HealthDay Reporter
TUESDAY, September 6, 2022 (HealthDay News). — Surgery for uterine fibroidsIt is possible to perform minimally invasive procedures that do not require hospitalization. A recent study found that Black and Hispanic women are less likely than other groups to receive these treatments.
Uterine fibroids, which are not cancerous growths in the uterus, are called uterine fibroids. Sometimes they cause no problems, but when they do — like heavy monthly bleeding and pain — treatment may be necessary.
A myomectomy is one option. This removes only the fibroids. HysterectomyThe procedure involves the removal of the uterus. Either surgery can often be done in a minimally invasive way — vaginally or through small incisions in the abdomen.
Yet in the new study, researchers found that Black and Hispanic women often did not receive those less extensive procedures — instead getting traditional surgery, with a large abdominal incision and a hospital stay.
Researchers said that the reasons for this aren’t entirely clear.
The investigators did discover that Black and Hispanic females were less likely to seek out a specialist in minimally invasive treatments than white women.
Uterine fibroids are quite common, especially among Black women, says Dr. Rebecca Schneyer, an obsetrician/researcher.GynecologistCedars-Sinai Medical Center is located in Los Angeles.
According to studies, 80% of Black women will experience uterine fibroids by the age of 50. By contrast, 70% of white women will have them by age 50. However, fibroids are more common in Black women than they are in white women. According to some estimates, 25% of Black women will have fibroids by the age of 30.
These women are more likely to have large or multiple fibroids and to experience more severe symptoms. They also tend to undergo more surgery than white women.
Schneyer stated that this is all the more reason to try to reduce disparities in care.
The majority of traditional abdominal surgery for fibroids can be performed safely. It is more painful and causes more blood loss than minimally invasive procedures.
For the new study — recently published in the Journal of Minimally Invasive Gynecology — Schneyer’s team examined records of more than 1,300 women who had surgery for uterine fibroids at Cedars-Sinai in recent years.
Many had a minimally-invasive myomectomy or other hysterectomy. But there were large racial disparities: White women had 81% who underwent minimally-invasive procedures, while 57% of Black and 65% respectively. Asian women had a rate that was comparable to white women.
Schneyer indicated that traditional surgery can sometimes be more effective depending on the size and number of fibroids.
However, these factors didn’t explain the differences in the type of surgery, according to the study.
Instead, Black and Hispanic women were less likely than white women to see a doctor who specialized in minimally invasive techniques: They often saw an obstetrician/gynecologist without that “sub-specialty” training.
The reason isn’t clear, considering that all patients were treated at one medical center and almost all had private insurance.
Schneyer suggested that it is possible that the first doctors who saw Black and Hispanic patients were less likely than later to refer them to subspecialists. This could be due to “implicit biases.”
However, she believes that “disparities with awareness” could play a greater role. White women are more likely than other people to be aware of minimally invasive options and seek second opinions.
Dr. Hye Chun Hur is a specialist in minimally invasive, gynecologic surgical procedures at NYU Langone Hospital Brooklyn. According to her experiences, some patients suffering from uterine fibroids will “doctor shop” and seek second, or even third opinions. Others will simply accept the first option.
Both Schneyer as well as Hur stated that doctors should explain all options to patients.
It’s also important, they said, for primary care doctors and general ob/gyns — the ones who refer women to sub-specialists — to be aware that minimally invasive procedures can often be done even when there are numerous fibroids or the uterus is large.
Schneyer explained that “a lot has happened in the last 20 years.” Minimally invasive surgery is a viable option more often than not.
Hur suggested that women who have been recommended for traditional surgery should seek out a second opinion. She suggested that they should seek out a second opinion from a specialist in minimally-invasive techniques if possible.
Schneyer also highlighted the availability of non-surgical options including medication to stop bleeding from fibroids.
Any treatment, Hur said, needs to be individualized — based not only on symptoms, but a woman’s age and pregnancy plans.
Fibroids can sometimes affect fertility, she said, so young women might consider having growths removed, even though they may not be causing any symptoms.
Hur stated that this may be particularly important for Black women because they are more likely to develop fibroids later in life.
For more information, click here
More information on uterine fibroids can be found at the U.S. Office on Women’s Health.
SOURCES – Rebecca Schneyer MD obstetrics, gynecology Cedars-Sinai Medical Center Los Angeles; Hye-Chun Hu, MD MPH, director, NYU Langone Hospital Brooklyn and clinical associate professor obstetrics, NYU Grossman School of Medicine New York City. Journal of Minimally Invasive GynecologyOnline, July 3, 2022.
