the U.S., making it the second most common major surgery performed on women of reproductive age. There is controversy about how many of these hysterectomies are really necessary. Clearly, 120,000 hysterectomies performed each year for DUB (without uterine pathology) are amenable to endometrial ablation. Moreover, many patients with uterine fibroids and abnormal bleeding can be treated via endometrial ablation. Fibroids account for 40% of hysterectomies each year.
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Each year US doctors perform about 600,000 hysterectomies. Indeed, after cesarean section, hysterectomy is the most commonly performed major operation on women in the country. Some of these operations are necessary to stop the growth of cancers of the uterus, ovaries, or cervix (if it's advanced). The majority of hysterectomies... are done to treat noncancerous conditions such as uterine fibroids, excessive menstrual bleeding, and other reproductive disorders. Yet many of these problems may be alleviated using less invasive methods.
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