Getting a Second Opinion Reduces Number of Hysterectomies
Alicia Armeli

secondopinion

Get a second opinion. How many times have you heard that before? If you’re a woman with uterine fibroids, maybe not enough. A study by researchers at the UCLA School of Medicine showed that the simple act of getting a second opinion meant women with fibroids were more likely to choose uterus-sparing treatment options, avoiding hysterectomy altogether.1

Uterine fibroids, although noncancerous, are common tumors that grow in the wall of the uterus and can be the source of heavy painful periods, pelvic pressure, and incontinence. While the majority of fibroids don’t cause symptoms, up to 50% of women with fibroids will seek treatment for relief.2

From July 2008 to August 2011, Nelly Tan, MD, and a team of UCLA radiologists and gynecologists at a multidisciplinary fibroid treatment center investigated over 200 women who visited the clinic for a second opinion concerning treatment options. Previous to their visit, the majority of these women had only been offered hysterectomy as a form of treatment.

After physical examinations that included an MRI scan, each patient met with a gynecologist and radiologist separately to discuss all options. Results published in the Journal of Therapeutic Ultrasound showed that of the 109 women who decided to transfer their care to the fibroid center, 70% chose uterine-sparing procedures and over 20% chose medical therapy or no treatment at all.

These numbers contradict what’s happening nationally. Found to be the most common major gynecologic surgery, 400,000 hysterectomies are performed annually in the US alone.3 And statistics show that nearly 70% are done to treat noncancerous conditions like fibroids.3  “We suggested hysterectomy in 4.4% of our patients although the majority had been offered hysterectomy at other facilities,” Dr. Tan and her team write.

This study mirrors other research that has shown nearly 40% of women seeking fibroid treatment aren’t given any other options besides hysterectomy.3 Many times it’s not OB/GYNs who tell their patients about minimally invasive options—but media, friends, and family who are the sources of this information.1

Dr. Tan and her team discuss that even though these women were already seeking a second opinion, which could’ve increased the likelihood of choosing an alternative to hysterectomy, their study showed how fibroid centers with both interventional radiologists and gynecologists working together could benefit women.

“In our patient population, most women were candidates for uterine-preserving options and chose to undergo a minimally invasive uterine-preserving treatment,” the authors conclude. “Our findings suggest that women desire minimally invasive therapies, and a joint effort between gynecology and radiology may be one option for institutions to improve access to most, if not all, of the therapeutic options available for symptomatic uterine fibroids.”

ABOUT THE AUTHOR   Alicia Armeli is a Health Freelance Writer, Registered Dietitian Nutritionist, and Certified Holistic Life Coach. She has master’s degrees in English Education and Nutrition. Through her writing, she empowers readers to live optimally by building awareness surrounding issues that impact health and wellbeing. In addition to writing, she enjoys singing, traveling abroad and volunteering in her community.

REFERENCES

  1. Tan, N., McClure, T., Tarnay, C., Johnson, M., Lu, D., & Raman, S. (2014). Women seeking second opinion for symptomatic uterine leiomyoma: role of comprehensive fibroid center. Journal of Therapeutic Ultrawound, 2:3, doi: 10.1186/2050-5736-2-3
  1. Soliman, A. M., Yang, H., Du, E. X., Kelkar, S. S., & Winkel, C. (2015). The direct and indirect costs of uterine fibroid tumors: a systematic review of the literature between 2000 and 2013. American Journal of Obstetrics and Gynecology, 213(2): 141-160. doi: 10.1016/j.ajog.2015.03.019
  1. Corona, L. E., Swenson, C. W., Sheetz, K. H., Shelby, G., Berger, M. B., Pearlman, M. D., Campbell, D. A., Delancey, J. O., & Morgan, D. M. (2015) Use of other treatments before hysterectomy for benign conditions in a statewide hospital collaborative. American Journal of Obstetrics & Gynecology, 212(3): 304.e1-7. doi:10.1016/j.ajog.2014.11.031