WOMENS-HEALTH Messages for August, 1999: Re: TAH is the only choice?

Re: TAH is the only choice?

From: William D. McIntosh, MD (anonymous@obgyn.net)
Fri, 6 Aug 1999 09:07:38 -0500 (CDT)

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In reply to: Susan: "TAH is the only choice?"

At Thu, 5 Aug 1999, Susan wrote: >
>I've been suffering with AUB for 7 months now and have exhausted the
>alternatives to hysterectomy. I spoke breifly with my gyn yesterday (he
>was 11 patients behind) and he offered nothing less than abdominal
>surgery. He said that in order to do a vaginal hyst, I'd have to have a
>certain measure of uterine prolapse. I have none. (I had one child by
>C-section and she was 3 lbs 2 oz) He also said that LAVH or laparoscopic
>surgery wasn't an option. He insisted that laparoscopic surgery was
>just as painful and required just as much recovery time. He said that
>the only reason Dr's were doing lap hysterectomies was that the hospital
>stay was shorter and therefore cheaper for the insurance companies.
>After all the research I've done about this, I find his words hard to
>believe. Can anyone give me some insight on this subject?
>
>--
>Susan
>The Estrogen Queen
>

There are always alternatives to abdominal hysterectomy, though they may not be as good. It is incontrovertable that vaginal and/or laparoscopic hysterectomies are not as painful as abdominal hysterectomies. The recovery time is similar, though the pain is usually much less, and with the supracervical lap hysts, even the time is reduced. On the other hand, there is no good evidence that laproscopic assisted vaginal hysts are any cheaper than abd hysts, and the insurance companies that I deal with (a motley crew to say the least) have no preference in this area.

Certainly, your history would tend to make any physician steer away from a vaginal proceedure, but that does not mean that a physician with superior laparoscopy skills might not consider an alternative. Get a second opinion.

-- William D. McIntosh, MD, FACOG Clarksville, TN

This is for educational purposes only. It is not intended to replace consultation and examination by your physician or other health care provider.

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