It seems to me that this is a worldwide problem even in highly civilized countries like Australia, United States, and Europe. There are several things we need to do, number one is to educate the patient. The second thing is to educate the gynecologists about the alternative methods. If they cannot perform these alternatives, we should persuade them to refer the patients to other centers. Financial aspects are important as a hysterectomy brings more money, a reason for advising the patient to accept this treatment.
New techniques require more skill with a higher failure rate.
At this present time we try to have better training programs for all gynecologists and once the senior gynecologists in the teaching hospitals in the private sector set the example, the others can no longer afford to do unnecessary hysterectomies. So educate the consumer, educate the gynecologist. We need, at least in the big cities, something like a fibroid clinic, where we have several experts. In these centers, all important information can be given to the patient. She can decide herself what she wants.