I found this article

Hysterectomy: The Operation Women May Not Need

Too many aren't offered alternative treatments

By Colette Bouchez
HealthScoutNews Reporter

TUESDAY, Dec. 10 (HealthScoutNews) -- Imagine you're sick and you have two health-care options.

The first involves a non-surgical treatment, requires a day or less in the hospital, has virtually no lasting side effects and offers a full recovery in 24 to 48 hours.

The second involves major surgery removing several organs, a lengthy hospital stay, weeks of recuperation and the possibility that you may suffer lifelong emotional and physical consequences.

Considering that either option would take care of your problem equally well, the choice seems obvious.

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http://www.healthscout.com/template....=166&id=510364

Oh dear.

Yes, there are alternatives. Yes, they are worth looking into. No, they can't cure anything - not guaranteed, and not premanently. They may help, and might be worth a try, but the existance of options does not mean that hysts are unnecessary.

I had...

23 years on the pill - Helped turn 20 years of pain into 20 years of mere discomfort and inconvenience - followed by 3 years of flooding, clotting, poor health, cramps, being housebound...

A D&C - It stopped the bleeding temporarily, no effect on cramps.

A partial myomectomy - long, difficult procedure, which required a general, and a laparoscopic tubal ligation along with it, and had some bad and lasting side effects, and more pain than my hyst.

Tried to have an endometrial ablation, but had a fibroid in the way.

My hyst fixed all my problems, once and for all, and I'm finally enjoying life without any pain or bleeding. Far from being "pushed into" surgery, I really had to fight for it. The difficulty in being allowed to have one cost me years of trouble - pain, giving up hobbies & activities, basically shutting down my growing business... My only regret is that I couldn't have had it sooner, and gotten on with my life.

It really ticks me off when people in the media proclaim that it was unnecessary. How much more suffering would they have liked for me to endure before it would be OK with them for me to seek a permanent and certain solution?

I'll second HorseWoman, I had many various problems that my Dr. said I could "cut and paste" as he put it, but he would not and could not guarantee that I would not have to have other surgeries later. Who wants two or three surgeries when you can have everything taken care of with one and not have to worry anymore. Until they come up with a sure thing, I think that hysterectomy is a better option for many women in my position.

Take care and good luck to you.

Wow, I'm trying to get a UAE myself, but from what I've read, that article is being rather overdramatic. There are women who experience decreases in sexual pleasure after UAE (on the order of 10%, according to the only research abstract I've seen on the subject), and the "75%" number sounds like an overestimate of sexual problems after hysterectomy (the highest number I've seen is 42%, which includes TAH/BSO patients at a time when they may not have gotten their HRT sorted out yet; a more comparable 10% for supracervical.) Plus, I've been told that I should expect to be out of work recovering for two weeks, not "48 hours".

Still, they've got a point that not all gynecologists talk about UAE. I had to bring it up with my gynecologist after she suggested hysterectomy. She later claimed that most of her patients "weren't interested" in UAE because their fibroids were already too large... Gee, maybe if she mentioned UAE *before* "try these birth control pills for six months and we'll discuss it at your next appointment." (I came back in 3 weeks.)

I may or may not be a good candidate for UAE; I'll find out at my "second opinion" appointments later this week. If I'm not, well, it's off to the castle...


References:

This was the research that mentioned 10%, and now I can't find it on the Web. :-( :
"Impact of Uterine Artery Embolisation on Sexual Function"
Authors:
A. Watkinson, Royal Free Hospital, London, England • F.J. Robertson • S. Babar • D. Maudgil • E.P. Torrie

Just found this overly upbeat article, for only finding that
"64% of the women who underwent the fibroid
embolism procedure reported no change in their sex lives
after UFE, and 80 percent said they still desired sex one to
three times a week":
http://www.pslgroup.com/dg/1F446E.htm
(Frankly, this one leans me back towards hysterectomy...)

The most complete research on hysterectomy effects on sexual function I've seen:
http://www.biomedcentral.com/1472-6874/2/1/abstract

Hi, Cherokeezz,

This article reminds me of the book called You don't need a hysterectomy. It seems to assume that all hysterectomies are unnecessary, and that positive alternatives exist for every woman.

All I know is that I bled, extremely heavily, for months on end, with no end in sight. My doctors tried medications and other surgical interventions. Nothing helped. Nothing stopped the bleeding. I had blood transfusions, and many trips to the ER. I kept bleeding. I couldn't leave my house, because I had to be close to the bathroom, at all times.

I had a hysterectomy, and obviously, that stopped the bleeding, when nothing else had. One of the conditions found during the pathologist's examination of my uterus was adenomyosis. I'm told that hysterectomy is the ONLY cure for adenomyosis.

I would urge any woman who is considering a hysterectomy to get at least two medical opinions, to consider the other options, and to try the options with which she feels comfortable. Inevitably, some women will choose a hysterectomy, in the end. For some of us, it is the best solution.

Best wishes,
Helen

It goes without saying that women need informative and non-biased information about treatments for uterine problems but the above article is almost nonsensical in it's simplicity and this statement in particular "The only time this operation should be considered is if the diagnosis is cancer, which accounts for about 15 percent of current hysterectomies, Bartsich says. " is misleading and false.

I opted for conservative treatment with the full support of my specialist (I'm only 31) tried surgical and medicinal alternatives but ended up having to have the hysterectomy which has eliminated the problems I was experiencing (symptomatic multiple large fibroids resulting in excessive bleeding and anaemia that nearly led to heart failure). My condition was life threatening and to suggest hysterectomy wasn't indicated in my situation is simply ridiculous.

I believe there are too many hysterectomies being performed unnecessarily (even one done on a woman who isn't fully informed of the options is too many) but it is a complete exaggeration to assume that unless you have cancer your surgery has been unnecessary.

Alternatives to hysterectomy aren't always the simple, brief day surgeries mentioned in the article either and I can't believe the first scenario presented in the above article - it's quite simply laughable and the truth is that current alternatives to hysterectomy don't suit everyone and don't have very good success rates with women usually on an endless round of doctors visits and procedure scheduling to redo the conservative procedure etc. I live for the day when an alternative is developed for someone going through what I was going through that took 30 minutes in day surgery and allowed the woman to return to work the next day.

For someone in my position hysterectomy was the only option to end the suffering and prolong my life. UAE was out of the question as I had too many fibroids and would have lost nearly all blood flow to the uterus anyway, myomectomy was also too risky due to number, size and location of fibroids, medication was unsuccessful, embolisation was also not indicated as my fibroids had huge blood vessels and would have continued to leech blood from the rest of my organs which were all beginning to fail - and at 31 I had too long to wait for menopause to hopefully shrink them - I simply wasn't going to survive that long in my former state of ill-health. After surgery I was told that I was probably a few days off emergency hysterectomy anyway.

Most women do actually explore all the alternatives and some of us have no choice at all. It irks me that someone would suggest that my hysterectomy was unnecessary because I didn't have invasive cancer - um hello, you CAN actually bleed to death if too much blood comes out and it won't stop.....

regards
Xaviera

Hi,
I feel as if I'm a victim of bad timing, in more ways than one. I too had fibroids, but when I first became aware of them and began having them checked out yearly, options like UAE were very new and my gyn didn't really discuss them with me. She'd mention myomectomy and say how much she loved doing it because it was "so bloody" (yeah, that really appealed to me), but couldn't really say whether I was truly a candidate for it. She and my PCP were content to promote a "watch and wait" philosophy. But I think in the long run, they did me a bit of a disservice. They wanted to spare me the radical surgery, but in the meantime, my quality of life was deteriorating. A year ago, I could barely run once around a track without bending over and feeling extreme pressure from the massive fibroid in my cervix. I taught 3 classes back to back last year and on days when I had my period, I'd wonder how I was going to make it through 50 minutes, even with 2 super tampons and a maxi pad! I was miserable. When I raised such quality of life issues with my doctors, my PCP said "well, pray for an early menopause!" and my gyn, when I mentioned my stress incontinence that was getting worse all the time, said, "well, that exercise you do [soccer and jogging] is really bad for your joints anyway, so why don't you do something else?"


I finally found another gyn, who said that 999 out of 1000 women wouldn't put up with what I must be suffering. He then carefully told me about every possible option for dealing with my fibroids, including a number i had never heard about. He told me about UAE and even offered to track down for me the location of an excellent radiologist he had worked with but who had since moved away. I felt that finally someone was validating that I justifiably felt miserable.

Since my surgery, I've been upset to read all the bad press about hysterectomies. I can see that they were sometimes performed unnecessarily, but now there almost seems to be a backlash in another direction. I was supposed to hang in there and be miserable and ill (last year I was anemic and also contracted pneumonia) and not pursue the activities I love so much, just to keep this organ I don't need anymore, an organ that was diseased but is supposed to embody my essence as a woman?

I'm still coping with some emotional aftereffects of this experience, but physically, and hormonally, I feel really really good and that's what I keep coming back to....

sorry to ramble on....

This is why the article struck a cord with me. I had a hysterectomy, and I wasnt even offered any other alternatives. I was told that I had cervical cancer and a hysterectomy was the only option I had.
Well after the doctor did the hysto on me he sent my uterus and cervix to the lab and it came back normal. No sign of cancer anywhere. I know I could have sought out second opinions, but I could not afford it, at the time I was working part time at minimum wage with no health insurance.
I just wish there was another option open to me at the time.
It bothers me that I cant have any more kids. I have one daughter, she is 4 now, but it would have been nice to give her a sibling.
My mom keeps telling me that it was better to be safe than sorry After the doctor told me there wasnt any cancer, the whole ordeal bugs me!
I wasnt in constant pain or bleeding heavily. My periods were regular every 28 days and no cramping.
So if I had a different option I would have gladly gone that route.

Hi Zula,

I don't know much about cervical cancer, but isn't there a test that your Dr. could do to definitely confirm that you had cancerous cells. That doesn't seem right to me either, that they removed everything and then no sign of cancer at all? I'm sorry that you had to go through all that.

Oh he did do other tests.
When my first pap came back abnormal he scheduled me for a Colpoloscopy, I went in and had that done, well he didnt like the look of that test, so he did a LEEP on me. He said that there were a few cells that looked bad and it could be cancer and the best thing for me to do is have the hysterectomy. Before it spreads.
I talked with my family and they agreed I should go through with it just in case there was cancer there.
Well I went through with it. Now I have a 7 inch scar where he cut me open and a swelly belly that wont go away, numbness from the belly button down and no sex drive what so-ever, even though I did keep my ovaries.

Ok...I quit whining now! LOL


thanks for letting me whine!