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Comment and Controversy

Why are we obsessed with hysterectomy?

April 2006 · Vol. 18, No. 4
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My colleagues, we are fixated on hysterectomy.

I’m tired of hearing, year after year, that the hysterectomy rate is stuck at 600,000 in the United States. We can justify this any way we prefer, but why do we have one of the highest rates in the developed world? Is it because we accept only amenorrhea as a sign of success, necessitating extirpation of the “diseased” organ? After all, we can do a vaginal hysterectomy in a snap, and the recovery is easy. Or is it our love of the many innovative “toys” used in laparoscopic hysterectomy?

Even when women come to us asking for hysterectomy, it is usually out of ignorance. They don’t know they have other options. Endometrial ablation, for example, is a low-risk procedure that offers excellent compensation when performed in an office setting. More importantly, it has high patient-satisfaction rates (>95% with microwave endometrial ablation). I believe it merits serious consideration.

Scott Kramer, MD
Fremont, Calif
Dr. Kramer is a consultant to Gynecare and Microsulis.

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Vaginal hysterectomy 
with basic instrumentation