Uterine Fibroids: Do You Need a Hysterectomy?

Eileen Bailey Health Guide
  • Hysterectomy is the second most common surgery performed in the United States with over 600,000 performed each year. [1] Many doctors believe that up to 80 percent of these are unnecessary.  One of the main reasons for hysterectomies is fibroids.

     

    Fibroids are muscular tumors that grow in the wall of the uterus.  They are also known as leiomyoma or myoma.  Up to 80 percent of women develop fibroids by the age of 50, however many never have any symptoms and do not even know they have fibroids. For some women, fibroids become a health problem, causing heavy bleeding and pain. Depending on the size of the fibroids, there can be pressure on the bladder or rectrum. When fibroids continue to grow, women can look pregnant, even when they are not.

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    According to Womens-Health-Advior.com, "there are times when hysterectomy may be unavoidable...but there are choices." Fibroids can be removed through a surgery called myomectomy which removes the fibroids and reconstructs or repairs the uterus. Dr. William Parker, a gynecologist in private practice writes, "Women are often told that myomectomy is not appropriate for them because hysterectomy is safer, is associated with less bleeding or that uterine muscle cancer may be present. Recent studies dispute all of those claims." Dr. Parker continues that myomectomy may be less risky for some women. [2]

     

    Risks of Hysterectomy

     

    Hysterectomies are considered safe. The Maine Women's Study studied 100 women who had this surgery and found that none had a serious complication or died. The risk of dying from this surgery for women between the ages of 35 and 44 is about 3 in 10,000. Another larger study showed that only about 2 percent of women who received a hysterectomy had major complications. [2]

     

    But some women do experience problems. One study showed that 13 percent of women with fibroids who had a hysterectomy had complications either from or after the surgery. These complications included bladder injury, ureteral injury, bowel injuries, pelvic infections and nausea or vomiting.  [2]

     

    The National Institutes of Health indicates that the risks from hysterectomy include:

    • Injury to nearby organs
    • Pain during intercourse
    • Early menopause
    • Problems from anesthesia
    • Allergic reactions to medications
    • Blood clots
    • Infection
    • Heavy bleeding [3]

    Hysterectomies, depending on the type done, can take anywhere from a few weeks to 6 or more weeks to recover. There are also emotional and hormonal considerations during your recovery period. Early menopause can send you on a roller coaster of hormonal fluctuations.

     

    Alternatives to Hysterectomy

     

    Fibroids often do not cause any symptoms or discomfort. They have growth spurts, the first being when a woman is in her 30's or 40's and then again at the beginning of menopause.  After menopause, fibroids shrink. If you are not having any discomfort or symptoms, it may be easier to simply wait it out, allowing nature to "take its course" and have the fibroids shrink on their own.

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    Myomectomies surgically remove the fibroids while leaving the uterus intact. While this surgery is not as common today as hysterectomy, it is still an option. If your doctor is not willing to discuss a myomectomy as an option, you have the right to seek a second opinion. This option is much more desirable if you still wish to have children.

     

    Other treatments for fibroids include:

    • Medications such as Lupron
    • Uterine artery embolidation - a procedure that emits particles to stop the blood supply to your fibroids
    • Endometrial ablation - a procedure that uses instruments to destroy the uterine lining
    • Focused ultrasound - a procedure that uses high intensity sonic energy to destroy the fibroids
    • Myolisis - a procedures that uses high frequency electrical current to cut off the blood supply to the fibroids causing them to shrink

    If a hysterectomy is necessary, there may still be a less invasive type of surgery. Laparoscopic supracervical hysterectomy requires a small incision in the navel and a telescope allows the surgeon to view the organ and remove it, in pieces, through the tiny incision. This type of surgery only requires 1 day in the hospital and women find recovery only takes 7 to 14 days.

     

    Benefits of Hysterectomy

     

    Many women live with pain and heavy bleeding from fibroids. A hysterectomy gives them the opportunity to live free of these symptoms. For some women, this surgery provides a sense of well-being and a renewed interest in sex.

    It is important to discuss all of the options with your doctor and decide which option best fits your needs and your lifestyle. If you have concerns, you should seek a second opinion.

     

    References:

     

    [2] "Do You Need a Hysterectomy for Fibroids?" Updated 2011, July 12, Willliam H. Parker, M.D., GynSecondOpinion.com: http://www.fibroidsecondopinion.com/hysterectomy-for-fibroids/

     

    [1] "Do You Really Need a Hysterectomy?" 2001, Author Unknown, Women's Health Advisor: Weill Medical College of Cornell University: http://www.womens-health-advisor.com/hysterectomy.html

     

    "Facts About Hysterectomies," Date Unknown, Staff Writer, Illinois Department of Public Health

     

    [3] "Hysterectomy Fact Sheet," Updated 2009, Dec 15, Reviewed by Edward Trimble, M.D., M.P.H., National Institutes of Health: http://www.womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.cfm#g

     

    "Uterine Fibroids Fact Sheet," Updated 2008, may 13, Reviewed by Steve Eisinger, M.D., F.A.C.O.G, National Institutes of Health

     

Published On: April 20, 2012