Can I request abdominal hysterectomy?

I go in for my pre-op tomorrow. My doctor had previously discussed wanting to try the LAVH, and after doing a lot of research I really really do not want this. I would much rather have the abdominal procedure. Which I am a good candidate for due to enlarged uterus, two large tumors, and five previous abdominal surgeries, and 2 laparoscopic ones. The vaginal surgery really freaks me out, just thinking about it is pretty much throwing me into hysterics over whether or not it will wreck my sex life. I sound kind of shallow, I realize that, but I would rather be in more pain after surgery than have my vagina cut open. It is freaking me out. So, can I request an abdominal procedure? I am thinking about not doing it at all if she will make me have it vaginally. :-/

I don't see why you can't request an abdominal surgery. Tell your surgeon how you are feeling. You don't sound at all shallow to me. Based on what I have read from these lovely ladies the vaginal option has a lot to offer BUT if the thought of it frightens you this much then you need to do what is right for you. There is nothing wrong with being worried about major surgery and this IS major surgery.

I think you should ask your dr to explain both procedures in detail (the "vagina cut open" part has me wondering). There are also good explanations and even videos (if you're not squeamish) on this site. Of course, you need to be comfortable with the procedure. And I don't think worrying about your sex life is shallow at all. Ask your dr about that too.

If you've had that many abdominal surgeries, my understanding is that either abdominal or DaVinci hysterectomies would be the best option for you due to adhesions. I had 3 prior c-sections so my doctor said only abdoninal or DaVinci for me. It took her an hour and a half to separate my bladder from my uterus and she said she would not have been able to do that via LAVH. I have read that less nerves that are related to sexual pleasure are damaged with a TAH or a DvH than with the vaginal procedures.

It is your body and your right to request a TAH if that is what you are more comfortable with.

I am pretty sure your going to have the same cut in your vagina either way if your cervix is being removed. I had davinci. I had 6 incisions on my belly, but my uterus was pulled out through my vagina and then shw stitched my vaginal cuff. With abdominal even if your doctor removes the uterus through your incision, you'll still have to be stitched up at the place where the vagina opens up to the abdomen, unless you keep your cervix. Have your doctor explain both procedures to you at your appointment. I think asking for TAH is going to do nothing different than give you a larger incision to heal.

Thank you ladies so much for your replies. I really appreciate them. I will definitely ask. I am a little nervous to bring it up, but I am going to. Thanks again. xo

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Originally Posted by melian Thank you ladies so much for your replies. I really appreciate them. I will definitely ask. I am a little nervous to bring it up, but I am going to. Thanks again. xo

Don't feel embarrassed to bring this up at all. You deserve to be informed about both procedures in detail so you can make an informed decision. It's ok, and your doctor works on vaginas for a living, so if your doc is uncomfortable talking about them , he's in the wrong specialty!! lol

I told my doctor that I didn't want laporoscpic or vaginal because I didn't want all the shoulder pain with lap or the vaginal cuts. I've had c sections so I've been through abdominal surgery twice before. She said okay, if that's what you want. Tell your Dr and I'm pretty sure it will be fine.

I'm pretty sure the vagina is cut regardless of which method is used, unless you have a sub total hysterectomy which means your cervix is left. When I did my research I decided to have a sub total as there are many benefits to leaving the cervix in place, and better sex is on near the top of the list. My doctor did not even discuss a sub total as an option but one week before the surgery was due I happened upon an article explaining the differences and advantages of one versus the other. I decided to leave my cervix intact and when I discussed this with my doctor he agreed that it was a good choice and that 25% of women are choosing this option. I wonder if it would be higher if we were given more information beforehand and it was presented as an option, not something to research yourself and then request. Of course it still means pap smears for the rest of your life, but to me thats not a big deal. I had to have my op abdominally because of the size of my uterus and giant fibroyds (the larges was a 20 week pregnancy size). I was also freaked out at the idea of having the op done vaginally should that have been an option so I understand your concerns.

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Originally Posted by Wookiewoo I told my doctor that I didn't want laporoscpic or vaginal because I didn't want all the shoulder pain with lap or the vaginal cuts. I've had c sections so I've been through abdominal surgery twice before. She said okay, if that's what you want. Tell your Dr and I'm pretty sure it will be fine.

I've had 3 c-sections and the gas pains after those was the same for me as the gas after my DvH. It was horrible, lasted for a week, and sent referred pain to my shoulder and neck. So, some women may still have the gas pain with a TAH.