Alternatives-to-Hysterectomy

Alternatives-to-Hysterectomy - Alternatives to Hysterectomy...

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Unformatted text preview: Alternatives to Hysterectomy Duncan Turner MD, MBBS, FACOG, October 28th 1998 Santa Barbara,California HYSTERECTOMY • 600,000 per year in USA • 35% chance by 60 • Traditional Surgery – 3 days in hospital – 6 weeks of recovery • Total Cost: $15,000 + loss of productivity TOPICS • Alternatives to Hysterectomy • Alternatives to Traditional Hysterectomy • Why? – New Treatments – New Surgeries – You Have A Choice Definitions • Hysterectomy – Removal of Uterus, With/Without Ovaries • Subtotal Hysterectomy – Removal of Uterus Without Cervix, With/Without Ovaries • Approaches – Abdominal (Laparotomy) – Vaginal – Endoscopic (Laparoscopic) The Uterus Definitions • Endoscopy: Looking through a narrow tube • Types of Endoscopy – Hysteroscopy - into uterus via vagina – Laparoscopy - into the abdomen – Cystoscopy - into bladder – Others Cost of laparotomy • $5,000 - $15,000 • 3 Days in Hospital • Significant Pain • 6 Weeks of Recovery Cost of laparoscopy • $4,000 - $15,000 • Outpatient or Inpatient • 3 Hours to 2 Days in Hospital • 3 Days to 3 Weeks Recovery Cost of hysteroscopy • $2000 • Outpatient • <3 Hours in Surgery Center • 1-2 Days of Recovery The Conditions • Abnormal Uterine bleeding • Fibroids • Endometriosis • Prolapse • Chronic Pelvic Pain • Cancer and Precancerous Conditions ABNORMAL UTERINE BLEEDING • Prolonged, Irregular or Heavy Bleeding • 30% of Hysterectomies • 200,000 a Year Causes of A.U.B.Causes of A....
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Alternatives-to-Hysterectomy - Alternatives to Hysterectomy...

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