pre-op worries

My surgery is scheduled for 8-5-02 - I have been reading too much - too much information is not a good thing. I am having trouble agreeing to the surgery my GYN recommends. She recommends vaginal hyst. that means loosing my cervix - there is nothing wrong with my cervix and therefore I would prefer to keep it. I am worried about vaginal shortening, vaginal prolapse in later years - I really don't care if it takes a couple more weeks to recover from abdominal surgery vs. vaginal. Please help and offer your opinions - the more I read medical research articles the more confused I get. I can't believe there is not more research to help us make decisions - especially since it is such a "common" surgery. Also, does anyone have ideas about how to research your surgeon? How do I find out how many surgeries she has done and what her success rate is......

Monica,

I know what you mean by reading too much -- but in this case, I think you need a final consult with your gyn. Are you having surgery for prolapse? Or for other reasons?

I'm scheduled for 8/1, but my surgery is with a urogynecologist -- am having a subtotal abdominal hysterectomy with anterior and posterior repair. I'm keeping my cervix (that's the "subtotal" part) -- for three reasons: it helps support the pelvic floor, I think it's important for sexual response and I didn't want my vagina shortened either.

If your doctor can't offer you concrete medical reasons that pertain to your situation personally to support his/her recommended course of action, then maybe you need to find another doctor who will. I know that sounds scary too -- but it seems to me that surgery is scary enough without being talked into a procedure you don't want.

Best wishes,
Cheryl

Monica

I had a TAH/BSO and as for vaginal shortening I'll be honest I can't tell any difference between how I was pre op and how I am now! but I agree do voice your concerns to your doc and get the reasoning behind why he/she is so set on a vaginal!!!! you can research your doc through the AMA ( american Medical Association) Don't remember the web addy but search for it through a search engin like yahoo or google! Best of luck to you!

I work for a docotr, and they DO have their reasons (medically) for doing a vaginal versus abdominal. Alot of hysts are done vaginally these days..so maybe he/she feels this type is best for you. Ask him, if it makes you feel better.

Not to make things even more confusing but the nurse at my gyno's office said they rarely do vaginal hysts anymore.

Monica,
Ask your doctor about having a supracervical hys. That is where they only take the uterus, and can be done vaginally, or lap assisted.

hello!

I too know too dang much, was driving myself crazy with questions and considerations which, thanks to this site, I would never have known about otherwise. I'm glad because I'm fairly certain that NOTHING will surprise me when I go up tomorrow, I feel wonderfully prepared, but it made the approach mucho scarier.

I also had an opinion about wanting to NOT have a TVH, for emotional reasons, and also because I'd read that there was more chance of bladder damage that way, and I've had bladder issues before. I went to my pre-op half thinking I would argue for abdominal, but as I was listening to my doctor go into his pre-op spiel, I realized that there was no way to get through this except by trusting in him and his experience. I ended up not asking a single question and sort of accepted that despite all my efforts, I would not be able to control every aspect of the operation or my chance of complications, etc.

Now, I sure wouldn't suggest this approach for every one. I'm only saying it worked for me, and I've felt a lot more calm since. Of course, my concerns were not about a part I wanted to keep, only the directions he was going to go. If your doctor's opinion on what should go and his/her responsiveness to your concerns makes it difficult for you to trust him/her, then THAT is the main problem. If you don't trust your doctor or you'll be a wreck in no time. Find another.

I do wonder if pressure from insurance companies have anything to do with going vaginal since its less expensive. But I usually dismiss the thought as too cynical. Any dr worth his salt would only recommend going that way if it was better for his patient, right?

Take care, and good luck!

Teena

My Doctor explained that even though my previous GYN. wanted to do a Vaginal Hyst. He wanted to do a ABd. Hyst. because:
A) with prior surgeries (two c-sections and a Sterilization) the bladder has already been moved B) due to the tipped uterus He can actually see better through the abdominal incision C) If you have any adhesions...highly likely with prior surgeries...again can see better...My two c-sections were done with vertical incisions and I asked if he was planning on just using the same incision site...He told me he could but....the lower horitontal cut heals much faster...So..I feel like that is a legitimate reason for Abd. versus Vaginal. .....That's my two cents worth I hope it helps someone or at least prompts some questions for your own dr.
Lady Violets aka; the

I have to have a TAH because of a fibroid that is pressing down on my cervix causing it to extend most of the way into my vagina! It's about an inch away from the opening. (Sorry about the graphic description.)

So, I didn't have a choice, but I am nervous because dear doc is going to try to "save" the cervix, but doesn't know if he will be able to correct the distortion. It all depends on how and where the fibroid is. I may wake up without it, and that worries me for the same reasons you all stated.

I also don't know if it will be a vertical or horizontal incision. He will decide when he does the final pre-op exam the day of surgery. It depends on if there has been any more shrinkage from the Lupron (or lack thereof). He wants to do horizontal but again, he will decide that on surgery day.

But he assures me that whichever route he goes, he will be very careful to prevent any of the icky side effects.

I trust him to do the right thing, but not knowing is kind of scary.

O.

I have no choice either. Had my pre-op consult last week, and thanks to all of you in hyster land, I had intelligent questions and much knowledge to start with. Because I have a fibroid extending through the cervix, my gyn felt it was not possible to save cervix because it is so involved. My other fibroids have enlarged the uterus so much that she doesn't feel she can access and see the top of the uterus unless a TAH is done with a vertical incision. The end result will be a tummy that looks like an anchor imprinted on it since I have a bikini incisions from 2 C-sections. After having it explained it made sense. Not thrilled about losing cervix. Will I have problems later in life? As for the change in sexual response, she said it probably will be different. Any comments on that from anyone? Thanks, you have all been a blessing to me.

FlossBoss