LSH: Due for LSH but could be Abdominal?!

Hello: I am scheduled for a LSH on 11/22/13 and am concerned b/c my doctor states he will have to do it abdominally if there is too much scar tissue. I have had 2 C sections - one almost 40 years ago - so I am thinking, of course, I must have scar tissue. Also, from reading these posts, I know that the abdominal surgery takes 4-6 weeks' recovery and I only have 2 weeks' paid sick leave left. I am at the point now that I am so concerned that I might re-schedule my hysterectomy for next year after I have acculumated more paid leave. I am having post menopausal bleeding - 2 prior D&C's showed no cancer.
Has anyone experienced this - going in to have a LSH and come out with having an abdominal one? My doctor says he won't know until he goes in there and he won't wake me up to tell me he has to do the more complicated one!

Help anyone and thanks so much. Joanne

Almost every one of us was told that there was a possibility that our surgeries could be converted. Thankfully, this happens fairly infrequently even among those who have had C-sections or other abdominal surgeries. You might ask your doctor what his conversion rate is - my surgeon said that she was very stubborn and that she would do everything in her power to get that uterus out without converting (which lead to my 4 hour surgery).

Even without an abdominal surgery, however, returning to work after two weeks is probably overly optimistic. Few people can return to work so quickly. If you are a slow healer or have any complications you will be unable to return so soon. You may want to reschedule if you must return in two weeks.

Thank you so much for taking the time to reply to my concern. I may reschedule partly due to the fact that I want to get a second opinion also. My doctor says he cannot guarantee I'll stop bleeding after my LSH and he cannot quarantee I won't have my LSH converted to an abdominal one. I guess I need a doctor to tell me that he is sure after I have this major surgery, I will no longer bleed. The closer I get to my surgery date, the more skeptical I become about going ahead with this surgery without getting a second opinion. Oh my, sometimes I don't know what to do!

Joanne

Second opinions are a good idea if you're unsure. :-)

If you *do* decide to postpone surgery, ask your doctor about going on some form of progesterone - Megace or Depo-Provera - to discourage further endometrial accumulation. My mother had some bleeding when she was 78. She turned out to have complex hyperplasia *without* atypia, which is the low-risk kind. Due to her other health issues, she's a poor surgical candidate, so she's on quarterly Depo-Provera shots and frequent check-ups. She's now 82 and so far, so good.

By the way, it's less that your doctor *won't* wake you up and more that he *can't*. By the time he finds out what he needs to do, you're already going to have laparoscopic incisions in your abdomen. To wake you up, he would have to close those up, move you to recovery and wait for the anesthesia to wear off sufficiently that you're not only awake but actually comprehending and remembering what is said to you. Then he'd have to wait long enough until it was safe to put you back under again *and* until the OR was free again - he'd basically be doing a separate, second surgery.

Thank you both so much for your replies. This website has been so informative and helpful to me.

Your explanation regarding why he can't or won't wake me up makes perfect sense to me. My doctor does not go into much detail about anything. One of the many reasons I need to have a second opinion. I have so many concerns but when I put them out to him, he makes me feel like I am asking dumb and unnecessary questions.

Also I will take your suggestions regarding the hormones to a new doctor I am seeing on 11/19/13.