TVH: Adeno/endo questions

About a month ago my Dr finally listened to me and did an ultrasound. He said that all of my pain ad problems were because of an enlarged uterus and adenomyosis. When I told my mom, she said that she had the same thing along with endometriosis. So, my first question: If endo is found, can it be taken care of during TVH? My next question is what happens if I start my period?
Thank You!

I think that with a TVH surely it will take care of the endo.... As with you starting your period, are you talking about before your TVH? If so then it will not matter , I am sure if you are on schedule to have the surgery that you being on your period will not make any difference.... its all coming out anyway..... I hope that you do well and be sure to let me know how you are...
Best Wishes....

Hi ((redtulipbug))!

I hope you find a lot of helpful support and information here at HysterSisters! The ladies here are wonderful!

I had my hysterectomy for endometriosis so I want to drop by with a bit of information since you have a bit of a concern in this area. I do not believe I would consent to a TVH if endo was suspected but not confirmed and already excised. If endometriosis is suspected, your doctor needs to be able to remove as much endo as possible either via a lap assisted hysterectomy or a type of abdominal surgery. A total vaginal hysterectomy is going to limit your doctor's ability to remove the endo.

A hysterectomy is not a cure for endometriosis and thus you want as much of it removed as possible. As it can not be diagnosed except via surgery, many times a laparoscopy is done first to diagnose and even clean up any endo that is found.

Have you had a second opinion about what is best for you? Does your doctor suspect endometriosis based on your symptoms or are you only concerned because your mom had it? It is true that if one woman family member has it, others can as well, but not always. Two of my SIL's have had hysterectomies. One had endo and the other did not. I have it but my mother and her mother and her mother (all of whom had hysterectomies) did not and my sisters and their doctors do not believe any of them have it.

I would suggest you talk to your doctor about your endo concerns prior to surgery and ask what will happen if any is found during your TVH. It is possible your doctor would leave the endo or your surgery could be converted to a TAH. You might want to ask your doctor if s/he would be able to do a lap hyst (such as the lap assisted vaginal hysterectomy) rather than the TVH in case endo is found.

As far as starting your period, many of us go into OR bleeding so generally it is not a problem at all! If anemia is an issue for you, do let your doctor know if you believe you will be on your period for your surgery. Some doctors do try to schedule so the patient is not on their period to minimize anemia issues.

I do wish you all the best for your upcoming surgery and hope that it is completely successful for you!

Redtulip,

I agree with Weiser. Endo can not be diagnosed through an ultrasound. A doctor can suspect endo b/c of your symptoms but can only verify that it really is endo through a laparoscopy. And as for adeno, since that is endo inside the walls of the uterus, it can be suspected but can only be verified through a biopsy of the uterus. You really should get a second opinion and see what another doctor says. The doctor that you went to, is he/she an GYN? If not, you might want to find a GYN that you can go to; through my own personal experience, I have found that they are more knowledgeable about endo/adeno than GPs are. And you may want to ask about a lap as a first step to finding out if it really is endo. It seems like a TVH is pretty drastic as a first step.

Good luck to you!

Thank you all for your replies! Yes, my DR is GYN. I have been with him for over 11 years, and we have tried many things before this step. I am 30 years old. For the last 20 years, I have had two week periods that are so painful I have passed out in the shower. I started passing clots that were the size of my fist two years ago. Recently, I also started feeling like everything was getting ready to fall out (VERY painful). I easily go through 20 super tampons in one day. At first I was weak in trying to explain my concerns to my DR, but I finally got tired enough that I said I am not trying any other kind of BC, and when they agreed to an ultrasound they found that my uterus is the size of a 4 month pregnant lady. I have had my two children, and my tubes have been tied for over 5 years, so for me this is not a drastic first step!! I hope this sheds more light on my situation. You guys are wonderful. One more week to wait!

redtulipbug
Hi.. my periods were also like this way before my LSH... I would also go through that many tampons....I had been on every kind of BC that there
was to try.. nothing regulated my periods.... they were irregular and heavy.....
I also had the pain.... even with having sex when it was not even time for my cycle I would bleed afterwards... then when I had my LSH on 3-6-09 my OBGYN said I had touch of endo... so with this surgery it left my cervix intact... well I maintained the abnormal bleeding and had to end up having a trachelectomy(removal of cervix) on 5-13-09... so I been through it and til today I have still had spotting although my OBGYN says it is expected this time and will subside... I am nervous as to that being true.. I am wondering if having the touch of endo may still have an effect on this now..... guess I'll have to wait and see. I go back for my follow-up on May 28th... I pray you will get better and know that I am thinking about you.... I would be glad to answer any questions you may have....
Best wishes.....

have you gotten a second opinion with an endo specialist? have you ever had a laparoscopy that diagnosed you with endo? if you do have endo, just removing your uterus and cervix vaginally wouldnt remove all the endo and adeno is only diagnosed through pathology after your uterus is removed. it sounds like you could use a second or third opinion since you are considering having major surgery without a diagnosis. what does your dr say about keeping/removing your ovaries?

My Dr does not suspect endo-- I do. Right now I get to keep ovaries. Cervix is going because of prior abnormal paps and freezings. I am not considering surgery-- I am jumping up and down for it. I was also offered ablasion, but I am not willing to go through the 6 weeks of an even worse period to get my uterus ready for this procedure, especially when it is not said to be effective for adenomyosis. Thank you ladies for asking all of these wonderful questions.