another question

Hi- I've posted before - I hope I'm not getting 'tiresome'.. Just have a lot of questions and everyone has been so helpful. Is the only difference between a vag. hyster. and an abdomen hyster. the recovery time/scar? I would think the vag. hyster would be more 'complicated'? If I do decide to have a hyster. is this my choice or does the doctor decide that? And about getting a second opinion- how exactly does one go about doing that ? I'm sure that is a stupid question- just never had to get a second opinion? Can I ask for another ultrasound or will my doctor do an exam at my follow up on the 24th? I had a lap/hysterscope on the 3rd.. can the doctor actually 'feel' if there are fibroids during an exam? on my 2nd U/S the tech noted that it could be endometrial carcinoma because my uterine lining was thicker than normal and I only had the one small complex structure... is it possible to do a biopsy w/out surgery? I have 3 fibroids - none which showed up on either vag. ultrasound? I'm probably sounding like a broken record - but I'm soooo confused .. thanks for all your help ladies !! Catherine

I had a vaginal hyst and recovery nothing compared to what I have read/heard about abd. hyst. Any time someone has abdominal surgery (hyst, gall bladder, etc), seem like recovery is tough. You would be amazed at all of the things you do, even on a lazy day, that affect your abdomen.

If you have a choice, go vaginally!!

Good luck

Kathy

Dear zone,

maybe I can help with some of these questions. First off, since there does seem to be some uncertainty about what might be going on with you, a second or even a third opinion seems advisable. Do you have a GP or internist who could make a recommendation for you? (my internist recommended someone else to me.) If not, are there big teaching hospitals near you? You could try calling the nurses on the gyn ward and asking them about good surgeons in your area.

Second, regarding vaginal vs. abdominal. Yes, the recovery time from vaginal is shorter. However, your surgeon will have to make that call ultimately. It depends on a number of factors, I believe: such as how large your uterus is, what exactly is going on in there, whether you've had vaginal births before, etc. It's a little hard to generalize. It requires more skill to do a vaginal hysterectomy as I understand, and can take longer. Most doctors will use that approach if they can, but doing the abdominal approach gives a surgeon a much better view of your insides.

I had a large uterus from fibroids, and my surgeon initially thought he could do a vag hyst but changed his mind on the morning of my surgery, because I had a very large fibroid right on my cervix and he was afraid of injuring the ureters. So I ended up with an abd hyst, but it was really no big deal.

do try to get another opinion, though, as it seems you're getting some confusing information about your condition.

good luck and let us know how things go!

I was to have my hysterectomy done completely laparoscopically through three approx. 1cm incisions in my abdomen and one in my belly button which is the least invasive way to have a hyst. As my fibroids and uterus were so large I ended up having the lap to cut and sew everything and then having the uterus removed vaginally meaning I also had my cervix removed.

I agree with the above poster who said that vaginally is much easier on the body than an abdominal procedure. My recovery was uneventful and at 3 months post op I've got more energy than ever, I'm even exercising and losing weight and my ovaries are functioning normally.

Having said that, even though I didn't have a large abdominal incision to remind me of the major surgery I'd had I knew that I had 100s of stitches inside and had to take things very slowly in the beginning. Most women in Australia take the vaginal/lap route these days but you need to find a surgeon who is skilled at doing hysts this way as they can be more complicated and take longer.

regards
Xaviera

Hi Catherine,

No you're not tiresome! Just anxious to learn! Really though, nothing stirs the imagination and gets one to worrying more than the possibility of major surgery. Questions are very normal.

Like stated already, recovery is more difficult with the abdominal surgery. My doctor said ab surgeries are easier because she can see everything. She also said verticle cuts are real easy for viewing but she does the bikini cut for the patient.

You may be lucky enough to have a choice if your uterus is still small enough to do the surgery vaginally, but ultimately, your doctor can make the decision. You may have other choices to make like keeping the ovaries and cervix depending on the procedure.

Second and even third opinions are so very important. Ask friends, co-workers, and family for recommendations. Talk with your neighbors, any female who has a few years with a gyn. Try to get at least two names. Once you decide who you would like to go to, tell your doctor. "I'm going for a second opinion and I will need a copy of my records please." Make sure this new doctor is on your insurance list. Get a referral is necessary. Tell the new office you are there for a 2nd opinion. This new doctor may or may not exam you. Some of us want to be examined again...others don't. Make up your mind and tell the new office what you wish.

I've gotten a lot of tests that I asked for but my doctor always agreed. I guess it would depend on when you had your last ultra sound. I like having a recent U/S with the results in my hand for the second opinion doctor. I normally get a test once a year.

My doctor made me feel my own fibroid during a vaginal exam. I have one that sits on top of my uterus. She placed my hand on top of my tummy during the exam and ...yep...I could feel it! Some of us can see and even feel the tumors when laying on our tummy.

As far as I'm concerned, that U/S tech should never, never have mentioned the word cancer. She is the tech only. She does not diagnose.

Endometrial(uterine) biopsies are done in the doctor's office. No surgery is required.

If your fibroids did not show up on the vag U/S , I'm assuming they were seen on the lap scope? I was told the interior of the uterus can be difficult and misleading. Ultra sound is a series of sound waves bouncing off the walls. It's not a clear picture and other things can look like tumors. If yours were seen with a scope then that would be a good picture!

No one really knows exactly what is inside until the doctor gets there...and sometimes the doctor are surprised!

I hope with the joint effort here that we answered most of your questions. Keep reading and asking....and take care, OK?