Let's beat the dead horse... Cervix...

Had my pre-op appointment for my March 22 davinci hysterectomy. I am having this because of heavy painful periods and possible adenomyosis . I'm only 30 so we are leaving the ovaries. This leaves the cervix. At first I was dead set on taking the cervix out, but now I'm not so sure. My doctor told me the pros and cons and is putting the ball in my court. I'm looking for your input. Thoughts?

Yes, it can be a difficult decision - it certainly was for me, too. I had a couple years of on and off abnormal paps and I have HPV so I'm probably a prime candidate to have my cervix removed. But, personally, I wanted to keep as much as I could and I did have two doctors who were actually recommending keeping the cervix because they felt it *might* decrease the chance of prolapse down the road (like maybe decades). I asked point blank, if I continued to have annual paps (which I don't mind) what kind of time frame were we talking about in detecting any cervical cancer. The doctor said: years. So I decided to keep my cervix and go in for the annual paps knowing to keep an eye on my cervix and if necessary, down the road, have it removed if cancer turned up. Maybe I'm being too blase, but there's no history of cancer in my family. A bit of my decision was informed by my having trouble stomaching the vaginal cuff - though I'm sure it would have been fine. The doctor said there was no clinical evidence that sex felt different without a cervix (and many, many women on here can attest to that) - but I hadn't done enough reading on here at that point to have heard that it's definitely the same without the cerivx. So in small part I wanted to err on the side of caution and keep my cervix. In terms of healing time I was able to take a bath and have sex sooner because I kept my cervix, but that's not really much of a good reason to keep it. And of course there's the small chance of a mini-period and new fibroids (which I didn't know about pre-op). But my period was never a big deal so I don't know that, that info would have changed my mind. In the end I'm glad I kept it, but of course if cancer pops up sooner than later (or ever) I may regret the decision. Good luck!!

Most of what I know about pros and cons of cervix removal I have learned on this site, so I am sure folks more knowledgeable than I will weigh in. It is a very personal decision and I think research varies. For me, I have had a positive HPV test for a nasty strain and have needed a colposcopy in the past. I have no desire to worry about cervical cancer in the future or to (possibly) deal with any "mini periods" since my real periods have been such a bear. BUT, I am not 30 and I do not know how I would feel if I were in your shoes. I think knowledge is power and hopefully more people will give their input. Best wishes for 3/22!

I didn't have a choice, my Dr is only letting me keep my right ovary, maybe. My paps have always been normal. I also wondered about the sex quality thing, but my Dr said it was possible, but not probable. Kind of nervous, but I think it'll work out. Now if I can just get my emotions under control. Doesn't help with all the drama at work!

Hi,

In my case the cervix was taken out and I haven't noticed any negative impact. Life is good.

My reasons:
1. Here in Australia it seems to be common practice. Current research doesn't indicate any clear advantage to keeping a cervix.

2. Whatever condition is impacting on the uterus will impact on the cervix because the cervix is part of your uterus. e.g. adenomyosis, fibroids. If I was going to go to the effort of having surgery to have my issues fixed then I wanted them totally fixed.
After bleeding heavily for almost 30yrs I was not interested in a mini-period no matter how 'mini'.

3. Family history of uterine and bowel cancer. Since I am susceptible to gynae cancer then no point in keeping it.

All the best in whatever you decide

	Quote:
Originally Posted by pookyl Hi, In my case the cervix was taken out and I haven't noticed any negative impact. Life is good. My reasons: 1. Here in Australia it seems to be common practice. Current research doesn't indicate any clear advantage to keeping a cervix. 2. Whatever condition is impacting on the uterus will impact on the cervix because the cervix is part of your uterus. e.g. adenomyosis, fibroids. If I was going to go to the effort of having surgery to have my issues fixed then I wanted them totally fixed. After bleeding heavily for almost 30yrs I was not interested in a mini-period no matter how 'mini'. 3. Family history of uterine and bowel cancer. Since I am susceptible to gynae cancer then no point in keeping it. All the best in whatever you decide

Glad to hear that, although I haven't had the accursed periods since aug of 2012, just the problem pains. Sure glad this site exists so us girls can talk.

You guys are hitting all the points I've been mulling over. There was an article published about the location of adenomyosis in hysterectomy specimens and they concluded that it was unlikely that adeno would be in the cervix. Problem? Their sample size was 30.

Like the other poster said there is rumor that sex is better. There is also rumor that there is more pelvic floor support. However, there is really no conclusive evidence either way.

Recovery would be faster. That's a given.

The thing that has me worried is that what if I go through all this and still have problems because I kept my cervix? Honestly, mini periods wouldn't bother me at all. I just don't want clots and pain that put me on the floor.

On the other hand what if I take the cervix out and then I have complications with say the vaginal cuff. Or sex sucks and I wonder if I should have left the cervix.

Things go wrong either way.

SOOOOOO confused.

Hi,

Just to add something regarding complications of the vaginal cuff.

I don't know the exact statistics re how common complications are - maybe one of the hostesses might?
But I suspect that they are not that common. Apart from the post op threads I have never heard of anyone with a complication.

Some questions to ask your surgeon pre op are:
"how many cuff revisions have you had to do"?,
"how many patients of yours have complications with their vaginal cuff post op"?
"why did those patients have complications"?

I didn;t keep my cervix, as Dr says fibroids can grow there as well, and I was full of them, and wanted them out. He did take my tubes as well, but left both ovaries.
I am 4 weeks post op, I have not had any issues with the vaginal cuff, or anything else. I dont see my Dr til April 4