SKOKIE, ILL – Physicians at Rush North Shore Medical Center in Skokie are leaders in performing less-invasive alternatives to hysterectomy, resulting in fewer side effects, shorter hospital stay and recovery, and sometimes preserved fertility.

 

Hysterectomy, or removal of the uterus, is the second most often performed major surgical procedure among reproductive-age women, after cesarean delivery, according to the National Center for Health Statistics. The number of hysterectomies performed in the United States increased from 592,000 in 1990 to 669,000 in 2002.

 

The majority of hysterectomies are due to fibroids, non-cancerous growths that develop in the uterus. Generally, they are watched and cause no symptoms. When fibroids grow excessively, they can cause pain with intercourse, pelvic pain and pressure, menstrual pain and heavy bleeding. Twenty to 40 percent of women over age 35 have fibroids.

 

Many women are looking for alternatives to hysterectomy for the treatment of fibroids if they wish to have children or do not want to lose their uterus. Alternative treatments for fibroids include hormone therapy and anti-inflammatory drugs; myomectomy, a surgical procedure that removes the fibroids, but preserves the uterus; and uterine fibroid embolization (UFE), a minimally invasive radiology procedure that decreases blood supply to the fibroids, ultimately shrinking them.

 

 

Uterine fibroid embolization results in shorter recovery time, shorter hospital stay and preservation of the uterus. The procedure also has fewer serious complications than hysterectomy or myomectomy.

 

“There are many options and alternatives and you have to individualize what’s best for the patient,” said Howard Topel, MD, director of gynecologic surgery at Rush North Shore Medical Center and a recognized pioneer and leader in the advancement of gynecologic laparoscopic surgery. When deciding on fibroid treatment, Topel considers the patient’s age, desire to bear children and the number and size of the fibroids.

 

Most hysterectomies performed today remove the uterus while preserving the ovaries. If the ovaries are preserved in a woman who still menstruates, side effects such as hot flashes, night sweats, personality change, loss of sexual desire, irritability and insomnia are eliminated.

 

If a woman does need a hysterectomy, Topel said, the surgeon can either remove the entire uterus or do a subtotal hysterectomy to preserve the cervix, which supports the bladder and reduces the chance for urinary incontinence. 

 

 

In a subtotal hysterectomy, Topel removes the entire uterus laparoscopically through several small incisions under a patient’s belly button. The ovaries and cervix are left intact. Patients leave the hospital the next day and often return to work two weeks later compared to the four-to-six week recovery for total hysterectomy. 

 

With the trend toward conservative surgery and alternative treatments, Topel’s practice is performing fewer hysterectomies. Still, there are conditions that warrant hysterectomy, he said, such as large uterine fibroids; and heavy bleeding, uterine cancer or chronic pelvic pain that does not respond to conservative treatment.

 

For more information about Rush North Shore Medical Center’s gynecologic surgery department and alternatives to hysterectomy, call 847-933-6000.

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