Cervix - to keep or not to keep?

Hi Ladies,
I am going to be scheduling TVH this week (with surgery in early December) due to chronic bleeding and pain. My doc suspects adenomyosis. I have had laparoscopy, hysteroscopy and ablation already. He didn't find any endo, but did find lesions on the outside top of my uterus and clefting on the inside -- he said both findings are consistent with adeno. He's urging me to do the TVH and I'm almost 100% sure that is what I'll do. But, I keep having second thoughts about the cervix. I really wanted to do the lap supracervical hyst and keep my cervix. He has discouraged that procedure as it is likely that my symptoms could continue if I keep my cervix. Still, I feel like I'd like to keep it. Anyone else go through this decision process? Any thoughts or experiences one way or the other? I don't want to go for another opinion, as my doc is fantastic. He is a friend and has been my doc through a very high risk pregnancy as well as through all of my other gyn problems these past few years. I do just wish I felt better about the cervix part of this.... Thanks! Laura

I went into surgery not knowing if I would have LSH or the abdominal removal, don't know why the vaginal technique was not an option. I wanted to keep "as much of myself" as possible, so I asked the surgeon to not remove the ovaries, tubes or cervix if they looked fine. The uterus had to go though due to the large size (adenomyosis). I woke up to find that the LSH was successful and only the uterus was removed. The surgeon did something to the end of the cervix (cauterized it I think) which effectively killed off any of the tissue that could cause bleeding in the future. I did not have any stitches in the vaginal canal which I hear can cause problems. I do have to get pap tests every year, but I am OK with that. My recovery was pretty good and sex was possible just 4 weeks after surgery. I am happy to have kept the cervix as I think it helped contribute to a faster recovery, but your case may not be the same as mine. Keep asking questions - you should have as much information as possible to make your decisions.

I did not keep my cervix and had a TAH. DR planned to do a LAVH but due to the ultrasound a week before surgery, found four large fibroids, he wanted to change directions and remove the cervix too and do it abdominally. I was fine with letting go of my cervix because there is less chance of problems in the future with the possibility of pain and bleeding.

I know everyone is different and you have to be happy with what you decide so keep asking questions and make the decision based on what you feel is right for you!

By the way I am post op 10 days and healing great. Feeling way better and taking it easy so that I continue to heal.

I wish you the best.

I am scheduled to have TAH on November 10th, 2010. After reading a lot and talking to a few friends/family that have had hysterectomies I asked my doc if I could keep my cervix and ovaries. Ovaries because of the hormones (my mom didn't keep hers and we all think she is crazy since the hysterectomy 20+ years ago, but I could be biased). I wanted to keep my cervix because I had read that sexual pleasure for some people is not as good without it (my doc said that is controversial and not much to back up that finding). Secondly, there is some evidence (from my reading) that keeping it in place could help prevent pelvic collapse. My doc supported either decision so I decided to keep it. The down side (according the to the doc) is 1) you have to keep getting paps; he recommended yearly if you've ever had a bad one or ever 2-3 years if they've been normal until now. 2) if they don't get every piece of the uterine tissue you could still have spotting every month when you would have a regular period. It would be light, but it would be there. SummerSister mentioned cauterization, which I haven't talked to him about, but which sounds like a pretty good way to prevent the spotting.
I hope the factors I used to decide are helpful. Good luck with your decision---I'm sure it will be find either way.

Yodie13

I had a D&C in July and the pathology confirmed adenomyosis and had my hysterectomy in Sept. When I talked to my Dr. about removing the cervix, I said "take it" because I didn't want to bleed any more. It was the right decision for me because the pathology from the cervix came back as endometriosis, so I would have had pain, bleeding and more problems which is why I had the hysterectomy in the first place.

I kept my ovaries because the Dr. said they looked OK, so I will still have hormones until menopause. I'm just 2 months out of the castle, but life is so much better without all the pain and excessive bleeding.

My doctor gave me the choice of having the cervix removed. I opted to have it done since I knew both ovaries had to be removed because of cysts. I had one surgery in 2008 to remove the cyst from my ovaries and ablation done. A few months later the pain was back and the cysts had returned even worse. So at the point of making my decision I said take it all because I don't what to have a 3rd surgery later because something started on the cervix. I also didn't know if my mother had cervical cancer at the time of her death because she was already very ill with heart condition and I knew the biopsy to check for the cancer would have been to much for her heart. Needless to say I wasn't taking any chances.

I'm 8 months post now and feel better now than I have in years. Life is good.

I had a TVH and recovery was very smooth and easy and no exterior incisions! Pre op I had pain, endometrioma, and heavy bleeding and prolapses and suspected adeno and endo. I did not want to keep my cervix since it is a part of the uterus, not a separate organ, and my surgeon felt my pain would continue with any of the uterus left. She is a urogynecologist who specializes in prolapses. She said there are many variables in prolapses and the type of surgery will not necessarily prevent them if they are going to happen in the future. She does, however, make sure everything is sutured properly to prevent any problems. Also as others have mentioned if you keep your ovaries and your cervix you can have mini periods although some doctors say it is rare. I have had no problems with sex post op, in fact it is better! Please don't hesitate to get a second opnion. It is not a matter of not liking or trusting yoru current doctor, it is a matter of getting enough information to make an informed decison. Good luck with your surgery!

Thank you ladies!!!

Hi Lovin2bf,

I had a LSH (Laparoscopic Supracervical Hyst) and I kept my cervix. I am still very happy with my decision.

In pre-op, my cervix was sturdy and I had had normal pap smears for years. My Dr. also felt that the cervix helps with pelvic support and with sex. He also told me that 3% or less of women get cervical cancer...so that was good odds for me...to leave it.

Since you are considering leaving your cervix...you might ask your Dr. about cervix cauterization. I had my cervix cauterized during my hyst..and I have not had any mini-periods in post-op.

Best wishes ~

Mary