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Ask Dr. John Lipman: Unnecessary Hysterectomy – Why Does My OB Push Hysterectomy without Mentioning UFE?

Ask Dr. John Lipman: Unnecessary Hysterectomy – Why Does My OB Push Hysterectomy without Mentioning UFE?

Question: I’m 41 years old and had a robotic myomectomy 4 years ago for fibroids, but my fibroids have come back. My Gynecologist is pushing hysterectomy, but said she’d do a myomectomy if I really preferred going that route since I might still want a child. She didn’t mention Uterine Fibroid Embolization (UFE). Am I even a candidate?

Answer: Unnecessary hysterectomy is a very important issue. If your fibroids are causing significant symptoms, then very likely you would be a candidate for UFE. While your Gynecologist is obligated to tell you all of your treatment options, most do not. Unfortunately, they often only talk about the procedures that they can provide, which is typically surgical (most often, myomectomy or hysterectomy).

 

One important side note here. Your fibroids didn’t “come back.” Patients are often left with the impression that when they undergo a myomectomy, the Gynecologist removes all of the fibroids surgically. This is rarely the case, and often there are more fibroids left behind than were taken out surgically (i.e. less than half of the fibroids removed).

Unnecessary Hysterectomy: What Do You Need To Know?

These fibroids that are left behind will obviously grow, and over half of the patients get their symptoms back within 4 or 5 years, sometimes 2 or 3 years. It is my opinion that no woman should ever undergo more than 1 myomectomy because if she did, she would set herself up for a third procedure.

This is in contrast to UFE, which is nonsurgical, typically knocks out all of the fibroids, and rarely requires another procedure to be done ever.

 

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