INTRODUCTION: Uterine fibroids affect up to 70–80% of individuals with a uterus by age 50. Hysterectomy is a common treatment, with abdominal, laparoscopic, robotic, or vaginal routes. Hysterectomy routes differ in recovery and complication risks, and inequities persist involving access to minimally invasive hysterectomy for fibroids. To explore patient understanding and considerations of various surgery routes, we analyzed relevant discourse on the social media platform Reddit. OBJECTIVE: We wished to explore how Reddit users describe their decision-making process regarding the hysterectomy route for fibroid treatment. Additionally, we wished to identify themes related to provider counseling, patient knowledge, and perceived availability of minimally invasive options. METHODS: We used the Reddit Apify data scraper to extract posts from r/hysterectomy and r/fibroids and sorted them by relevance. We then conducted a quantitative analysis of content type and a qualitative analysis using Atlas.ti Cloud. RESULTS: We selected the 100 most relevant posts and their 518 related comments. Of these, 359 (58%) were users sharing their personal experience, and 220 (36%) were users expressing solidarity. Qualitative analysis revealed that users consider recovery time, family involvement, and symptom severity when considering hysterectomy routes. Many described feeling torn between external pressures and self-doubt (“is it really bad enough to go through with this?”). Preconceived ideas about surgical routes also played a role (“I was hoping to be able to do laparoscopic to cut down on healing time”). For others, the final route depended heavily on the surgeon’s comfort and expertise, with minimally invasive options limited by travel distance (“you don’t get to decide, the surgeon does ... the moral of my story is that you do get to choose your doctor”). CONCLUSIONS: Hysterectomy route choice reflects a balance of patient priorities and physician expertise. Reddit narratives reveal opportunities to improve counseling and strengthen shared decision-making. Further research on incorporating social media-derived perspectives may enhance patient education and quality of care.
Tawakley et al. (Fri,) studied this question.