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Hysterectomania raises serious concerns

Concern is growing that a large number of hysterectomies are being carried out in Malta unnecessarily. And figures released recently which show that over 600 hysterectomies are undertaken on average annually is doing little to quell these worries.

Hysterectomy – the removal of a woman’s womb - might be one of the most common of all surgical procedures, but that doesn’t make it any less traumatic for the woman undergoing the operation.

There is a general perception that the medical profession in Malta take the options of hysterectomy lightly. Indeed, statistics shows that Malta has one of the highest hysterectomy rates compared to other European countries.

And from investigations carried out by MaltaToday disturbing revelations surface of women in their late twenties and early thirties who were advised to have unnecessary hysterectomies.

Very little is made of the side effects of hysterectomy.

There are many reasons that a hysterectomy is carried out.

It can and does help to ease many gynaecological complaints, such as heavy, painful periods, fibroids, a prolapsed womb, endometriosis or pelvic inflammatory disease. And although it is rarely performed for reasons of saving life, it can be a permanent cure for some gynaecological cancers.

But over the years, this common operation has become the centre of much controversy as concern has grown as to whether hysterectomies are being carried out unnecessarily, or too speedily with many women ill-prepared to deal with the after-effects of such serious and permanent surgery.

In Malta, over 600 hysterectomies are carried out at St Luke’s hospital on average per year. Last year the number dropped markedly to 489, but medical contacts told MaltaToday stress that this is likely to indicate an ever-growing number of operations being undertaken privately than an overall decrease in the amount of surgery taking place.

Malta runs parallel with many European countries with the majority of hysterectomies being performed on women aged between 40 - 50, however many do occur below and above this age group.

According to the Department of Health Information, age group distribution of patients is not routinely analysed, but in 1998, this was done and published. As the table below shows, the greatest number of hysterectomies – 276 - was carried out on women between 40 – 49, while those in the age bracket 50 – 59 came second. There was, however, still a significant number of younger women – 86 who were under 40 years of age – that underwent the operation.
Dealing with the trauma of a hysterectomy is not easy for women. The fact that they can no longer have children is something that has to be faced, while some feel less feminine or ‘female’ than before the surgery.

In addition to this there are a number of health implications due to loss of this major muscle and/or the loss of oestrogen and testosterone when ovaries fail or are removed, coupled with the loss of sexual fulfilment.

Women taking Hormone Replacement Therapy to counteract the loss of oestrogen and testosterone often get side effects such as weight gain, breast tenderness, headaches. The usual method of administering HRT is to start with the lowest dose and to gradually increase it until the menopausal symptoms are relieved.

With so much to deal with in the aftermath of a hysterectomy, it is not surprising that women and their loved ones began exploring whether enough was being done in the way of offering alternative treatments to such major, permanent surgery. And just who benefited most from the operation being carried out sooner rather than later.

In this day and age patients are much quicker to question the medication and surgery being offered. And although this is an era when we are informed women should now told they need to be sure they know what the operation will mean and whether they would prefer to decide to live with their condition, it is unclear whether this is happening and too late for some.