In an article in the “Parisien”, interventional radiologists regret the systematization of ablation of the uterus or prostate while less cumbersome and less invasive solutions exist to preserve the organs.
Are too many uterus and prostate removed in France? This is what interventional radiologists say today. In an article from Parisian, these specialists who intervene under the guidance and under the control of imagery to treat organs or treat tumours, regret that many surgeons practice ablations while other solutions, less cumbersome and less costly for Social Security, could be practiced. However, the patients concerned are rarely informed.
A safe but underused technique
This is particularly the case for hysterectomies, that is to say the removal of the uterus. According to radiologists, 20,000 to 25,000 women are affected each year, especially when they develop a uterine fibroid, that is to say a benign tumor that can cause intense pain and heavy bleeding. In the majority of cases, women with fibroids are offered by their gynecologist to have the uterus removed.
However, radiologists point out, there is another much less cumbersome method: embolization. Performed in less than an hour under local anesthesia, it consists of blocking the arteries of the fibroid using microbeads. Thus it necroses, which stops bleeding and pain. For Professor Sapoval, radiologist at the European Hospital Georges-Pompidou, in Paris (XVand), this method not only makes it possible to cure the fibroid while preserving the uterus, but “the risk of major complications is halved, the work stoppage is one week compared to two months”.
Reluctant gynecologists
Although written in the recommendations of gynecologists, only 3% of patients in France benefit from embolization. How to explain it? For Dr. Cohen, radiologist at the European Hospital in Marseille, the answer must be sought in the surgical culture of gynecologists. According to Doctor Jean-Philippe Masson, president of the National Federation of Radiologists (FNMR), it is also a question of money. “Everyone is paid on a fee-for-service basis, so they don’t want their market taken away from them. However, an embolization costs Social Security four times less!”
Asked by The Parisian, Marie, 44, successfully underwent embolization in the spring of 2019, after being initially offered a hysterectomy by her gynecologist. The operation showed that she had five fibroids, one of which was 7 cm. “It was a bit painful but I was relieved to know that I was going to be healed.” She was able to return home after a night of observation.
As for the partial removal of the prostate, it can also be avoided thanks to the technique of embolization. But, as Alexandre de la Taille, head of department at the Henri-Mondor hospital in Créteil (Val-de-Marne), and member of the French Urology Association, reminds us, “the problem is that the prostate grows back”. More recent, the technique has not yet been fully validated.
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