A Plethora Of Unnecessary Hysterectomies

Recent reports that a Consultant Gynaecologist removed the womb of a woman without consent, is not a very unusual occurrence in the field of clinical negligence. Caroline Richmond, the woman at the centre of the GMC complaint, is only one of a significant number of women who, over many years, have undergone hysterectomies, without receiving adequate information.

It is a fact, accepted by numerous medical practitioners, that there are many women of child bearing age (and who have not completed their families) suffering from fibroids, who have undergone hysterectomies in the absence of knowing or being told, that there were alternative possible treatments that may have been appropriate. One such recent treatment is fibroid embolisation. Advice that a patient should have a prophylactic hysterectomy to prevent fibroids becoming malignant, may be incorrect. It is known that a number of patients were put in this position by their Gynaecologists.

The following are treatment options for fibroids:-

• Drug therapy
• Myomectomy (removal of fibroids alone and not the entire uterus). Most commonly used in younger women who wish to maintain their ability to have a child - whether performed by hysteroscopic, laparoscopic or abdominally.
• Hysterectomy (whether vaginal, laparoscopic or open surgical procedure).
• Uterine fibroid embolisation; which is a new approach and undertaken by Interventionist Radiologists in specific NHS centre.

Over many years, perhaps decades, hysterectomies have remained for far too long, the treatment of choice for many gynaecological conditions, including fibroids and there are still many Consultant Gynaecologists that have not changed their practice and still automatically proceed to hysterectomy without giving patients a choice or enabling them to give informed consent.

The criticism - of unnecessary hysterectomies (not necessarily for fibroids alone) must be recognised, since in recent months, Britain’s largest private health insurer (BUPA) announced that Surgeons who are to perform hysterectomies on a private basis and who require funding under a patient’s policy, will need prior authority. After extensive consultation with the profession, BUPA has drawn up “evidence-based” guidelines on when a hysterectomy is necessary and therefore eligible for cover.

In many cases, hysterectomies should be seen as a last resort. Its impact on a woman’s psychological and sexual well-being, can be quite dramatic. Many women never come to terms with the need for Hormone Replacement Therapy.

Thanks to Gary McFarlane at Veale Wasbrough for allowing us to reproduce this article

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