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The Hysterectomy
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The Women's Health
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Dr. Hope Haefner

Women's Health
Registry

About Women's Health

Each year, 650,000 U.S. women have a hysterectomy. Two primary indications for hysterectomy are abnormal uterine bleeding and uterine fibroids. However, there are treatment options for these conditions. Designed by Drs. Elisabeth Quint and Deidre S. Maccannon, the Hysterectomy Alternatives (HALT) Program at the University of Michigan Health System increases awareness among patients and physicians of alternative treatment options available through UMHS gynecology staff. The HALT program also provides women with these conditions information and counseling on hysterectomy alternatives, as well as access to these treatments.

Abnormal Uterine Bleeding

Abnormal uterine bleeding may appear as prolonged, heavy menstrual flows; intermittent bleeding between periods; or absence of a menstrual period. Irregular ovulation or a problem with the uterus are two possible causes. However, abnormal uterine bleeding often is the result of an underlying condition and should be evaluated by a physician.

The HALT Program offers the following treatments for abnormal uterine bleeding:

• Medical therapy includes hormonal treatments or other prescription medications.
• Endometrial ablation involves removal of the uterine lining by burning it away or by vaporizing it. This is done through use of a heated balloon or electric current attached to a tube-like medical instrument inserted through the vagina.

Uterine Fibroids

Uterine fibroids are noncancerous tumors that grow slowly within the wall of the uterus or attached to the uterine wall. Although the cause of uterine fibroids is unknown, about 25% of women have them. Fortunately, most never have symptoms nor need treatment. Symptoms may include pelvic pressure, heavy periods, cramping, and pelvic or lower-back pain.

To treat uterine fibroids, the HALT Program offers the following:

• Medical therapy (explained above).
• Laparoscopy involves inserting a small telescope into the uterus through a small abdominal incision, and allows the surgeon to see into the uterus while carefully detaching and removing the fibroids.
• Hysteroscopy involves the insertion of a thin telescope called a hysteroscope through the cervix into the uterus. Small fibroids can be detached from the uterine wall by use of thin instruments attached to the hysteroscope.
• Uterine artery embolization involves blocking the flow of blood to a fibroid by inserting a small catheter into the groin. This procedure is used to reduce the size of large fibroids.
• Myomectomy, often used for multiple fibroids, involves removing fibroids through abdominal surgery, leaving the uterus intact, allowing for future childbearing.

Most treatment options mentioned above can be performed as an outpatient procedure or with just an overnight stay.

If you have been diagnosed with abnormal uterine bleeding and/or uterine fibroids, the HALT Program can provide education and counseling to help you determine, with the help of a member of our staff, which treatment option is best for you. The HALT Program is located in the University of Michigan Health System's Taubman Outpatient Center, in the OB/GYN Clinic. To make an appointment with Drs. Quint and Maccannon, call (734) 763-6295.

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