Dr. Pradeep Muley

Hysterectomy is not a cure or panacea for all uterine fibroids complaints, considering the impact losing the uterus may have on various physiological functions, says Dr. Pradeep Muley Head, department of Interventional Radiology.

The word hysterectomy has it’s origin from the Greek hysteros, meaning uterus, and “ectomy” meaning removal. Hysterectomy, therefore, refers to the surgical removal of the uterus (womb). Such patients, naturally, do not have menstrual periods and cannot bear children. Today, hysterectomy is the commonest major gynecological operation performed on women. About 600,000 hysterectomies are performed every year in the USA. The statistics for India are not known but are likely to be more staggering because of the vast population

Despite great advances in non-surgical method, hysterectomy even today is considered a major undertaking. A recent survey in 2002 showed that this surgery is associated with a mortality of 0.38 per 1000 and serious postoperative complications in about 3 per cent. Therefore, even though hysterectomy is curative for many gynecological complaints, it is not a benign procedure that can be taken lightly.

The single most common reason for hysterectomy today is fibroids. Fibroids are benign tumors of the muscles of the uterus. Women with small fibroids are best treated by leaving them well alone. Only those fibroids that cause symptoms will need treatment which does not necessarily mean removal of the uterus.

Heavy menstrual bleeding affects around 30 per cent of women and causes lethargy, exhaustion and repeated infections due to anemia. At times, it also results in social embarrassment. Since 1843, when it was first described, hysterectomy has been considered as the “gold standard” for heavy periods. Today, one-fifth of all hysterectomies are done for this reason. In majority of such patients have uterine fibroids in their uterus.

Since the uterine fibroids are treated with-out surgery by technique called “Uterine Artery Embolization” for fibroids. This is a simple 20-minute procedure, with more than 97 per cent success, after which the patient can go home in 24 hrs and resume normal life within two-three days without sacrificing her uterus, even no surgical scar, no blood transfusion, no general anesthesia, any number of fibroids treated in one sitting.

With all these exciting possibilities now available, hysterectomy is not a cure or panacea for all uterine fibroid complaints, considering the impact losing the uterus may have on urinary, bowel, mood and sexual function. Despite these reservations, it is required as treatment of cancer of the uterus and ovaries and sometimes for some non-cancer gynecological problems as well. Whenever possible, it is better to go in for uterine artery embolization for uterine fibroids rather than the older traditional surgery for removal of uterus.

Dr.Pradeep Muley
Head, Senior Consultant Interventional Radiology
Fortis Hospital, Vasant Kunj, Aruna Asaf Ali Marg,
Vasant Kunj, New Delhi 110070, INDIA
Mobile 91-9810492778
website www.indianinterventionalradiology.in
E-mail muleypradeep@hotmail.com