Attitudes and Beliefs About Hysterectomy in Patients with Uterine Fibroids.

An estimated 70% of women in the United States are diagnosed with fibroids1. When symptomatic, fibroids can cause a range of disruptive and harmful symptoms including heavy bleeding, pelvic pain, urinary and bowel symptoms, and infertility or subfertility. While the number of non-invasive treatment options has grown, surgical management remains a mainstay, providing the only definitive treatment for fibroids.

As of 2013, hysterectomy was the most common procedural treatment for fibroids (168 per 100,000 women), with myomectomy coming in second (51.4 per 100,000 women)2. Desire for childbearing is frequently a primary consideration, but many patients seeking surgical management for symptomatic uterine fibroids (SUF) desire uterine retention regardless of fertility concerns. This may lead to discordance between provider and patient in formulating a safe and effective plan of care. Some studies have suggested that there is increased blood loss during myomectomy compared to hysterectomy, while others have shown no difference in overall perioperative morbidity 3-7. However, myomectomy is not considered definitive treatment, with a recurrence rate of over 50% at five and up to 84.4% at eight years, potentially requiring repeat surgical intervention 8,9.

Studies from the Urogynecology and gynecologic nursing literature have reported patients’ attitudes toward hysterectomy and suggested a multitude of factors that influence patient decision-making 10-19. Few have investigated these questions in women with SUF20-22. The goal of this study is to investigate the attitudes toward and beliefs about hysterectomy that may influence the decision-making of women with SUF.

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