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Here is the best post on hysterectomy that I’ve seen in a long time of 3+ years that I am involved with this site.

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Uterine artery embolization is a relatively non-invasive procedure to stop the blood supply to the existing uterine fibroids in order to eliminate them. It involves a catheter through the artery and lasts for about an hour, but after the procedure, the uterus is intact. The fibroids do not have blood to feed them, so they disappear. But is it really a better solution than the hysterectomy, given that the symptomatic uterine fibroids may return within a year or two, and that with hysterectomy they cannot return because the uterus isn’t there any more?

Here’s a comparative study, with the full name of

Uterine artery embolisation or hysterectomy for the treatment of symptomatic uterine fibroids: a cost-utility analysis of the HOPEFUL study

by Wu, O. and Briggs, A.H. and Dutton, S. and Hirst, A. and Maresh, M. and Nicholson, A. and McPherson, K. (2007), and published in BJOG: An International Journal of Obstetrics and Gynaecology 114(11):pp. 1352-1362.

They wanted to see which procedure should be favourized from the standpoint of UK NHS. There were 649 women who underwent UAE (Uterine Artery Embolisation) and were followed for the 8.6 years in average, while there were 459 women with hysterectomy, which were followed for up to 4.6 in average.

Two main measures were the Costs of procedures and complications, and Quality Adjusted Life Years (QALY) UAE had the lower cost, £2536 versus £3282, small reduction in quality of life (8.203 versus 8.241 QALYs) when compared with hysterectomy. However, when the quality of life associated with the conservation of the uterus was incorporated in the model, UAE was shown to be the dominant strategy—lower costs and greater QALYs.

The result of the study is that simply more women should be allowed to UAE instead of going directly to hysterectomy. This is especially important if the woman wants to preserve her uterus.

The abstract of the Uterine Artery Embolisation or Hysterectomy For the Treatment of Symptomatic Uterine Fibroids study is published by the University of Glasgow.

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Hysterectomy recovery in  real life is terra incognita in each case. When you speak with women about their hysterectomies and other surgeries as well, they tend to minimize the problems that followed, especially if that happened long time ago and all went well, after all. When you start digging, you hear how it really was. Now, with the ability to blog, many women post their “internal” problems as “external” posts, for everyone to learn and see. In this blog, truered37 had three posts, the first one on 48 hours before the operation, and the first and second followups.

Of course, we wish her all the luck in the world and the best of recovery in the future!

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When you read forums and somebody says they are heading for hysterectomy, almost always one or two participants stands up saying that hysterectomy was the best thing that ever happened to them in their lives! OK, maybe that’s how it was for them, but not everybody has their own little “happy hysterectomy”. The case in point is Christine from Atlanta, let’s quote from this article:

Exactly one week after the hysterectomy, Christine awoke in horrible pain and immediately went to her doctor’s office. When she passed out in his waiting room, an ambulance took her to a hospital.

A CT scan revealed urine was accumulating in her abdomen. Christine says her doctor explained what he thought went wrong: When he was using a cauterizing tool, he must have nicked the ureter, the duct that carries urine from the kidneys to the bladder. “He really owned up to it,” Christine says.

The next day, her doctor implanted a nephrostomy tube, so Christine’s urine could accumulate in a bag outside her body. A week later, she had a third procedure to insert an internal stent to replace the tube and the bag. When that stent caused her pain, doctors removed it in a fourth surgery. Today, Christine is scheduled to have a fifth procedure to fix her ureter, which has become almost completely blocked by scar tissue.

Grant says the complication that caused all these problems — the nicking of a ureter — would most likely be considered a regular complication of the surgery, and not negligence. This means that even though Christine has clearly suffered, she wouldn’t have a case. “Just because you have a bad outcome doesn’t mean you can sue,” he says.

Since she lives in the USA, her relatives wanted her to sue, but it doesn’t seems it is possible — her costs are too small for an attorney to have a profit at court. (That’s what happens when you live in a profit driven justice system.) She is not well, and the money is gone. Being a physician herself, she knows how major surgeris can be dangerous…

Bottom line: avoid hysterectomy if you can.

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