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Dx Hysterectomy- Unnecessary Treatment: Read more...


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Observations:
Unnecessary Hysterectomy


The Examiner reports that:
"Hysterectomy rate plummeting in the US" by 40% from 2002 to 2010. The review of 7,438,452 women undergoing inpatient hysterectomy between 1998 and 2010 found that the number of hysterectomies performed for each of the following indications declined: fibroid tumors (-47.6%), abnormal bleeding (-28.9%), benign ovarian mass (-63.1%), endometriosis (-65.3%) and pelvic organ prolapse (-29.4%). The average hospital case volume decreased frm 83 procedures per year in 2002 to 50 cases per year in 2010."

"The Fact sheet on Hysterectomies from the CDC reference only 2000-2004 with the three leading causes of hysterectomy as "uterine fibroids, endometriosis, and uterine prolapse."

Outpatient Hysterectomy Volume in the United States OB Gyn 2017 Jul 130(11):130-31.
"The perceived decline that has been reported in national hysterectomy volume may represent lack of reporting of surgeries performed in ambulatory settings. This information has considerable implications for business, public, health interventions, and insurance carriers among other key stakeholders in women's health care delivery."

Medications/ Treatments Used with or as an alternative to Hysterectomy Treatment:
1. Hysterectomy with or without oophorectomy (ovaries)
2. Conservative Surgery:
3. Endometrial Resection:
4. Endometrial Ablation: saline, electricity, cryo
5. Uterine artery embolization:
6. Medical: Anabolic Steroids:
7. Medications and Treatments for Endometriosis/ bleeding: Lupron, Depo-provera

*[Editor] Published Medical Articles:
Conclusions "Endometrial resection and ablation offers an alternative to hysterectomy as a surgical treatment for heavy menstrual bleeding. Both procedures are effective, and satisfaction rates are high. Although hysterectomy is associated with longer operating time (particularly for the laparoscopic route), a longer recovery period and higher rates of postoperative complications, it offers permanent relief from heavy menstrual bleeding. The initial cost of endometrial destruction is significantly lower than that of hysterectomy, but, because retreatment is often necessary, the cost difference narrows over time".

*Therefore, Goldrath used danazol while others used luprolide acetate to 'thin' the lining pre-operatively to improve outcome. Unfortunately, the long term conclusions are of short-term benefit only. "The effect of these agents on longer-term postoperative outcomes was reduced with time. No benefits of GnRHa pretreatment were apparent with second-generation ablation techniques."

*[Editor] It has been known that there is only one 'receptor' in the endometrial cell: called the Androgen-Receptor although it is receptive to estrogen, progesterone and testosterone. While testosterone was tried in the 1950's to prevent hysterectomies for bleeding, up to two-thirds of testosterone is converted to estrogen (ergo, bleeding). The use of a testosterone derivative that cannot be converted to estrogen combined with a chemical to block the estrogenic effects of Sex Hormone Binding Globulin, offers a potential medical treatment to create a near perfect 'dry' or atrophic endometrium as noted by Sheri, with stage VI endometriosis, in her Testimonial.

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