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Was that surgery really necessary?

Jan 28, 2015 02:00PM ● By Cate Reynolds
A new University of Michigan study finds that nearly 18 percent of hysterectomies performed for benign indications were unnecessary, and pathology analysis for nearly two in five (38 percent) of women under 40 did not support undergoing a hysterectomy.

More than 400,000 hysterectomies are performed in the U.S. each year. About 68 percent of surgeries for benign conditions are done because of abnormal uterine bleeding, uterine fibroids, and endometriosis.

“Over the past decade, there has been a substantial decline in the number of hysterectomies performed annually in the United States,” says senior author Daniel M. Morgan, M.D., associate professor in the Department of Obstetrics and Gynecology at the U-M Medical School.

“An earlier study found a 36.4 percent decrease in number of hysterectomies in the U.S. in 2010 compared to 2002. However, despite the decrease in numbers of hysterectomies in the U.S., appropriateness of hysterectomy is still an area of concern and it continues to be a target for quality improvement.

The American Congress of Obstetricians and Gynecologists recommends alternatives to hysterectomy, including hormonal management, a minimally invasive gynecological procedure called operative hysteroscopy, endometrial ablation (a procedure that destroys the uterine lining), and use of an intrauterine device as primary management of these conditions in many cases.

“The study provides evidence that alternatives to hysterectomy are underutilized in women undergoing hysterectomy for abnormal uterine bleeding, uterine fibroids, endometriosis, or pelvic pain,” says Dr. Morgan.

--Sarah Hagerty
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