Dr. William Parker is a Clinical Professor at the UCLA School of Medicine with private practice in Santa Monica, California. He is on the editorial advisory board of The Journal of the American Association of Gynecologic Laparocopists. He is a reviewer for a number of obstetrics and gynecology journals.
Dr. Parker discusses possible alternatives to hysterectomy. He emphasizes that in many cases hysterectomy is not required, and encourages women to pursue alternative treatments to surgery.
The alternatives to hysterectomy will depend on what the original problem is. So let’s just take the two most common indications for hysterectomy. The first would be fibroids. First of all, the majority of women, probably 80% of women with fibroids don’t need any treatment at all, just watching them over a period of time when women get their menopause the fibroid shrink. If you’re not having heavy bleeding or pain or other symptoms, you don’t need anything and I see a fair number of women who have been told by other physicians to have a hysterectomy and they need to do nothing. So that’s always good news when you come in here; you need to do nothing.
Myomectomy, just removal of the fibroids and preservation and reconstruction of the uterus would be an alternative and there are there ways to do that. One is the traditional way through bikini incision for larger fibroids, but smaller fibroids can be taken out through the belly button with laparoscopes and then fibroids in the uterine cavity can be shaved out through the cervix without even any incisions as in outpatient with two-day recovery. So those are surgical options.
We also have laparoscopic super-cervical hysterectomy which is a hysterectomy, but is really a week recovery instead of a six-week recovery. So, if hysterectomy is what you choose to do, that’s a less invasive way to go. Uterine artery embolization where fine little particles are put into the blood vessels going into the uterus and fibroids that makes the fibroids shrink over a period of few months works really well both for bleeding and for pain.