I need input please! hysterectomy needed

My pap results came back with carcinoma in situ. Dr. recommended conizatioin, and D&C. In mean time, I developed fullness in my abdominal area. He ordered a sonogram. It showed uterine enlargement.

He said "12cm, has to come out".... I asked what could cause it- he basically mumbled, Didn't really answer- I did make out endometrosis. mumbled something about it's probably not fibroids- due to the size of my uterus, they would have shown up on sonogram. I thought endo was outside of the uterus- like in your abdominal area? Does that cause uterine enlargement? He did say possibly, but, probably not- uterine cancer. I am 33 and never have had any abnormal bleeding. I do have tenderness/ mild pain from mid cycle until I get my menses. Some months I can feel my ovaries mid cycle until a few days after my menses starts. I've thought it was from painful ovulation and constipation. Now I am wondering????

He wants to do a laparoscopy to see what is going on, a cone biopsy and a D&C in one surgery then do a second surgery and do a hysterectomy. I am wondering why 2 in hospital surgeries? I have never had any surgery so, I am a bit hesitant to say go ahead. I am getting a second opinion.

Thanks,
Karen

Karen,

Based on what you've written it sounds like he is doing the lap to see what is going on with the uterus. The carcinoma in your carvix has to be treated, and that can usually be done without a hysterectomy. It sounds like the biopsy and lap are being done to possibly spare the second surgery-these test may reveal a condition that can be treated without hysterectomy, or perhaps not treated at all.

Endo affects the uterus and often areas outside of the uterus. Your doctor's approach sounds ok to me (though I think he could have explained it to you better). But you are doing theright thing by seeking a second opinion.

Thank you-

I do feel he doesn't explain things well. He said that it is "standard procedure" that a uterus over 12cm is taken out. I tried to find this on the internet and could not find it anywhere. Unless I miss understood him- he said that I 'needed' a hysterectomy. He did say the lap was to see what was going on and what would need to be done.

I have 3 children and I wasn't planning on anymore so, I don't mind the operation. I just wish they could magically take it away. I have never had any surgery and I am a bit nervous.

Karen

"Needing" a hysterectomy and actually "having" one are two different things. When I was 17, my doctor told me I needed one to end all of my problems. However, he was very adamant that he would not perform the procedure on me until much l was much older. Since your doctor obviously does not have a great bedside manner, perhaps he meant the same thing? He also may have assumed that you would agree with him since you are not planning any more children.

As for the two procedures, your doctor might be covering himself by checking it out first. Your insurance might also dictate that.

Good luck and keep us updated!

I haven't heard of an "industry standard " that a uterus of a certain size must come out. It would really depend on why the uterus is that size; what symptoms you have, etc. This is a very good question for the second opinion doc.

Endo can only be diagnosed through the lap procedure. But from what I understand from endo sufferers their pain is almost constant, to the point that many of them can't work or take care of their families. (in severe cases). If you don't have symptoms or you have symptoms that can be managed without surgery, but your doc says you need to have a hyst for endo, get at least another opinion, maybe two opinions. It doesn't sound correct to me. And, you can't cure endo by just removing the uterus. You would have to take the ovaries, as endo is technically a disease of the ovaries. It you aren't having major symptoms of endo, this seems quite drastic to me, for a woman of 33.

I recently had a TAH for Carcinoma in-situ of the cervix. A Leep procedure was done first. It came back as CIS with a positive endocervical margin. So I opted to get the hysterectomy. I was able to keep my ovaries as they are in "Great" condition. (DR's words).
I would advise you to get the answers to your questions clear and in writing, if needed. Do your research, get a second opinion and then make your decision. I don't know about the enlarged uterus. So, I can't speak on that. This is a procedure not to be taken lightly. But, also, do not be frightened if it is what you choose to do. You should find a lot of answers here, on this site. Also, try the Cancer Concerns forum for the CIS. Just don't let the Dr.'s brush you off. It is your body and your decision. So, get those answers and understand them.
Good Luck,
Anna

Thank you all for the replies.

Could adenomyosis cause enlargement of the uterus? is that common? I read somewhere that autoimmune problems can cause reproductive problems such as adeno and endo. I do have an autoimmune problem I just haven't received a diagnosis yet as to which one.

I am glad I am going in for a second opinion this Thursday. I used to go to this OB/Gyn before. He welcomes questions and throughly explains things. He does this in his office - not while you are sitting on a table in a gown. The only reason I stopped was- because I let my GP do the pap smears to save a seperate trip to the doctors. My GP refered me to the OB/Gyn in his building. I didn't ask to go to my prior OB/Gyn- I just figured I'd be having a repeat papsmear every few months. If I had only known it would be more involved........ I will let you know what the other Dr. says. I probably will be doing surgery through his office.

Thanks again,

karen

I am hoping that a hysterecomy won't be needed but, if it is, I am okay with that outcome. I am making my list of questions for the new doctor. My appointment is tomorrow.

Karen