vertical vs. horizontal incision?

I'm also new here- my pre-op is scheduled for this Thursday, May 7, and after reading so much information on this site- I have a lot of questions for my doctor. My TAH is scheduled for June 2, and I feel like I've been on a roller coaster of emotions. I'm 47 and I've been dealing with fibroids for the past 20 years.
Until the last few years they really didn't bother me, but now they've grown and basically every bad symptom you can have from these wonderful things, I now have. I'm tired of always being uncomfortable, being in pain, I've now become anemic, and I'm ready to have my life back, but am scared to death to have this surgery!
My largeset fibroid is 12 cm. and my doctor feels she may have to use a vertical incision. I'm a little nervous about that and having it heal ok. Any feed back on a vertical incision from those of you who have also had one? It just seems like it would have to heal easier with a horizontal incision, but maybe there isn't much difference?
When I first made the decision to have this surgery- I was terrified of the surgery itself, then I was afraid I might not wake up again, but now I think after reading so many of your post, I'm worried about complications after the surgery, and so hoping I'm making the right decision. Many of you seem glad you did it and feel your quality of life is so much better. That's what I'm praying for. I'm trying to stay positive. My DH has been absolutely wonderful, but I'm so glad I found this site, it's help me stay a little more calmer than I think I would have.

Thanks for all the information everyone has been giving! It's a big help!!

Hi, I'm not sure if I'm the best person to answer your question but I can tell you my experience from my 1st surgery (I'm about to have it again unfortunately, probably later this month, I'll be 41 in a couple of days). I had a myomectomy in 1998 at age 30. My doctor wanted to do a hysterectomy but I wasn't married and had no children, so I only had the fibroid removed. Had I known what I now know (the high likelihood of it recurring) I would have let them do the hysterectomy the first time. I was like you (absolutely terrified) and was literally in tears until I was put to sleep, had my parents all upset too. The first doctor I went to was very casual (and insensitive I might add). She said she probably would do a vertical incision since my fibroid was so large and that way she could go as far with the incision as she needed to. (yikes!) I was imagining myself waking up cut up to the breastbone or something like that. She said it might or might not be cancer and she might or might not have to do a hysterectomy anyway when she got in there. Needless to say, I was a basket case and in tears when I left. I decided to get a second opinion and boy am I glad I did (not saying you should have to do that, I just didn't care for the whole demeanor of this doctor I'd seen). You would have thought a woman would have been the most caring and sensitive to what another woman was going thru. Not in my case. I found a really good doctor who was recommended by my sister-in-law. He saw no reason to not be able to do a bikini cut (let's face it, neither are going to feel that great). What I worried about, more so than the scar, was the amount of muscle having to be cut. It was explained to me that a vertical cut goes thru less muscle and a bikini cut goes across them, obviously cutting most of them. Nevertheless, I had the bikini cut, and horrible as it looked for quite some time, for several years now, it's really almost become invisible. It's just above the pubic hairline. You can't see it at all with underwear on. Kinda sad that it has to be cut again now. I've never worn a bikini in my life, even though I'm slim, but before the surgery I did wear bikini panties and ever since I've had to change the style that I wear because it seemed the edge would get down in the scar area and I felt like it was sawing me in half when I moved. VERY tender. I had alot of partial numbness in the area that was cut (the best way I know how to explain it is if you put your hand up flat against someone else's hand and then take your free hand and run your thumb and index finger up and down both hands at the same time, sort of that half feeling sensation). I had thought it'd always be that way but again, the last few years I think it feels pretty much normal again. Until this next surgery again...just my luck. Anyway, I just saw my doctor last week and he described my current fibroid as "huge" (in pregnancy size terms, about 14 weeks if that helps). I feel like I'm walking around with a cantaloupe stuck out front although it isn't as visible according to what I'm wearing but I hate looking like I'm pregnant. And I'm just very uncomfortable. But my doctor is doing the bikini cut (horizontal) on me again. Probably will cut away the original scar tissue, if there's any, and go thru the same area again. I think some doctors have a preferance of one cut or the other and I'm sure we all want them to do it the way they're best at. Another reason I got a second opinion was the hospital. The first doctor would only do my surgery at a hospital that is notorious for having staph infection, so there was no way I was having it there. I'm not good at sizes in cm but it sounds like your largest fibroid is bigger than mine (bless your heart, I KNOW you're miserable). My first one was about 8 inches in diameter and was taken out of about a 5 inch incision (I had alot of bruising). My first fibroid was just one large one and they think this one is also, although they won't know for sure until they get me in surgery.

I plan to order that swelly belly set to use this time. I would have given anything to have some support & protection for my stomach while I was healing last time. Just a suggestion. Having a small pillow to have over your stomach when you cough or drive is a good one too. I don't know if my comments will help you any, I hope they will. I've never replied to any before but I can definitely identify with how you're feeling. I hope your surgery goes well and that you heal really fast with no ill effects. The main thing I think is to not over-do anything, really take it easy and follow your doctor's orders. Even when I felt better on days, if I did too much, even the least little bit, I'd pay for it for days feeling horrible. Again, I hope this helps ease your mind just a little. Good luck on May 7th!

I had the vertical and I don't like it. I wanted the bikini cut so that the scar would have been less noticeable and it would have healed better.

The vertical one seemed to me to be longer and to run more of a risk of opening. I am a larger woman so this worried me the whole time. Now my scar still looks bad and my stomach is parted with an indented incision scar. My stomach looks like a frontwards butt. Not appealing at all. The bottom of my incision seemed to drain more and heal slower maybe because of gravity, it is also a thicker scar at the bottom.

Just my opinion and my experience. Hope it helps you. Good luck.

Thanks! Your reply's do help. She wasn't positive that she would have to do the vertical- but the largest fibroid is at the bottom pushing everything up and out. I'm small framed and atleast to me- it's very noticeable and I am tired of feeling like I'm pregnant. I am worried about the scarring with the vertical- but more so the healing of it and worrying it's going to have a higher chance of coming apart and not healing as well. I'll see what my doctor says Thursday - after begging for a horizontal!
I have been seriously thinking about ordering the swelly belly thing. Here I was so looking forward to a flat stomach again after all this time only to hear about this swelly belly deal! To me it seems like it would make sense that it would help, but for those of you out there that have used it- do you feel like it was worth it to purchace this? I work out 7 days a week even if it kills me- hoping it will help me through recovery. I think it's going to be a real test for me to sit around and do nothing- but I realize you only have one chance to heal right and if that's what it takes, then that's what I'll do. It's so nice to be able to read post from women that have been through this and their advice on what to do or not to do!

Thanks again!

My sister had a vertical cut and I had a bikini cut, and we both healed just fine. My doctor said because of the size of my uterus, he might have to do a vertical but ended up doing the bikini. I don't mind the scar - looks kind of like a smile I've been told.

Susan, I have my pre-op on 7th and surgery on the 2nd. We are twins!
Keep me posted on how your pre-op goes.

susank47,

You seem worried about healing--recovery, pain, etc. Have you considered having a less invasive hyster. I had four 3/4 inch incisions and was back to normal in three weeks. I had a very large fibroid uterus so my recovery took a little longer than some sisters. Ask your doc if he can do it laproscopically. There is plenty of info on this site about the various types of hysters available. You may have to find a different doc, not all docs are the same. Some can't do the laproscopic procedures and so they don't offer them.

Please do your research, make sure you know about all the options. You may not need a big incision at all, just little ones. Let us know what your doc says and what you decide. Good luck.

Pat

I should have included in my post that my mother also had a hysterctomy at age 37 (in the late 70's) and she had the vertical cut. I don't remember her having problems healing (our whole family waited on my Mom hand and foot and made her stick to the doctor's orders). It would seem to be to almost be a little more painful though, only because your clothes waistbands will have no choice but to cross over it and maybe keep it more tender. Not saying my bikini cut wasn't tender, it was very painful, but at least I could wear loose fitting clothing and not have it rubbing it (I wore big granny panties). I didn't have a "normal" recovery the first time. From the time I woke up I had a nauseous migrane headache and vomited for several months. Not sure what triggered the migranes, doctor said probably stress (gee ya think?). Like I said before, I was a basket case. But the vomiting pulled & jerked my incision area constantly so that I had a harder time getting over the soreness. So I don't know what to expect this time around, last time was definitely not a normal recovery. I'm not going to lie, the thought of possibly having that happen again is enough to bring me to tears right this minute. I had wondered if maybe the anesthesia might have triggered the migranes but I thought I was going to die from the pain before they finally stopped. I was still having them when I went back to work and was anemic on top of that because of the blood loss (keeping my uterus made the surgery longer and I also lost more blood than just doing a hysterectomy). Needless to say, I didn't have any pep in my step for quite some time. Honestly it was about two years before I felt "normal" again, but I think most people have a better experience than what I did (thank goodness, wouldn't wish that on my worst enemy). Has anyone else ever heard of getting migranes like that after a surgery? Just wondering. I would have loved to have had this site back in 1998 the first time around.

That's my thought with the vertical incision is the location of it and clothes constantly rubbing over it ect... and healing properly. I'm not so worried about pain as I am infection I guess. I'm thinking maybe if I get the swelly belly band this might help to protect it also?? Any thoughts out there on that?

I also have a form of vertigo which has gotten much better over the past two years, but wondering if the anesthetic might set that off. Thinking that just can't be much fun to be vomiting with an incision. So I totally understand your worry over the migraines. That would be awful.

Thanks for all your help! I'll see what my doctor says about all of this at my pre-op tomorrow.

Let me know how yours goes tomorrow also!