When patients undergo hysterectomies, they are often unaware of exactly which organs they have had removed or are unfamiliar with the full range of surgical options available, according to a Dec. 1 story from The New York Times, which is based on interviews with physicians and patients.
Six key takeaways from the report:
- Hysterectomies, the removal of the uterus, are the second most common surgical procedure among women in the U.S., with nearly 500,000 performed annually. Nearly half of all women will undergo the procedure by the end of their lives. Despite their prevalence, many patients lack clarity about the specific type of hysterectomy they have had and thus, which organs they have had removed.
"I would say 50% of patients don't know the specifics around their surgery," Emily Von Bargen, DO, a urogynecologist at Boston-based Massachusetts General Hospital, told the Times. "It really is mind-blowing."
- Confusion often arises from misunderstanding regarding the type of hysterectomy patients are undergoing: a "total" or "partial." The former removes both the uterus and cervix, while a partial hysterectomy leaves the cervix in place. Removal of the ovaries is a separate procedure, an oophorectomy, and can accompany either type of hysterectomy. However, many patients are under the false impression that a total hysterectomy automatically includes removal of the ovaries, while a partial spares them.
- In some cases, surgeons also misuse the terms. To avoid confusion and ensure patients are aware of exactly what organs are being surgically removed, Dr. Von Bargen said she asks patients directly what they understand a hysterectomy to mean. "To some people, a partial hysterectomy means keeping my ovaries," she said.
- Miscomprehension about which organs were removed can hinder appropriate follow-up care, experts say. For instance, if patients believe they have had a full hysterectomy and years later find out they still have a cervix, they may miss out on routine Pap smears that screen for cervical cancer.
- Historically, surgeons often removed ovaries alongside the uterus as a preventive measure against ovarian cancer. However, research has since linked ovary removal to increased risks of cardiovascular disease, osteoporosis, dementia and other health issues, particularly when performed before menopause. Studies have shown this is largely due to the abrupt loss of ovarian hormones, which are crucial for protecting bone, brain and heart health during menopause.
- Experts told the Times leaders can address these challenges by prioritizing patient education, standardizing surgical counseling protocols and incorporating shared decision-making into care models.