The United States leads the world in~ hysterectomy rates, an achievement

that is not a reason for pride. American women are up to six times as

likely to have a hysterectomy as are women from other medically

sophisticated countries, an unjustifiable disparity. Gynecologists know

that many hysterectomies are performed unnecessarily, because there are

frank discussions of the subject in professional journals and textbooks.

However, the prevailing attitude is that the unneeded operations are

done elsewhere, by other gynecologists. Hospitals have rules that should

prevent unnecessary surgery, but hysterectomy statistics show that these

have had little impact. The reasons are primarily financial. Hospitals

watch their balance-sheets as carefully as business executives do; empty

sessions in operating rooms and hospital beds vacant for days on end are

a much more immediate source of anxiety than the fact that women have

had surgery that could have been avoided. Also, routine hysterectomies

provide a comfortable way of life for many physicians. This occurs

despite the fact that some women have found that they encountered

more pain, complications, and new symptoms after surgery than they

expected.

This book teaches you how to identify an unnecessary hysterectomy.

It also shows you how to avoid hysterectomy for diseases that prompt

even responsible gynecologis~ts to reach for the scalpel. New diagnostic

procedures, medications, and operations have become available, poten-

tially displacing hysterectomy as the second most often performed

gynecological operation in the United States. Today, the only hysterec-

tomies that are unavoidable are those performed for cancer or in response

XV