How to decide on vaginal cuff vs. keeping cervix?

What are the pros and cons? My most recent MD says she would do the DaVinci approach laparascopically, and take everything except the ovaries although she may have to convert to an abdominal incision. She says it is best in my case (large fibroids pressing against sacral nerves) to take the cervix, as fibroids can grow from that tissue base ... but wouldn't this be an invitation for vaginal vault prolapse? What holds up the vagina, when everything else is gone? It seems like it would be untethered.

They do attach it to other structures, it's not just floating loose. There is disagreement over whether keeping the cervix helps prevent prolapse. Also having abnormal paps would be a consideration. A lot is personal preference, along with the reason for the surgery. I haven't had prolapse issues, and I had no option to keep the cervix. I have read posts from women whose cervix regrew fibroids, but I don't think it happens frequently. I don't know if there's a way to predict when that might happen. Sometimes women save the cervix but later have surgery to remove it, if it causes problems. It's a hard decision, maybe discussing it more with the Dr could be helpful, too. Good luck with your decision.

OK...gonna get down in the weeds here..but one consideration is your sex life. Specifically, how sensitive is your vagina and cervix and do you have pleasure when you have deep penetration and cervical stimulation?
If you recieve most of your pleasure from clitoral stimulation and do not enjoy the feeling of cervix being bumped...then I would say let them take the cervix to be safe from further cervical problems..they do have ways to stabilize your vagina.
However, if you find it pleasurable to have deep penetration and recieve most of your pleasure from that deep penetration and if you enjoy cervical stimulation, then you need to consider that the removal of your cervix and formation of the vaginal cuff will change that sensitivity. Not that it will in any way end your sex life...however..it is a factor.
I chose to keep my cervix....due to sexual pleasure associated with it...as well as the fact that my cervix was clean and has never been unhealthy. In my surgery to remove a large uterine tumor...they did everythign above the waist...so no stitches in the vagina and a little faster healing time.

Make the best choice for you! Put your health first of course but then look at your own pros and cons. Best wishes.

I had DaVinci June 1st, and decided to keep my cervix. And I am so glad I did. I had fibroids also, and while my Dr warned they can grow on the cervix, it is very very unlikely. Keeping the cervix made my recovery so much easier, I had zero pain, and was normal at 2 days post op. So different from many many other ladies. He also advised that less than 5% of women can still get mini periods, if I am one of those he said it will be so light not even a panty liner would be required, I would only notice when I wipe. I had zero bleeding after surgery, not even a tinge, and my period was due 3 weeks ago, and I have had nothing. But like he said, if I decide later I don;t want it, it is a 15 min out patient procedure to take it...not a big deal. But we definitely can't put it back if I decided I wanted it...so to me, it was definitely worth keeping. Sex is also not usually painful when you get to resume if you kept your cervix because nothing was messed with down there. I have 2 friends who had DaVinci about the same time as me, and both had their cervix removed, they both have already had infections in the vaginal cuff and still have a lot of pain. I was driving and shopping 2 days post op, gardening, walking all day a the zoo....feeling better than normal. And I really think it is due to keeping the cervix, and a lot of prayer also!!! But I am sure there are a lot of women who got rid of their cervix and are very glad they did. Discuss it all with your Dr, but know bottom line the decision is yours.

I am so happy that Dwadeb had such a great experience and recovery!
But I now feel as though I need to temper that with the fact that keeping your cervix is probably NOT the reason the recovery went so well.
I don't know her doctor or situation but most of us on here who have had the davinci and who kept our cervix have had a doctor restrict us from any activity or driving for at least a WEEK for good reason.
Although I would say our healing is faster than those with vaginal cuffs, it really depends on the person and on how much digging around they had to do during your surgery.
For me personally it was VERY similar to healing from a C-section. No driving allowed for 2 weeks...no lifting over 10 lbs for a month. Stayed off work for over 3 weeks and was not cleared for regular sexual activity until 8 weeks.

No matter what way they do it...or whether or not you keep your cervix, this is MAJOR surgery and requires healing time. Do take your time and decide if it is the right move for you.

I had DiVinci and had the whole lot removed. My reasons for removing my ovaries were, my age, my bone density, my other endocrine issues. My reasons for removing my cervix were, my fibroids, I had had quiet enough periods through the last year alone and did not want even a "mini period", Fibroids can grow on the cervix and on the pathology after surgery, it showed that this was happening to me so I am glad I did do it.

I have had a very good recovery. I have my limits and I have learned to respect those. I have had a couple "O's" with ourtercourse and I am not disappointed.

It's a personal decision. You will make the right decision for you at the right time. Gather your information now, get opinions and second opinions and know that even if you decide to keep it (we are so attached to our goodies) that you have made the right decision for now even if that means surgery later. Know one knows the future. I made my decison at my hospital pre-op appointment when I had the great opportunity to speak to a nurse my age that had this all done 5 years before. She was frank about her disappointments, the pros and cons of it all. Up until that time I had intended to keep my ovaries and cervix. I am happy with the decision I have made. I look forward to pretty panties and painfree sex.

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Originally Posted by Twitch I am so happy that Dwadeb had such a great experience and recovery! But I now feel as though I need to temper that with the fact that keeping your cervix is probably NOT the reason the recovery went so well. I don't know her doctor or situation but most of us on here who have had the davinci and who kept our cervix have had a doctor restrict us from any activity or driving for at least a WEEK for good reason. Although I would say our healing is faster than those with vaginal cuffs, it really depends on the person and on how much digging around they had to do during your surgery. For me personally it was VERY similar to healing from a C-section. No driving allowed for 2 weeks...no lifting over 10 lbs for a month. Stayed off work for over 3 weeks and was not cleared for regular sexual activity until 8 weeks. No matter what way they do it...or whether or not you keep your cervix, this is MAJOR surgery and requires healing time. Do take your time and decide if it is the right move for you.

My Dr released me to drive the day I was released. The only restrictions I had was lifting. He said nothing over 15 lbs for 2 weeks. But I probably went overboard on that and didnt lift anything, regardless of the weight. He explained to me that most women slow up their recovery from lifting and bending, so thats what I tried to avoid. I actually found the Dr off from the hystersisters site. he teaches DaVinci to other Dr's across the country. So I figure he must know what he is doing. My incisions seem to be much smaller than that of other sisters on here. I dont know what it is like to have your cervix removed, but I kow the nurses in the hospital told me that the women they have seen seem to bounce back almost immediately when he leaves their cervix..of course their are exceptions to everything, but in general. I think it is just finding a Dr who is experienced and knowledgeable. My OB/GYN is not the one who did the surgery....I love her and she is great, never thought I would go to anyone else, but I just did not have peace about her doing the surgery. So I traveled 3 hrs from home to have him do it. After doing my research..weeks of it...I knew he was the one. So my advice to anyone would be...research, and then researc h some more, find the Dr who is best for you and what you need. And ask tons and tons of questions...I went in with a notebook full on my first visit to him and he spent almost 2 hrs with me...and answered every last one of them!

Thank you all so much for your input! You are a lovely group of sisters, and I do appreciate your help.
I am currently leaning toward keeping my cervix if at all possible; will have to discuss with the MD more at my next appointment.
Hugs to all!

The vagina is held up using your own internal ligaments. My doctor explained that DaVinci hysterectomies leave the based vaginal vault than the other hysterectomy options because the way it's done, it raises everything (bladder, vagina, and rectum) and so reduces the risk of prolapse.

If the doctor believes fibroids may grow on your cervix (which is simply the neck of the uterus and not a separate organ) I'd consider taking it.

Before my hysterectomy, I could insert my middle finger and feel my cervix when my knuckle got to my vaginal opening. Now with a vagina cuff instead of a cervix, I can insert my middle finger all the way to the webbing of my fingers without even being able to reach the end of my vagina. My vagina is longer and higher than before.

Some doctors believe that leaving the cervix doesn't help prevent prolapse at all. They describe it as small, button sized, and not enough tissue to prevent prolapse.

My cervix was removed. I had davinci 12 weeks ago.My doctor wanted it removed because I had several bad pap tests and a few times of cryo on my cervix. She said there were no good reasons to keep mine, but had plenty of good reasons to remove it. It took a while longer than most ladies for my vaginal cuff to heal. I was a very slow healer apparently.At 12 weeks I notice absolutely no difference with my cervix being gone at all. I am not sure how I will feel years from now, but as of today I notice nothing bad.