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Study Compares Benefits of Hysterectomy Vs. Medical Treatment

Posted - Mar. 26, 2004 at 8:59 a.m.



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One in four American women will undergo a hysterectomy.

Many believe the procedure does more to improve their quality of life than medication. But new evidence seriously questions that view.

Researchers compared hysterectomy, which is a major surgery, with medical treatments, and found either option can be a good one.

Hysterectomy is the most common major surgery performed in the U.S., with over 600,000 performed a year.

Most are performed for heavy bleeding. Treatment usually starts with medication, hormones, to try to control the problem.

But when that doesn't work, surgery-- which involved taking out the uterus-- is often considered.

However, Miriam Kuppermann, Ph.D. and M.P.H., says, "In the last decade there have been questions raised regarding the appropriate use of hysterectomy and specifically whether this procedure might be done a little too frequently."

Researchers at UCSF and in Finland decided to take a closer look. They compared hysterectomies with medical treatments to find out which gave patients a better quality of life.

In two separate studies, women were randomly assigned to get either a hysterectomy or prolonged medical treatment. The bottom line: In the long term, both groups thought they were better off.

"The results of our study suggest that both hysterectomy and expanded medical treatment are viable and reasonable approaches for a woman who has abnormal bleeding."

That's because in both cases, ultimately the problem-- the bleeding-- went away.

But that's not to say the two treatments are equal. Roughly half of the women treated with hormones opted out and had the surgery anyway.

So should women save time and go straight to a hysterectomy if the medical treatment doesn't work right away?

No. The odds are even. There's a fifty percent chance of eventually opting for a hysterectomy. But there's also a fifty percent chance the hormones will work if you continue the medical treatment.

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