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Opinions please Opinions please

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  #1  
Unread 08-29-2015, 08:10 AM
Opinions please

Hi,

I'm a newby to the site (from the UK) and will soon be having a hysterectomy.
I have recently had a hysteroscopy and was supposed to be having an ablation at the same time but my surgeon discovered many more fibroids than previously shown on scans. There are about 15 intramural fibroids and now huge submucosal fibroids too, the ablation wouldn't work.

Does anyone know if I would need to have an abdominal hysterectomy, due to the size of the fibroids, or would the other methods still be possible?
Also, what are everyones opinions of taking the ovaries away or leaving them?

I have an appointment with my surgeon in 3 weeks to discuss the different hysterectomy options but would prefer to have the opinions of the experienced women before I go.

Thanks in advance
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  #2  
Unread 08-29-2015, 08:19 AM
Re: Opinions please

The type of incision can depend on the skill of the surgeon and his/her willingness to try harder to make it a more minimal outcome for you.

It took me FIVE doctors to find one willing to do a laparascopic surgery, removing only the uterus (keeping ovaries and cervix), with my 20-week pregnancy sized uterus. The first 4 said it couldn't be done.

I can't speak for all situations. I only know that in my case, it was "impossible", until I found a doctor who made it possible, to do a much more minimal surgery.

Re: Ovaries. Have you had any biopsies? If not, then your doctor probably doesn't feel the need to. In which case, your ovaries are likely healthy and will produce hormones for many more years to come. If you've had any reason, i.e. a positive biopsy, then yes, removal is recommended.

In my case, I had had abnormal pap smears but biopsies were always negative. So he left the ovaries, but took the fallopian tubes, as it's often thought that cancer presents first in the F. tubes. The pathology came back negative on the F. tubes (and uterus), so there was no reason to believe I'd have cancer in my ovaries, so a good decision by the surgeon. Each case is individual though.
  #3  
Unread 08-29-2015, 08:40 AM
Opinions please

  Quote:
Originally Posted by Summer2015 View Post
The type of incision can depend on the skill of the surgeon and his/her willingness to try harder to make it a more minimal outcome for you.

It took me FIVE doctors to find one willing to do a laparascopic surgery, removing only the uterus (keeping ovaries and cervix), with my 20-week pregnancy sized uterus. The first 4 said it couldn't be done.

I can't speak for all situations. I only know that in my case, it was "impossible", until I found a doctor who made it possible, to do a much more minimal surgery.

Re: Ovaries. Have you had any biopsies? If not, then your doctor probably doesn't feel the need to. In which case, your ovaries are likely healthy and will produce hormones for many more years to come. If you've had any reason, i.e. a positive biopsy, then yes, removal is recommended.

In my case, I had had abnormal pap smears but biopsies were always negative. So he left the ovaries, but took the fallopian tubes, as it's often thought that cancer presents first in the F. tubes. The pathology came back negative on the F. tubes (and uterus), so there was no reason to believe I'd have cancer in my ovaries, so a good decision by the surgeon. Each case is individual though.

I had biopsies and I had pre cancerous cells on my cervix, there is a lot of scar tissue on my cervix, but that was around 20yrs ago. For that reason i thought taking the cervix would be a good idea, do you think that would still affect the ovaries decision?
I've read that taking the ovaries increases the risk of heart disease and strokes, which I'm at risk of anyway.

I also have scarring from a c-section and I've read that a vaginal hysterectomy isn't recommended with that.

There's so much to consider!
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  #4  
Unread 08-29-2015, 08:48 AM
Re: Opinions please

I don't know about the precancerous cells on the cervix having anything to do with the ovaries. I would ask your doctor about that.

When you say "precancerous", but this was 20 years ago, have you had a recent biopsy? I would want a current biopsy of cervix and uterus prior to making any of these decisions.

It took me many doctors, many tests, and many reports, before I made my decision. I had numerous ultrasounds, numerous biopsies, and and MRI. We only have one set of female organs; once they're gone, they're gone. Think long and hard and do as much research as possible before removal.

Just because you've had precancerous cells on your cervix in the past doesn't mean you have to get it removed. I've had precancerous cells on my labia that were later determined to be lichen sclerosis, which is now completely gone.

I had 4 ultrasounds which showed all my fibroids, one as large as 9 cm. Turns out, I never had fibroids at all. My FIFTH doctor ordered an MRI, which showed adenomyosis. Pathology showed I never had fibroids. One doctor said I had "huge fibroids, golf-ball sized", on my ovaries, so they had to go. FIFTH doctor said nope, no fibroids, ever, and he was in there, saw with his own eyes, and left my healthy ovaries.

I live in one of the biggest cities in the U.S. with the "absolute best" medical care in the world. Each of my first 4 doctors was considered "the best". So glad I kept on looking.

Do your research, is all I'm sayin'.
  #5  
Unread 08-29-2015, 10:16 AM
Opinions please

My fibroids had enlarged my uterus to 22-week size. I was referred to a laparoscopic surgeon, who prescribed 2 monthly shots of Lupron to shrink them to where I could have a laparoscopic procedure; the final report indicated my uterus was 16-week size. The cervix and the ovaries are 2 separate decisions. My surgeon wanted to remove my cervix, but I pushed to keep it because it was perfectly healthy, I had no history of cancer or other issues, and I realized it would be better for my recovery and long term health. I kept my ovaries, and had my Fallopian tubes removed, for reasons the others have discussed. However, each case is unique; you need to do your research, and speak with your doctor to decide what's best for your individual situation. Best wishes for whatever you decide!
  #6  
Unread 08-29-2015, 11:07 AM
Re: Opinions please

As far as I know, cervical cancer and pre-cancer aren't estrogen fed.

Endometrial pre-cancer and cancer usually *are* estrogen fed. If you've got endometrial cancer, a gyn oncologist will usually recommend taking the ovaries to reduce the chances of a recurrence. That's why you might want to have an *endometrial* biopsy before having surgery. It's an office procedure, a bit of pain for a moment and then it's over.

The other reason for taking the ovaries would be if you have ovarian cancer in your *immediate* family - mother, grandmother, sisters. Great grandaunts and female second cousins three times removed don't count.

If you don't have endometrial cancer and you don't have a family history of ovarian cancer, keep your ovaries. They do all sorts of nice things for your heart, bone density and cognitive function.

*Do* have your surgeon take both Fallopian tubes. Recent research indicates that's where ovarian cancer often starts. You won't miss your tubes at all.

My surgery was for endometrial cancer rather than fibroids, so I can't advise on a method. However, I had abdominal surgery myself and I had an easy recovery, with minimal pain and no complications. I was back to work at a part-time desk job at four weeks and life was back to normal at eight weeks. If that's what you end up, it's not horrible. :-)
  #7  
Unread 08-29-2015, 01:29 PM
Opinions please

  Quote:
Originally Posted by TitanicPrincess113 View Post
My fibroids had enlarged my uterus to 22-week size. I was referred to a laparoscopic surgeon, who prescribed 2 monthly shots of Lupron to shrink them to where I could have a laparoscopic procedure; the final report indicated my uterus was 16-week size. The cervix and the ovaries are 2 separate decisions. My surgeon wanted to remove my cervix, but I pushed to keep it because it was perfectly healthy, I had no history of cancer or other issues, and I realized it would be better for my recovery and long term health. I kept my ovaries, and had my Fallopian tubes removed, for reasons the others have discussed. However, each case is unique; you need to do your research, and speak with your doctor to decide what's best for your individual situation. Best wishes for whatever you decide!
Thank you, apreciate the info x
  #8  
Unread 08-29-2015, 01:30 PM
Opinions please

  Quote:
Originally Posted by SurprisedInNB View Post
As far as I know, cervical cancer and pre-cancer aren't estrogen fed.

Endometrial pre-cancer and cancer usually *are* estrogen fed. If you've got endometrial cancer, a gyn oncologist will usually recommend taking the ovaries to reduce the chances of a recurrence. That's why you might want to have an *endometrial* biopsy before having surgery. It's an office procedure, a bit of pain for a moment and then it's over.

The other reason for taking the ovaries would be if you have ovarian cancer in your *immediate* family - mother, grandmother, sisters. Great grandaunts and female second cousins three times removed don't count.

If you don't have endometrial cancer and you don't have a family history of ovarian cancer, keep your ovaries. They do all sorts of nice things for your heart, bone density and cognitive function.

*Do* have your surgeon take both Fallopian tubes. Recent research indicates that's where ovarian cancer often starts. You won't miss your tubes at all.

My surgery was for endometrial cancer rather than fibroids, so I can't advise on a method. However, I had abdominal surgery myself and I had an easy recovery, with minimal pain and no complications. I was back to work at a part-time desk job at four weeks and life was back to normal at eight weeks. If that's what you end up, it's not horrible. :-)
Thank you, apreciate the info - especially re fallopian tunes x
  #9  
Unread 08-29-2015, 01:36 PM
Re: Opinions please

I can't add much to what everyone else has already said here, but I'll throw in my 2 cents as well.


I kept my ovaries and my cervix. My main consideration for both was whether they posed a statistical risk of cancer. Because I have no family history of ovarian or cervical cancer, I decided to keep both my ovaries and cervix. I also read that having the ovaries removed can contribute to heart disease, something that does run in my family, and osteoporosis - I'm already plenty short, thanks, so I didn't want that.

As for the type of surgery, it does depend on the size. I don't recall my measurements, but I had three large fibroids inside of my uterus. The whole thing weighed 2.5 lbs after removal. Because of the size, I had to have a full incision. It's not really that bad, and so far, comparing my own recovery to the sisters who had surgery in the same week, I'd say I'm holding up just fine as compared to those who had laparoscopic surgery. I did get a second opinion, and that helped to put my mind at ease as to whether I was doing the right thing. It sounds like you have some time before you have to commit, so I'd recommend getting a second opinion as well.
  #10  
Unread 08-29-2015, 01:36 PM
Opinions please

Much thanks for all the info ladies. I have learned a few things and have been given food for thought. It is much apreciated 😊 xx
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