SAN ANTONIO -- Women are revolting against gynecologists who refuse to provide uterine fibroid embolization (UFE) instead of hysterectomies, according to a presentation at the 26th annual scientific meeting of the Society of Cardiovascular and Interventional Radiology (SCVIR).
"The vast majority of gynecologists have negative initial opinions toward (UFE)," said Dr. Michael Wysoki, a clinical assistant professor of diagnostic radiology at Yale University School of Medicine in New Haven, CT. "Patients who underwent UFE did not continue seeing most of the gynecologists who maintained their negative opinion about the procedure."
Wysoki performed a telephone survey of 50 women who underwent the UFE procedure between 1998 and 2000 at his hospital. He received responses from 42% of the women.
"We're finding that women are really taking charge of their own destinies and are not totally depending on their gynecologists' opinions," Wysoki said.
For some women, the decision to have non-cancerous fibroid tumors sealed off and shrunk through catheter-based embolization procedures stems from their desire to have children. One woman in the survey, said no to hysterectomy, had UFE, and is now pregnant, Wysoki said. She had seen 12 gynecologists before she found someone who would refer her for the UFE.
Wysoki said the study was prompted by the wide variation in hysterectomy rates across the United States. He noted that male gynecologists perform 60% more hysterectomies than women gynecologists. He asked the women who sought UFE instead of hysterectomies what they thought of their gynecologists.
"All the gynecologists except one -- a woman -- offered hysterectomies to the women as a first choice of treatment," Wysoki reported. "Ninety percent of the patients were the ones who initiated discussions of embolization for their fibroids."
Among the comments made by the gynecologists to their patients:
- "Go be an experiment if you want to. I want no part of it."
- "This procedure is experimental. It won't work."
- "It's a new procedure. It's not safe and you'll need a hysterectomy anyway."
He said 76% of the women said their doctors were initially opposed to the procedure, but after the operation was performed, 43% of the physicians altered their view of UFE to a more favorable position. If the gynecologist remained in opposition, 8 of 9 women refused to return to that practice, Wysoki said.
"I and several of us have all seen patients who have fired their gynecologists over this issue," said Dr. Robert Vogelzang, a professor of radiology at Northwestern University School of Medicine. He said that often gynecologists tell their patients -- in attempts to discourage the procedure -- that the embolization operation is very painful.
Dr. Lindsay Machan, an associate professor of radiology at the University of British Columbia in Vancouver, and moderator of the session at which Wysoki presented his data, urged the researcher to continue to pursue contacts with the other women to add statistical weight to the survey.
By Edward Susman
AuntMinnie.com contributing writer
March 5, 2001
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