Hysterectomy cases on the rise in India, doctors & health experts concerned

Jammu:  A new study has indicated that the preferential choice of private hospitals over public hospitals might be the reason for the increasing number of hysterectomies in India. Hysterectomy is the surgical procedure for uterus removal.

Peculiarly, it is the second most frequently performed surgery for women. In the 21st century, many countries which had a history of high prevalence of hysterectomy surgeries earlier, are reporting a decline. However, in the last few years, there are many reports about the increasing hysterectomy cases in India. For instance, in America 6 out of 1,000 women undergo hysterectomy while in India, it is 17 out of 1,000, two times higher.

The researchers wanted to find out typical health issues faced by Indian women for which the hysterectomy is done. They also looked at the type of healthcare facility where hysterectomy surgery is carried out. The National Family Health Survey (2015-16) for the first time collected data on hysterectomy and when, where and why it was performed. This helped researchers to decipher reasons for the increasing trend of uterus removal surgeries in India.

It emerged that that excessive menstrual bleeding is the main reason for carrying out the procedure. A state-wise comparison revealed that Andhra Pradesh and Bihar had high number of hysterectomy surgeries done and most of them in private hospitals. Before 1997, only 43% of hysterectomy surgeries were performed in private hospitals but by the end of 2016, it had increased to 74%.

The study also points to the North-east states as an exception to the general pattern of hysterectomy surgeries where low number of hysterectomy surgeries are performed and most of them in public hospitals. This indicates the strong local-level public health infrastructure and preference for public hospitals.

Sometimes doctors may be prescribing the procedure even though patients can be treated without it. “With the advancements in medical science, now hysterectomy need not be a necessity in many cases. Women can take other options, such as oral remedies, hormonal injection, etc., to treat problems such as heavy menstrual bleeding and fibroids,” pointed out Trupti Mehar of the International Institute for Population Sciences, Mumbai, who conducted the study along with Harihar Sahoo.

Generally, patients who undergo hysterectomy believe that the surgery would relieve them from gynecological problems, but it can also cause new health issues. “The women are not informed about the long-term consequences of this surgery. Women after the surgery can suffer from many musculoskeletal disorders like back pain, muscle pain and joint pain. Another common problem is significant weight gain after surgery which reduce the agility of women and hampers their ability to do work. Many studies have also found an association between hysterectomy and an increased risk of diabetes, osteoporosis, heart disease and even depression,” said Mehar.

Apart from the choice of the healthcare facility, there are other important contributing factors for the predominance of hysterectomy. Still, there is a need to ensure the private health sector are regulated and monitored for their adherence to medical ethics, the researchers insisted.

The findings have been reported in the Health Care for Women International Journal.

S Suresh Ramanan is a contributor at India Science Wire.

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