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In Sweden, thirty-three women were “mistakenly” victims of having their uterus removed, after receiving a wrong diagnosis. Dr. Samuel Salama, obstetrician-gynecologist, sheds light on this matter.
In Sweden, almost thirty-three women underwent unjustified hysterectomies after they had precancerous changes in the cervix. How to explain such a medical error? And when should a hysterectomy (really) be carried out? The answers of Dr Samuel Salama, obstetrician-gynecologist.
33 unjustified preventive hysterectomies
This Tuesday, October 22, Uppsala University Hospital admitted to having operated “in error” on 33 women between 2023 and 2024, who presented cellular changes that were precursors to uterine cancer.
The medical team in fact encouraged women to undergo a “preventive hysterectomy” – that is to say a surgical removal of the uterus – even though it was not necessary.
“We deeply regret what happened. Removal of the uterus is a major operation, with significant and irreversible consequences.“, said Johan Lugnegård, chief doctor of the hospital, quoted in a press release. “We apologize to the women affected.”
These women, aged 38 to 85, fortunately had “finished procreating“, specified Gudlaug Sverrisdottir, director of women’s health care at the hospital, in the columns of the Swedish newspaper Läkartidningen.
Nevertheless, the moral and physical damage remains present: the diagnosis made was incorrect and none of these surgical interventions was justified.
The hospital warned the victims of its error
A rather rare occurrence in this type of case: it was the hospital structure which decided to sound the alert, after noting an unexplained increase in the number of diagnoses of this type.
“We were too strict in our assessments […] which led to systematic overdiagnosis“, recognizes Tommie Olofsson, manager of the university laboratory of the establishment.
The hospital also assured to “financially compensate” the thirty-three women concerned.
According to Dr Samuel Salama, obstetrician-gynecologist in Neuilly-sur-Seine, several things must be distinguished.
“In the case of this case, the indication of the anomalies seems correct, but it is the diagnosis which seems erroneous. Indeed, at the precancerous stage of the cervix, the uterus should not be removed. In case of mild dysplasia (development of abnormal cells on the surface of the cervix), simple monitoring is necessary, and in case of severe dysplasia, part of the uterus must be removed. It is therefore only in the case where cancer is proven that surgery must be carried out. There is no other possible alternative.” confirms the doctor.
But to diagnose cervical cancer, a biopsy must first be carried out (an examination which consists of taking a sample of tissue from the cervix).
“The samples must be analyzed under a microscope, staining the cells. However, within the Uppsala University Hospital, the mystery remains unsolved. Did a single person make a mistake when performing this analysis? Where are all the doctors who ruled on the operations? What is certain is that in France the decision to intervene (or not) is collective: multidisciplinary consultation meetings are held to measure the benefit-risk balance of each operation.“, assures Dr Samuel Salama.
The doctor also adds that each case is unique. A young woman suffering from cervical cancer may, for example, be reluctant to undergo this operation (because it would compromise her maternity plans).
“In this case, of course, the operation can be a subject and we take the time to discuss“, he says.
Removing a uterus is never trivial
Dr Samuel Salama would like to emphasize that there are many possible alternatives to surgery, particularly to treat progressive pathologies (fibroids, polyps, abnormal joining of the sides of the mucosa, etc.):
- embolization (which consists of injecting a solid or liquid agent into an artery or vein in order to occlude a vascular area. For example, in the case of a fibroid, it will involute, deprived of vascularization).
- taking medication:
- or even hysteroscopy.
If these alternatives are to be considered, it is because removing a uterus is never trivial.
“A woman may experience this operation badly and even develop depressive symptoms afterwards. We must therefore take the time to mature this intervention… and also remember that we do not remove a healthy uterus for X or Y reason!“, he says in conclusion.