Wednesday, September 21, 2011

Doctors' Group Ignores Hysterectomy as a Cause of Incontinence; Urinary Problems Cost U.S. Women $13 Billion/Year

They call themselves Urogynecologists, women's doctors who do not deal with pregnancies or infertility or  hysterectomies, only what they refer to as "pelvic floor disorders" including urinary incontinence. So you'd like to think they'd be upfront about the fact that hysterectomy is one of the major reasons why 40% of all U.S. women find themselves leaking urine by the time they hit the age of 60. (Interesting coincidence: that's the same percentage of women who undergo a hysterectomy by the time they are 60.)

In fact,  a very large and long study of Swedish women found that a woman's chance of incontinence at least doubled after a hysterectomy.

This group of doctors has even put a price tag on what it costs women to deal with incontinence: an average of $15 a week for pads, laundry and dry cleaning. If you multiply that by the 17 million women--a low estimate--who have this embarrassing problem, and then by 52 weeks, you find out that incontinence is costing American women at least $13 billion a year. This calculation does not include the cost of the various prescription medications now being promoted by drug companies to relieve incontinence.

Yet, you can search the website of the American Urogynecologic Society (AUG) or their new information website, Voices for PFD, and you won't find a mention of hysterectomy. The closest you get is this statement with its vague reference to surgery: "Sometimes, very clear-cut events such as pregnancy, vaginal delivery, surgery, radiation or accidental injury can lead to these kinds of problems..." Notice that all of these causes of incontinence are essentially unavoidable--except surgery for hysterectomy, which is avoidable with other treatments in 70 to 90% of cases.

But wait, these doctors have a solution to incontinence, once you've got it:  More surgery! Last year, the AUG released results of a study showing that two years after women had surgery to try to cure stress urinary incontinence, their cost per week had dropped to $4 from $15 while their episodes of incontinence dropped from 23 per week to 3. Hooray.

The final irony is that just a few days ago, the AUG released its own study of information about incontinence on various web sites and found them "inadequate." Two physician reviewers evaluated more than 50 websites and found them "not comprehensive, relevant or accurate."

I tried to reach Dr. Steven Minaglia, a Hawaii-based physician whose team reviewed the websites, but he had left for a trip to China. Perhaps when he gets back he can ask them to review why AUG's own website doesn't bother to tell women about the connection between hysterectomy and incontinence.

Perhaps he could start by having them review the Swedish study.

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