AAGL Study Finds Women Still in the Dark about Minimally Invasive Treatments for Pelvic Health Disorders

as seen in AAGL-news, Aug. 13, 2008:

Women expect doctors to educate, but awareness gaps are significant

Cypress, CA – A new awareness study found that virtually all women expect their OB/GYN to
inform them about minimally invasive treatments for common pelvic health disorders (PHDs),
yet comparatively few are aware of the newer treatments designed to cause less pain and
provide shorter recoveries. Russell Research conducted the study for AAGL, the preeminent
organization of gynecologic endoscopic surgeons.

“I expect my OB/GYN to tell me about the least invasive treatments, even if he or she doesn’t
offer them and would need to refer me to someone else,” was the near-universal assumption
(98%). Women expect their gynecologist to offer them treatment options with the least amount
of pain (98%) and to consider how treatment will affect their lifestyle -- factors such as recovery
time, lost wages and additional child care costs (94%).

The survey results revealed that women’s expectations are not being met:

• Endometrial ablation is over 90 percent effective in providing relief from heavy menstrual
bleeding, but less than half of those suffering from heavy bleeding had ever heard of it.
• Myomectomy, a minimally invasive procedure for removing fibroids, relieves heavy
bleeding due to fibroids in 90 percent of cases. Only 45 percent of women with fibroids
were aware of this option.
• Sling procedures are effective in treating women with mild to moderate Stress Urinary
Incontinence (SUI) and in some cases can be performed on an outpatient basis with no
incisions. Two-thirds of those with SUI had never heard of sling procedures.

“This survey confirms what we have long suspected – that women with PHDs are not being fully
informed about the range of available treatment options,” said Charles E. Miller, MD, President
of AAGL. “When half of women suffering from a given condition are unaware that they may be
candidates for a minimally invasive procedure that spares them pain, time and disruption of their
lives, there is a clear need for stronger efforts in patient education.”

Women did agreed however, that they should be more proactive by asking for alternatives
(97%) and are quite likely to pursue a second opinion if they think they may be a candidate for a
minimally invasive procedure that their own doctor does not offer (90%).

Four types of PHDs are prevalent among women of childbearing age: stress urinary
incontinence or SUI; abnormally heavy menstrual bleeding; fibroids (non-cancerous uterine
growths); and pelvic organ prolapse (when female organs shift position due to weakened
muscles). In this survey, one out of every two women reported experiencing one or more PHD.

Hysterectomy (removal of the uterus and sometimes the ovaries and fallopian tubes) continues
to be the procedure most commonly used for PHDs other than SUI. The most common type of
hysterectomy is the total abdominal hysterectomy or TAH, which is performed through an open
abdominal incision and carries all the normal risks of major surgery such as bleeding, infection
and anesthesia.

Less than four women in ten realized that TAH is associated with a three to six-day
hospitalization, a four to six-inch scar, and a long and painful recovery period of a month to six
weeks.

In contrast to a TAH,a laparoscopic hysterectomy is a minimally invasive technique that can be
done on an outpatient basis and enables most women to resume normal activities within a
week. Less than half of the women surveyed were aware that this option exists.

Even fewer (40%) were aware that other minimally invasive treatments might let them avoid
hysterectomy or open surgery altogether.

Historically doctors have been the number one source of information for women’s health, but in
this survey the Internet was on a par with doctors as a preferred source of information about
gynecologic minimally invasive procedures. Forty-two percent and 43 percent cited the Internet
and their gynecologist, respectively, as the first place they would go to learn more about their
gynecologic options.

“The AAGL is committed to patient education as a key to increasing women’s access to
minimally invasive procedures,” said Dr. Miller. To that end, the organization has recently
added a more robust patient education section to its web site at www.aagl.org.

“When women are fully informed about their condition and the available treatments, they feel
more confident in exploring their options with their OB/GYNs. This simple step could help
thousands of women avoid the pain and extended recovery associated with open surgery,”
Miller added.

A summary of the full survey is available on www.aagl.org.

This survey was conducted among 526 women aged 18+ via the Internet by Russell Research,
an independent research company based in New York City. The margin of error for the sample
is 526 +/-4.4%.

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