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ACOG Statement on Alternatives to Hysterectomy

Press Release

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Updated September 05, 2003

Updated September 05, 2003
Washington, DC -- Several recent news stories have presented inaccurate information concerning ACOG recommendations on when hysterectomy may be indicated. In particular, ACOG recommendations on the treatment of fibroids have been misrepresented. ACOG thus reiterates its long-standing advice provided in both patient and physician education materials.

Hysterectomy should only be performed for medical reasons, and only after alternative options have been discussed and explored with the patient.

If a physician advises a hysterectomy, women should consider getting opinions from one or more other physicians.

In the case of fibroids, which are non-cancerous tumors growing in or on the uterus, women may need to do nothing at all, particularly if the fibroids are not causing any problems. For women who are experiencing problems - such as pelvic pain, bleeding, or infertility problems - women and their physicians should rule out other causes of such conditions before treating fibroids.

In cases where fibroids cause problems, ACOG notes that there are other, less invasive alternatives to hysterectomy such as medications that temporarily shrink fibroids or a surgical procedure known as a myomectomy. This surgery removes the fibroids but preserves the uterus. Depending on the number and size of the fibroids, this may be done either through outpatient techniques such as hysteroscopy or with more invasive abdominal surgery that requires a hospital stay and recovery time equivalent to that of a hysterectomy. [See Guidelines for Women's Health Care, 2nd Edition, 2002; Surgical Alternatives to Hysterectomy in the Management of Leiomyomas, ACOG Practice Bulletin no. 16, May 2000.]

Medical science is also exploring other potential treatments, such as the newer uterine artery embolization (UAE) procedure. ACOG believes that more research is required before such procedures can be recommended as a routine treatment option, but ACOG is encouraged that an expanding number of treatment choices may be available in the future.

The allegations in some news stories that ob-gyns are motivated to perform hysterectomies for financial gain are not only untrue claims against physicians devoting their lives to improving women's health, but they are patently absurd in today's medical liability climate.

As in other health care matters, a woman's decision whether to have a hysterectomy is an individualized one, made after consultation between a woman and her doctor. Ob-gyns are women's partners in health care who believe that an informed patient can make the best choices about what is right for her.

Women wanting more information on these subjects may request our patient education pamphlets "Uterine Fibroids" (AP074) or "Understanding Hysterectomy" (AP008) by emailing resources@acog.org or calling 202-863-2518.

Source: ACOG

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