Because all surgeries involve some form of risk, the decision
to operate should never be made lightly. Controversy over
for surgical procedures abounds, with several studies suggesting
that some patients may not receive vital care, while others
are exposed to unnecessary risks.
The Agency for Health Care Policy and Research (AHCPR) sponsored
a series of studies intended to improve the quality of patient
care, specifically practice guidelines and criteria for surgical
procedures. One of these studies, the Women's Health and Hysterectomy
Project, focused on hysterectomy because "it is the second
most common operation women have, and there are significant
concerns among researchers and the public that it might be
Researchers examined 497 women from nine Southern California
managed care organizations who had the procedure between August
1993 and July 1995. A staggering 70% of the hysterectomies
were judged "inappropriate" based on published criteria.
Hysterectomy involves removal of the cervix, uterus, fallopian
tubes, and sometimes the ovaries. Although uterine or cervical
cancer, fibroid tumors, and other serious conditions may make
this type of surgery unavoidable, the authors of this study
note that they found "substantial evidence of underuse of
established diagnostic and therapeutic regimens before proceeding
to hysterectomy." Before you go under the knife, get a second
opinion from a health care professional, and make sure you're
fully informed of possible nonsurgical options.
Broder MS, Kanouse DE, Mittman BS, et al. The appropriateness
of recommendations for hysterectomy. Obstetrics & Gynecology
2000: Vol. 95, pp199-205.
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