Hysterectomy, a procedure in which the uterus is removed, is the second
most common surgery among female patients. However, according to a new
study, an estimated 20 percent of the surgeries may not be medically necessary.
While the rates of hysterectomy have fallen in recent years, more than
400,000 hysterectomies are still performed annually in the United States.
Concerns about whether the medical procedure is clinically appropriate
in light of the patient’s condition also remain.
As the researchers highlight, almost 70 percent of hysterectomies are intended
to treat benign conditions, such as abnormal uterine bleeding, uterine
fibroids, and endometriosis. Guidelines from the American College of Obstetricians
and Gynecologists state that doctors should recommend that patients with
benign gynecologic conditions try alternative treatments, such as hormonal
therapies and endometrial ablation, prior to undergoing hysterectomy.
However, this does not always occur in practice.
To determine how well health care providers adhere to the guidelines, the
researchers studied the medical records of 3,397 women who underwent a
hysterectomy for benign gynecological disease. As detailed by Medical
News Today, the study revealed that 37.7 percent of the patients were not
offered alternative treatment prior to undergoing a hysterectomy.
The researchers also found that pathological findings following surgery
among 18.3 percent of women did not support the need for a hysterectomy.
Even more concerning, the rate of unnecessary surgery was higher in women
under 40, who may have wanted to have children. According to the study,
37.8 percent of women under the age of 40 years had pathology that did
not support the need for a hysterectomy, while the rate was only 12 percent
for patients aged 40-50 and 7.5 percent for women over 50.
As highlighted by the study authors, their findings “provide evidence
that alternatives to hysterectomy are underutilized in women undergoing
hysterectomy for abnormal uterine bleeding, uterine fibroids, endometriosis
or pelvic pain.”