How to Avoid
Unnecessary Gynecologic Surgery
learned the hard way that not all doctors are created equal.
She and her husband Al, a successful developer, decided on lakeside
living five years ago. Then age 49, Claudia began to experience
pain, heavy bleeding and abnormal periods due to uterine fibroid
"I went to one gynecologist who put me on a drug to shrink the
fibroids, which slammed me into early menopause," said the dynamic
grandmother, who was a top producer in real estate and had a
successful interior design business in Michigan. "Both my body and
my mind were negatively affected," she said. "It was an extremely
painful four years."
She was told she could have had a hysterectomy right then to end the
problem, but today she is glad she avoided the procedure until she
found the right surgeon.
Hysterectomy-Yes or No?
Hysterectomy, or surgical removal of the uterus, is the second
most common major procedure performed in the United States today,
following cesarean section. Approximately 600,000 American women
have hysterectomies annually at a cost of almost 5 billion dollars.
By age 60, 1/3 of American women have had the procedure.
According to William H. Parker, MD and Rachel Parker in A
Gynecologist's Second Opinion (Penguin/Plume) American women are
twice as likely to have a hysterectomy as women in England and four
times as likely as Swedish women. French doctors almost never
perform a hysterectomy for fibroids, which is the most common reason
for hysterectomy in this country. Endometriosis and pelvic pain are
other common reasons for hysterectomy.
Many factors including cultural attitudes, physician training, the
availability of elective surgery in a particular country and the
ability to pay for care contribute to different rates of
hysterectomy in different countries.
Another contributing factor is whether or not the physician is able
to offer the patient a variety of options.
Do Research and Know Your Options
Through research Murawski learned the difference between
gynecologic surgery done the old way, with long abdominal incisions,
and the minimally invasive way, which has been practiced for more
than a decade.
She discussed several additional options with Dr. Tom Lyons of the
Center for Women's Care & Reproductive Surgery,
including laparoscopic myomectomy, or removal of the fibroids
only. Because of her extremely negative reaction to drug therapy,
she was not interested in pursuing that further. Often, where other
physicians will recommend a major surgery, Lyons suggests either a
'wait and see' approach or an easy, in-office procedure such as
Murawski chose the least invasive surgical procedure, the
Laparoscopic Supracervical Hysterectomy or LSH. Dr. Lyons developed
this procedure in 1990 and has performed hundreds of them
The older traditional 'bikini incision' means slicing through
abdominal muscles and nerves which can take weeks or months to heal,
and sometimes causes radiating pain down the legs. With laparoscopic
procedures, patients endure less pain, less risk and recover more
Importantly, LSH leaves the cervix intact
as a keystone support to the female anatomy, which improves sexual
function post-surgery and helps prevent pelvic prolapse later.
Discerning patients who aren't willing to settle for "the way it's
always been done" find Dr. Lyons on the Internet and come from as
far as Tokyo, Rome, Madrid, Australia and Buenos Aires.
"I've heard from so many women about residual problems after these
surgeries, like bladder leakage problems or pain from scar tissue.
After surgery I was up in four days-and after three weeks I had to
remind myself not to overdo!" said Claudia. She resumed golfing
after six weeks. "Dr. Lyons and his team are so great!" she
A recent American study done by a female doctor at Harvard found
that most women who had a hysterectomy performed because of moderate
or severe symptoms were "very satisfied" with the results of
surgery, and they noted an improvement in their quality of life.
Although Dr. Lyons has trained hundreds of surgeons around the world
on the LSH technique he developed, most doctors don't perform it.
Some surgeons refuse to perform laparoscopic procedures on a large
uterus. The size of the uterus is not an issue or a problem for Dr.
"It's especially important that patients choose a surgeon who is
experienced in working with lasers and laparoscopy. LSH requires
more skill than open abdominal hysterectomy. It's easier on the
patient, but more challenging for the surgeon," explained Dr. Lyons.
One of the most important factors in helping people choose
appropriate medical care is a comprehensive understanding of the
reasons for treatment, the risks, and the potential benefits. This
especially applies to hysterectomy. If hysterectomy has been
suggested as an option, women should carefully weigh the pros and
cons, the alternative treatments, the potential benefits and risks,
and the physician's track record.
Many surgeons will attempt a laparoscopic procedure and feel it
necessary to convert to an open surgery with a long incision during
the procedure. Make sure to ask your surgeon about his or her
conversion ratio. Dr. Lyons' conversion ratio is less than one
Email the Center for Women's Care
Center for Women's Care &
Reproductive SurgeryŠ 2006
1140 Hammond Drive, Suite
Atlanta, Georgia 30328.
Toll Free 1 (888) 545-0400
Metro Atlanta (770) 352-0037
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