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Pre-op Decisions
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12-29-2001, 10:49 AM
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Guest
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Pre-op Decisions
This week my gyn and g.p. both recommended TAH for a 9cm+ fibroid. I'm 50; they advise HRT & only view removal of the cervix as optional. I've read thru the pre-op & alternatives message boards & am totally confused! Most posts seem to suggest
leaving ovaries in unless there's a problem (no family history of ovarian cancer; ovarian cyst removed abdominally 32 yrs ago). My drs. feel you avoid all possible future cancers by removing everything possible. Please clarify the following:
(1) Is it true that this fibroid is too large to remove vaginally?
Can you be dilated to make that possible?
(2) Is it true that removal of the cervix can lead to bladder problems? I have slight bladder problems now which may or may not be caused by the pressure of the fibroid.
(3) Does anyone reading these boards agree with my doctors that you should remove ovaries, uterus & possibly cervix along with the uterine fibroid, given my age? I have not gone thru menopause yet, and have heavy periods & bloating.
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12-29-2001, 11:21 AM
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Guest
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Posts: 1,925
Hysterectomy: August 20th, 2001
Surgery Type: TVH
Ovaries: Kept 1 or both
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Pre-op Decisions
Hi there! I think the leaving the cervix and ovaries is a personal thing. My doc was just the opposite about my ovaries and I am also 50. I was probably more on the edge and ready to fall into menopause, but he said he really doesn't believe in taking things out when they are healthy. There was no question about my cervix because I had a vaginal hyst so it went along with my uterus.
That's a pretty big fibroid you have there. My fibroids (3) were not that large so I'm not too sure about that. It may depend on where the fibroid is also. Mine were intramural, my uterus was prolapsed and enlarged. My op report does say that he took my uterus out in sections. I would go with what ever your doc says on this. Did he do an ultrasound to be sure of the size? My fibroids didn't even show up on the ultra sound or the hysteroscopy and D&C. I guess they were buried in there pretty darn good!
I have not heard that removal of the cervix causes bladder problems. Of course, I may have missed seeing that here. I haven't had any problems with that personally.
Hope this helps.
Sending you s!!
Sherry
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12-29-2001, 11:30 AM
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Guest
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Posts: 149
Hysterectomy: December 20th, 2001
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Pre-op Decisions
HI,
Sounds like you need to do your research with other Doctors. Since you seem to be uncomfortable with what the one you have told you. It's your body and you should'nt feel pressured to remove anything. Most of your questions only a Doctor could answer. Remember that 2.5cm equalls one inch. Good luck on your search.
God Bless
Sue
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12-29-2001, 03:00 PM
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HysterSister
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Posts: 2,014
Hysterectomy: December 12th, 2001
Surgery Type: TAH
Ovaries: Kept 1 or both
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fibroids
smmosk
I too had fibroids - multiple. At the ultrasound the largest was 7cm and growing. I also had enlarged uterus (larger than a football). I ignored the pain and very heavy bleeding for around 4 years before getting anything checked. Once I had my ultrasound everything just seemed to happen really fast.
I didn't have a choice whether to go vag or abd. You really need to talk to the doctor.
I had to have abd due to the uterus and in the end I was glad I hadn't had a choice. When they opened me they actually found another mass on one of the fibroids. I knew I was losing the uterus, left ovary and fibroids. I wasn't aware they were going to take the cervix as well. If it was mentioned before surgery, I couldn't have been listening properly. Anyhow I'm not upset about it.
I only have my right ovary and the general concensus is that I won't have to take HRT. I am 44 and have not got through menopause either.
I had stress incontinence before surgery (I put this down to fibroids decreasing my bladder capacity to 34 percent - I had a bladder study done). Since surgery I have had bladder discomfort more than problems. Every day this discomfort is decreasing, so I am hoping with time it will settle down totally. i don't know if I am imagining it or not, but the stress incontinence doesn't seem to be anywhere near as bad. I can cough and not pee myself.
I am now 18 days post op and feeling great. Still not doing much, but I know I have to allow my body to heal.
At the end of the day you really do need to discuss (at length) all your concerns with your doctor/s and do what is right for you and what you are comfortable with.
Regards and I hope everything goes well for you.
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12-30-2001, 07:31 AM
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HysterSister
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Posts: 519
Hysterectomy: November 1st, 2001
Surgery Type: TVH
Ovaries: Kept 1 or both
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Pre-op Decisions
Hi smmosk!
s to you! I would agree with the other ladies here to have further discussions with your doctor. If you are uncomfortable with the answers, then please seek additional opinions.
In answer to your questions.... 1) Really not sure 2) I believe the cervix does provide support of organs within the pelvic floor. There are procedures for tacking or slinging the bladder however if this is a concern. I also experienced pressure and incontinence with fibroid pressure, had my cervix removed with no additional procedures and so far am doing great - and my bladder symptoms have gone. 3) I also kept my ovaries. Although, my doctor and I had an understanding that if they were not healthy, he could remove them. Initially, my doctor also recommended removal - to prevent future problems. Well, I did not feel comfortable with this approach and my doctor had no problem with that. You should know also that even past menopause, your ovaries will continue to provide some hormonal benefits!
I hope you find answers that work for you. All the best to you!
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