TAH: Why perform a TAH & BSO for fibroids causing heavy bleeding?

Hi Ladies

I have nobody to ask this question of so you are it.

Ive been bleeding practically non stop for a year. Tried everything ie transemic acid, progestin, merina which was expelled and zoladex injections to stop bleeding in preparation for the TAH. Phew. Am cleared for uterine cancer. If its just uterine fibroids causing this why does he need my ovaries, cervix and fallopian tubes?
I'm just a bit confused. Is he looking for ovarian cancer? Thanks JD

	Quote:
Originally Posted by Bones1963 If its just uterine fibroids causing this why does he need my ovaries, cervix and fallopian tubes? I'm just a bit confused. Is he looking for ovarian cancer? Thanks JD

Good question, and I'd question your doctor. Are you at risk for ovarian cancer (family history)? Do you have recurring cysts causing pain which other treatments haven't helped? Have you had abnormal paps or family history which put you at risk for cervical cancer? Current theory is that ovarian cancer may start with the tubes, but again, are you a risk? If these answers are no, be blunt and ask him why he's taking more. Some doctors still operate under the questionable guidelines of "You don't need them anymore", and I daresay that's a red flag. The articles you'll read here generally follow "keep it if it's healthy" but some women opt to have things other than their uterus removed because they had immediate family members who dealt with cancer.

I had uterine fibroids - lots of them. My doc is a minimalist and skilled in laparoscopic surgery, so I had a laparoscopic supracervical hysterectomy and kept my ovaries, tubes and cervix. My surgery and recovery were textbook. Even though I'm 54 and likely menopausal (my period never went away), my ovaries are still producing the hormones which my body is used to.

Here are some articles which you might find helpful:

Should I Keep My Ovaries?
Should I Keep My Ovaries if I'm Near Menopause?
10 Questions to Help You Decide About Your Cervix

If you're not satisfied with your doctor's answers, seek a second opinion. He might not be skilled in less invasive surgeries and is doing what he's always done. That doesn't mean it's the right surgery for you.

The tubes are typically taken as that's where ovarian cancer starts/flourishes. Have you had cervix issues previously (bad paps, further testing, etc)? Mine is taking my cervix since I've had bad paps and had colposcopies to find if I had cervical cancer. Last one was CN1, so it can just go.

Not sure why they are taking your ovaries, has there been problems noted on scans? Mine is opting to let me keep them, unless he sees something wrong with them.

What reason has your surgeon given you for wanting to remove your ovaries? If they're perfectly healthy, then I would recommend keeping them. I kept mine at age 48, because my surgeon and I agreed that the benefits of their continued hormone production still outweighed the risks. I did have my Fallopian tubes removed, to lower my risk of ovarian cancer, because recent studies suggest that it frequently starts there. As for the cervix, my surgeon wanted to remove mine, because I had fibroids, and he was concerned about more growing there in the future. I pushed for a supracervical approach, because my cervix was perfectly healthy, with no history of cancer or other issues, and my research indicated that I would be better off keeping it; now, looking back, I'm quite happy with my decision. You need to do your own research, and decide on what's best for your individual situation. If you and your surgeon aren't on the same page, then I would recommend getting a second opinion. Best wishes for whatever you decide!

Ladies

Thank you for your replies. You have all made it a lot clearer for me.

Looking at the risk factors for Ovarian cancer I do have several of the risk factors. Might have to have a quiet word with my sisters too.

I am now quite happy for him to do the total hysterectomy. Prevention will be far better for me.