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Myomectomy vs hysterectomy
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07-01-2014, 05:58 PM
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HysterSister
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Posts: 7
Hysterectomy: July 23rd, 2014
Surgery Type: SAH
Ovaries: Kept 1 or both
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Myomectomy vs hysterectomy
I am scheduled for a supracervical abdominal hysterectomy in which they will take out the 8 cm fibroid, my uterus, and falopian tubes. and keep the cervix and ovaries.
I am not sure why i opted for this instead of a myomectomy.
the more i read about second opinions, the more i second guess my decision.
I am not sure of the difference or why i chose the hysterectomy anymore.
and advice/clarification?
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07-01-2014, 08:51 PM
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HysterSister
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Posts: 28
Hysterectomy:
Ovaries: Kept 1 or both
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Myomectomy vs hysterectomy
I'm in the same boat. Two regular OB/GYNs told me there'd be "nothing left" if I did myo, & I didn't question it. I did, however, know that I wanted surgery by a high volume surgeon, someone who didn't deliver babies. I got a name, went to consult for hysterectomy, & he started talking myo! I was like "I didn't think that was possible, are you sure???" Lol.
It didn't even sink in, I went to a consult w a 2nd surgeon, & still said I wanted a hysterectomy. I was so focused on what type of hysterectomy, keep cervix or not, etc. It was only after going in depth into all those details w the 2nd surgeon, that it sunk in. Then I could think about myo as an alternative.
So now I do feel back at square one. I've scheduled re-consults w the surgeons, even though I feel a little dorky. (Like, can't she make up her mind?) And it does feel like the decision is taking more time than I wanted. I thought I would be recovering by now. But a hysterectomy is irrevocable so I think it's important to be certain. Good luck w whatever you decide.
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07-02-2014, 08:28 PM
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HysterSister
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Re: Myomectomy vs hysterectomy
It's okay to change your mind and get lots of opinions! Being scheduled doesn't mean you have to go through with it.
For me, the right choice in a surgeon was someone who practiced as an obgyn in private practice most days of the week, and then did surgery a couple days of the week. I probably could have found someone with more myo experience, but I certainly wasn't her first myo, she performs surgery regularly and, for me, it was extremely important that I had someone who would listen to me. The confidence and care with which she spoke about both the surgery - and how my body would be treated in the O.R. - made me feel very secure. I personally wanted someone who would be invested in me not just as a surgical opportunity, but as a person and ongoing patient (she's also now my regular obgyn). What someone needs and wants in a surgeon can be really different from person to person.
I think that immediately jumping to a hysterectomy as the first option isn't necessarily about how many surgeries someone does, but about how they practice, how they view their patients' bodies, and how up to date they are. Even though she's not a high volume surgeon, my obgyn NEVER, EVER suggested hysterectomy. She didn't even assume that there would be major surgery, though that did end up being necessary. She did, however, do three pre-op consults with me instead of the standard one because I was so nervous about everything, and she took the time to fully answer 10-20 questions at each of those appointments. I went into my surgery feeling fully informed and like I got to be a full member of my treatment team.
I am so glad that I waited until I found a surgeon that I felt REALLY good about. When she got in there, she found 24 more fibroids than anticipated. There are definitely surgeons out there who would have converted to a hysterectomy at that point - instead, she took the time to remove 28 fibroids over the course of 4 hours, even though she initially though she'd only have me in surgery for 2 hours to remove 4 fibroids. Even when I was under anesthesia and couldn't advocate for myself, she took the time to honor my wishes. THAT is what I want in a surgeon, whether they are high volume or not.
Based on what I've read, unless there is a HUGE, HUGE number of fibroids (triple digits), it's not true that there will be "nothing left" of the uterus. I can't help but wonder if surgeons say that when they don't want to do a more intricate and time consuming surgery. My surgeon told me that once she removed the 28 fibroids and had my uterus all stitched up, it already looked far more normal than it had when she first saw it.
You can find one of the articles about the whole "nothing left" idea here: http://www.fibroidsecondopinion.com/...-swiss-cheese/ Here's an excerpt:
"Fibroids start as a single cell and then produce collagen and other proteins that make the cells swell. As fibroids grow, they push away the normal muscle. A good analogy: when an onion grows in the ground, it pushes away and compresses the dirt around it, but does not destroy the dirt. Likewise, fibroids push away the normal muscle, but do not destroy it. So, when fibroids are removed with myomectomy, all the normal muscle is still there and can be sutured back together. When the uterus heals after surgery, it looks like a normal uterus."
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