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Health And Medical

Black Women Less inclined to Get Laparoscopic Fibroid Surgeries

By Amy Norton

HealthDay Reporter

TUESDAY, Sept. 6, 2022 (HealthDay News) — Surgery for uterine fibroids can frequently be done through minimally invasive techniques that avoid a hospital stay. But Black and Hispanic women could be less inclined to receive these treatments, a recently available study finds.

Uterine fibroids are non-cancerous growths in the uterus. Sometimes they cause no problems, however when they do like heavy monthly pain and bleeding treatment could be necessary.

One option is surgery: a myomectomy, which removes just the fibroids; or perhaps a hysterectomy, which removes the uterus. Either surgery can frequently be done in a minimally invasive way vaginally or through small incisions in the abdomen.

Yet in the brand new study, researchers discovered that Black and Hispanic women often didn’t receive those less extensive procedures instead getting traditional surgery, with a big abdominal incision and a hospital stay.

The reason why aren’t completely clear, the researchers said.

However the investigators did discover that Black and Hispanic women were not as likely than white women to see a medical expert who specialized in minimally invasive techniques.

Uterine fibroids have become common, but especially so among Black women, said researcher Dr. Rebecca Schneyer, an obstetrician/gynecologist at Cedars-Sinai INFIRMARY, in LA.

Studies also show that about 80% of Black women could have uterine fibroids by age 50, as will 70% of white women. But Black women typically develop them sooner: By some estimates, one-quarter of Black women have fibroids by age 30.

Also, they are more susceptible to having numerous or large fibroids, suffer more intense symptoms, and much more often undergo surgery in comparison to white women.

“That’s even more reason we ought to be attempting to reduce disparities in care,” Schneyer said.

Traditional abdominal surgery for fibroids is normally safe. Nonetheless it causes more pain and loss of blood, and has an extended recovery time than minimally invasive procedures.

For the brand new study recently published in the Journal of Minimally Invasive Gynecology Schneyer’s team examined records greater than 1,300 women who had surgery for uterine fibroids at Cedars-Sinai recently.

Most had a minimally invasive myomectomy or hysterectomy, but there have been substantial racial gaps: Among white women, 81% underwent minimally invasive procedures, versus 57% of Black women and 65% of Hispanic women. Asian women, meanwhile, had an interest rate much like white women.

Schneyer said periodically traditional surgery may be the better option, according to the amount of fibroids or size of the uterus, for instance.

But those factors didn’t explain the disparities in surgery type, the analysis found.

Instead, Black and Hispanic women were not as likely than white women to see a medical expert who specialized in minimally invasive techniques: They often times saw an obstetrician/gynecologist without that “sub-specialty” training.

How come unclear, since all patients were treated at exactly the same infirmary and almost all had private insurance.

It is possible, Schneyer said, the doctors whom Black and Hispanic women initially saw were less inclined to refer them to sub-specialists, perhaps because of “implicit biases.”

But she suspects that “disparities in awareness” might play a more impressive role: White women could be more prone to find out about minimally invasive options, or seek another opinion.

Dr. Hye-Chun Hur focuses on minimally invasive gynecologic surgery at NYU Langone Hospital Brooklyn. She said that in her experience, some patients with uterine fibroids are indeed more prone to “doctor shop” and seek second or third opinions, while some accept the original option presented in their mind.

The onus ought to be on doctors, both Schneyer and Hur said, to describe all treatment plans.

It is also important, they said, for primary care doctors and general ob/gyns the people who refer women to sub-specialists to keep yourself updated that minimally invasive procedures can frequently be done even though there are many fibroids or the uterus is large.

“A whole lot has changed during the past 20 years,” Schneyer said. “Generally, minimally invasive surgery can be an option.”

For women who’ve traditional surgery recommended, Hur said, “seeking another opinion is definitely advisable.” However they should try, when possible, to obtain that opinion from the specialist in minimally invasive techniques, she added.

Schneyer also stressed that non-surgical options can be found, including medications that control bleeding due to fibroids.

Any treatment, Hur said, must be individualized based not merely on symptoms, but a woman’s age and pregnancy plans.

Sometimes fibroids affect fertility, she noted, so some ladies might consider getting the growths removed, even though they’re not causing symptoms.

Which may be especially important, Hur said, for Black women, because they are at greater threat of developing numerous fibroids at a younger age.

More info

The U.S. Office on Women’s Health has more on uterine fibroids.

SOURCES: Rebecca Schneyer, MD, obstetrics and gynecology, Cedars-Sinai INFIRMARY, LA; Hye-Chun Hur, MD, MPH, director, gynecology services, NYU Langone Hospital Brooklyn, and clinical associate professor, obstetrics and gynecology, NYU Grossman School of Medicine, NEW YORK; Journal of Minimally Invasive Gynecology, July 3, 2022, online

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