Hi Jenell!
I had my hysterectomy and A&P repairs for prolapse last year. My uterus was so far down that my cervix was hanging out of my body, and I had both a cystocele (bladder prolapse) and rectocele (prolapse of the rectum), so I didn't have a choice. If your prolapse is not severe, a hysterectomy seems a bit drastic to me when you consider all the possible outcomes.
To answer your questions ... While the uterus doesn't produce hormones itself, indirectly it is related to hormone production in the ovaries. The uterine artery is a major component of the blood supply to your ovaries. Removing the uterus disrupts that blood supply so the ovaries will get less blood circulating to them afterwards. Sometimes that can mean they will stop working for a while, but then they manage to reestablish an adequate blood supply using collateral vessels and start working again... sometimes not, and they never work again. Sometimes they'll work fine initially but will peter out earlier than when you'd have gone through menopause without the hysterectomy. For some women, this is no big deal; they just start on HRT when their ovaries quit working and feel great and never look back. But for many, it can be a very long, tough struggle. I'd hate to think of you having to go through that if you don't have to, especially at 29. I was 45 and perimenopausal at the time of my surgery so to me it didn't seem quite so scary, and still it has not been a walk in the park.
You will doubtless get many differing opinions on whether orgasm is the same or different after a hysterectomy. For me, it was different at first (weaker and shorter) but with adjustments in my HRT it has gotten to where it's about the same. But that took about a year and a lot of effort. I can't speak for others, though.
About the vaginal vault prolapse after a hyst... yes, it can happen. In order to minimize that possibility, in my case, I had a bladder suspension done, plus I am careful to use adequate vaginal estrogen and testosterone and keep up with my kegels. In addition, I watch carefully how much I lift... never over 25lbs and no more than 10lbs for extended periods of carrying.
Speaking of kegels, has your DR talked with you about building up the health of your pelvic floor muscles? If your estrogen and/or testosterone levels are low, that can contribute to prolapse. Sometimes correcting the hormonal situation and working hard on those kegels can really help with prolapse. It might be worth considering if your prolapse, like mine, was precipitated by hormone changes.
In your Pre-Op thread you also mention some ambivalence about whether you're really ready to commit to definitely not ever having another baby. At 29, as you said, it's very hard to be sure whether how you feel now is how you'll always feel. When I was 29 I didn't even want children. By the time I was 38 I had two of them, both of whom I wanted. At 45, at the time of my hyst, I was sure I didn't want any more, and still I had some feelings of loss about knowing I could never bear another child. Those feelings can be pretty powerful, especially if you are on the younger side.
Finally, no one really knows all the potential far reaching effects of removing organs from the body, healthy or not. The Road Less Traveled forum here at Hystersisters is filled with ladies who have had other issues crop up after their hysterectomy that have required further surgeries or led to their having to deal with pain on a daily basis, or both. While this doesn't happen to everyone, it happens, and you can't know ahead of time whether you will be one who has problems or whether you'll coast through and come out feeling wonderful. For example, I developed recurrent diverticulitis after my hyst (the diverticulae had taken years to form, but the initial infection was triggered by the hyst) which led to a perforated colon and ultimately to my having to have most of my colon removed just a couple of months ago. I'm OK, but now I'll always be wondering if that was it or if there's more coming.
I'm glad you found us and are taking the time to explore all your options. A hyst is an irreversible, life altering procedure. So many of the alternatives aren't, and they might have a chance to help you. If I'd have had a choice, I'd have gone for the other options first. Unfortunately, I didn't... and I think that's the only way to go into a hyst. If you have choices and don't exhaust them first, then you may find yourself second guessing yourself down the road about whether it was worth the hormone stuff or any other consequences you might experience (like the inability to bear children). If you know it's the last resort/best choice, you can commit yourself fully to dealing with whatever comes and making the best of it rather than always looking back and asking 'what if?' That's why second (third, fourth, as many as it takes to be absolutely SURE) opinions are sooo worth it!
I hope this helps... keep us posted on how your appointment goes, OK? Good luck!
s,
-Linda
I have an apt with a urogynocologist...
I talked to her nurse today on the phone and she said my case is the type this Dr specializes in and she is fitting me it for a second opinion prior to my already scheduled TVH date. The nurse said she has done many repiars for prolapse that do not include a hyster. I'm really hoping this apt goes in my favor, now I just have to wait until July 10th now!!!! waiting for this apt is worse than waiting for surgery!!! I'm so excited I may have found a specialist, but I'm even more excited that I found this board and gained more knowledge of this type of surgery and I'm going to be able to make a much more informed decision.
