Fewer than half of women diagnosed with uterine fibroid tumors are informed of less invasive alternatives to hysterectomy, such as uterine artery embolization, according to a survey conducted by the National Women’s Health Resource Center and scheduled to be released on Wednesday, the Wall Street Journal reports (Etter, Wall Street Journal, 11/7). More than 90% of the 615,000 hysterectomies performed in the U.S. are conducted because a woman has fibroids, endometriosis, abnormal bleeding, or a prolapsed or fallen uterus — all conditions for which less invasive surgery or nonsurgical treatments are available (Kaiser Daily Women’s Health Policy Report, 8/16/05). Uterine artery embolization — which involves a small abdominal incision and local anesthesia — has a lower rate of complications and requires less recovery time than hysterectomy and is usually covered by health insurance. Some gynecologists fail to tell their patients about the procedure, possibly because it is performed by interventional radiologists and not gynecologists. As a result, gynecologists — who perform hysterectomies — do not receive the fee they might have obtained when the patient chooses UAE instead of hysterectomy (Kaiser Daily Women’s Health Policy Report, 8/24/04). According to the survey — which was conducted on behalf of Rockland, Mass.-based Biosphere Medical — 40% of women diagnosed with fibroid tumors were told by their gynecologists about uterine artery embolization and almost 58% were told about hysterectomy. The percentage of women told about uterine artery embolization is “still way too low given the fact that [the procedure] is a mainstream therapy,” Robert Vogelzang, an interventional radiologist at Northwestern Memorial Hospital, said, adding, “The only conclusion to make is my colleagues in gynecology simply don’t want the word out, and that’s because they don’t do the procedure.” Gynecologists dispute the allegations that they withhold information from their patients, according to the Journal. The American College of Obstetricians and Gynecologists said that the treatment only provides short-term relief for fibroid-related symptoms and that it is considered “investigational” for women who want to remain fertile. James Spies, an interventional radiologist at Georgetown University Medical Center, said ACOG’s view is “too simplistic and out of date.” According to a five-year study Spies co-wrote and published in the journal Obstetrics and Gynecology, 75% of women who underwent the procedure had long-term success (Wall Street Journal, 11/7).
Source: Kaiser Network
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