Confused about removing uterus & cervix? Pros and cons of removing the uterus?

I'm 53 years old and have gone through menopause. I'm scheduled for an oopherectomy June 23rd.

I have a large cyst on my ovary, I think its the size of a large baseball. Doctor is recommending removal of both ovaries as he said the one side is damaged. He stated that the guidelines for a woman my age, having gone through menopause and having abdominal surgery should have the ovaries, fallopian tubes and uterus removed as they are not functional and he says I would greatly reduce my risk of ovarian cancer and other cancers that occur in the uterus. I know that I would never have to have pap tests again.

I'm not sure about removing the uterus? Can anyone tell me what the pros and cons are of removing the uterus and I gather the cervix would be removed at the same time.

I'm not sure if this could impact your sex life and yoru ability to feel pleasure?

Does he suspect the cyst is cancer? If not, and the pain is not debilitating, then I would wait until you have your answers to the questions.

Personally, I would seek a second opinion unless you totally trust this doctor.

Unless there is cancer or precancer, personally I would let him only take the one ovary. The ovary still provides the body with other hormones besides estrogen. As for you uterus and cervix, again, what is their condition? Are you have bleeding, endo, any pre-cancer? I really think you need more information why to take it all besides preventive AND get a second opinion.

I'd suggest getting a second opinion. To me it sounds as if even though there's no history of gynecological cancer in your family, your doctor's being really quick to recommend the removal of everything he considers unnecessary after menopause on the longshot chance that you *may* get cancer.

There's good research out there that shows that even after menopause, our ovaries continue to produce low amounts of hormones that protect our bone density, hearts and cognitive function. If one of your ovaries is damaged, then that one has to go, but I'm not hearing a compelling argument for removing the other one as well, let alone removing other healthy organs.

The one thing you might *want* removed is the Fallopian tube of the healthy ovary, since there's some research suggesting that ovarian cancer actually starts in the Fallopian tubes.

You mentioned that the doc proposes doing this via laparatomy, i.e., abdominal incision. One thing I would ask about is the length of the incision and the recovery time for removal of the cyst-bearing ovary alone vs the ovary, the uterus and the cervix. I had an abdominal hysterectomy with removal of both ovaries and tubes as well. Recovery wasn't bad at all, but it's not something I would have done if I didn't have to!

The other thing to be aware of is that your cervix is part of your pelvic floor. Removing it weakens the floor to some degree. Mine's been gone two years now and so far, so good, but again, I'd suggest not doing it unless you have to.

As for Pap smears, I still have "vaginal vault smears," which are basically the same thing except just a bit south of where my cervix used to be.

All good questions. I'm going to ask some of these questions to the librarian at the hospital and nurse.

I'm leaning towards removal of the one side as they are probably damaged. I'm wondering if there is any reduction in the risk of ovarian cancer if you do just the one side?

I recommend Lauren Streicher's Essential Guide to Hysterectomy book. She goes into pro & con of each. I'm going to leave my ovaries but have my cervix & Fallopian tubes removed. My doc mentioned that research shows cancer can start at the tubes... So out they go. I'm leaving my ovaries so I can ease into menopause vs. hrt. I hope that helps? Good luck!!!

	Quote:
Originally Posted by CAdolph All good questions. I'm going to ask some of these questions to the librarian at the hospital and nurse. I'm leaning towards removal of the one side as they are probably damaged. I'm wondering if there is any reduction in the risk of ovarian cancer if you do just the one side?

The most important thing to do to reduce your risks of ovarian cancer is to get your Fallopian tubes out (on both sides), since current research suggests that's where ovarian cancer starts.

It's true our organs will not function as they did in our childbearing years however there are many opposing opinions a post menopausal woman's uterus and ovaries protect our hearts and bones as we age. Your doctor's remark they have no function is questionable because there is an abundance of research proving functionality but at a different capacity.

I fought long and hard to keep my body intact when diagnosed with a very problematic fibroid tumor and I'm glad I did. I had the fibroid embolized which is not a recommended treatment per gynecological societies who only offered complete hysterectomy based on my age. I am one year older than you. Every fiber in my body said no!

If I were in your shoes I would have the cyst removed only and I would be very careful what I signed. The risks of cancer are quite low when there is not a family history.

I'm with Sisterduke. Keeping as much of your body and organs intact when there are only benign issues is very important.

I wish I would have pursued alternatives with greater perseverance. You can't get back what you lost and it can have great impact on your quality of life. Many in the medical profession are way to eager --without thoroughly exploring the alternatives and ramifications -- to remove a women's organs.

Thanks again for everyones comments.

I do know that I need the one side out as the cyst has damaged it. I have gone through menopause so my ovaries are not functional. I could either get both sides done and keep my uterus and cervix or get all of it out.

I'm making a chart on all the pros and cons of the different options. The cyst is probably not cancerous. The doctor is recommending the whole procedure because of my age 53 years old, being past menopause and for prevention. It's such a tough decision. I'm going crazy.

I will read the book that you recommended.

Thanks!

I feel concerned when a doctor recommends removing organs "because you don't need them anymore". It used to be generally accepted to feel this way about the ovaries for women who are close to or past menopause. Now it's understood that even past menopause our ovaries release small amounts of hormones that play an important role in our bone, heart, sexual, and cognitive health. Women who are past natural menopause and have ovaries removed will still experience surgical menopause. It is to your benefit to keep at least one ovary if it's healthy.

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There is merit in removing the fallopian tubes. Recent studies indicate ovarian cancer starts there, and removing them doesn't have negative health consequences for the patient. Regarding your uterus and cervix, if they are healthy and you have no genetic predisposition to cancer in these organs I don't understand why your doctor would recommend removing them. Hysterectomy is major surgery, has the risk of serious complications and has approx a 6 week recovery time. Many women feel it takes 6-12 months to feel back to their regular self and activities. No one can guarantee how you will feel after or what your sex life will be like. If you feel uterine contractions with orgasm, that will be gone. My sex life has changed dramatically since my hysterectomy which really saddens me. Also having a hysterectomy does not guarantee no more pap tests... I still go yearly to have a vaginal vault smear for pap testing.

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I suggest a second opinion. Doctors have different perspectives and may offer different treatments. They also have different skills and may offer a different type of surgery. Once you have surgery, it's done. For better or worse, there's no going back. You are worth a second opinion.

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