LAVH: I think I made a mistake :( possible endo - do I keep my ovaries?

I'm scheduled on September 17 for LAVH due to fibroids and enlarged uterus. I have heard from a few friends who have had hysterectomy that I should keep my ovaries no matter what! So when I went to my gynecologist last week I told him that's what I want. He said if he sees during surgery that I have endometriosis on them that leaving them would mean I'd probably have to have another surgery in the future. I told him I didn't care and wanted to keep them anyway... I'm 30 years old and didn't want to be thrown into menopause yet. But now I'm having doubts and scared that all of my symptoms may not be just from the fibroids but also possibly endometriosis??? If that's the case then I would end up in the same pain I'm in now and the surgery would be for nothing HELP, what should I do?

Hugs to you, there's definitely a lot to think about with this surgery. If I were you, I'd tell the doc that you want to keep the ovaries if you can BUT, if there is evidence of endometriosis, he can take them out to save you from further pain and more surgeries. I hear that HRT is really good these days, so you'd be able to manage surgical menopause. But that's just my opinion. I know you'll figure it out

Others who have endo will be along. But from what I have read, you are rarely ever endo free. The best chance is to get it all out which means if the ovaries are covered with it, then unless you want further surgery, they need to go.

On the other hand, is your doctor an endo specialist? It is strongly recommended here that if you have endo to have a doctor that specializes in it. they know how to find and get as much as possible. If it is on your ovaries, I would think that is the only surgeon that might be able to excise it and save one or both ovaries.

	Quote:
Originally Posted by lowatson I'm scheduled on September 17 for LAVH due to fibroids and enlarged uterus. I have heard from a few friends who have had hysterectomy that I should keep my ovaries no matter what! So when I went to my gynecologist last week I told him that's what I want. He said if he sees during surgery that I have endometriosis on them that leaving them would mean I'd probably have to have another surgery in the future. I told him I didn't care and wanted to keep them anyway... I'm 30 years old and didn't want to be thrown into menopause yet. But now I'm having doubts and scared that all of my symptoms may not be just from the fibroids but also possibly endometriosis??? If that's the case then I would end up in the same pain I'm in now and the surgery would be for nothing HELP, what should I do?

BIG hugs! It's a huge decision for sure. Hopefully some of the sisters who had their ovaries removed young will comment soon.

I had a similar dilemma when I had my thyroid removed in my mid-20s. One side of it was growing out of control and the other wasn't. My endocrinologist said, "Sweetie, you're awfully young to lose your entire thyroid. It's a very important organ. The unaffected side may go on to do the same, or it may live a long and happy life. I can take the diseased half and leave you with the healthy one, which may mean you need another surgery to remove it if it becomes diseased too. Or I can take it all now. Unfortunately, I can never give back what I take away." I went the cautious route and kept the healthy half. Sadly, it didn't work out for me and the next year I had to have a total thyroidectomy to remove the other half which had become diseased.

Was I annoyed by needing a second major surgery? Absolutely. Did I regret my decision to make the cautious choice? Not for one moment. I feel I made an educated choice that was supported by an expert in her field, based on the information we had.

I encourage you to do the same, whatever your choice may be.

	Quote:
Originally Posted by charlotteel Others who have endo will be along. But from what I have read, you are rarely ever endo free. The best chance is to get it all out which means if the ovaries are covered with it, then unless you want further surgery, they need to go. On the other hand, is your doctor an endo specialist? It is strongly recommended here that if you have endo to have a doctor that specializes in it. they know how to find and get as much as possible. If it is on your ovaries, I would think that is the only surgeon that might be able to excise it and save one or both ovaries.

My doc is an OB/GYN not an endo specialist. He told me that the only way of knowing if I have endometriosis is during the surgery. I had an ultrasound that showed no cysts on my ovaries, but 2 large fibroids and several smaller ones. Is there another way besides surgery to find out if I have endo?

Hi lowatson -

You are young to be having this surgery, and do need to review the pros and cons of this surgery given your condition and age. You can also seek other opinions - there may be other options. Surgical menopause at age 30 may be difficult, and may have health consequences as well.

Please know that having a hysterectomy does not cure endo, and neither does removing the ovaries. You need an expert to remove the disease. Have you been diagnoses with endo, or with fibroids, or both?

Here are articles dealing with this:
Should I Keep My Ovaries or Not if I Have Endometriosis?
Does an Oophorectomy and No Estrogen Cure Endometriosis?
Is a Hysterectomy the Answer for Endometriosis?

Make the decision that is right for you, in consult with your doctor.

I have been diagnosed with fibroids and enlarged uterus. I haven't been diagnosed with endometriosis, my doctor told me the only way to know if you have it is during my hysterectomy. I'm not sure if my symptoms are only from fibroids or if I possibly have endometriosis as well.
Symptoms are heavy/frequent bleeding
Back pain
Extremely bloated, to the point where I feel like something is pushing my ribs out
Fatigue
Bladder issues (hurts/pressure when trying to pee)
Abdominal pain (all the way up to my belly button)

Does any of this line up with endometriosis or could ask of this be caused by fibroids?

So sorry to hear you have to make this decision so young. I don't know if my story will help. You sounded so much like me before surgery, I thought I would share.

I am 48 and had hysterectomy due to what I thought was fibroids only. Prior to surgery, I was hemorrhaging and had been anemic. Every month for as long as I can remember was painful to the point of nausea and vomiting when I was younger, and most recently blinding pain at unexpected times. The doctor told me I'd need a hysterectomy when I was 40, but I thought I could make it to menopause w/o surgery. Um - can we say wrong!

When I knew I had to have hysterectomy, the keep the ovaries/not keep the ovaries thing was a real issue for me. Two female physicians saying keep them (including gyno) and two male surgeons saying get rid of them. Geez, that helped! This site, WedMd and NIH were very helpful to me. I made the decision to get rid of them.

I cannot explain, I just listened to my gut. Sans crystal ball, I really can't say what made me more comfortable with that decision.

Post surgery I found out I had endometriosis and ovarian cysts. Hate to say it, but I did feel validated. At my age I guess the decision was a little easier to make.

I didn't start HRT until my 2wk followup appt with doctor. She gave me a patch and it actually seems to be fine. I've had a few night sweats I'm hoping will go away, but so far so good.

I would say do your research. Ask as many people and physicians as you need to, to help you feel comfortable with your decision. For every argument, there will be a counter-argument. There are no easy answers on this one. I sincerely wish you the best of luck with whatever you decide and hope your recovery is an easy one.

I am 32 and will have my TLH-BSO on Oct 2nd. I am choosing to remove the remaining ovary I have. (I lost the first one because my ovary was the size of a grapefruit and had a dermoid cyst, chocolate cyst and another cyst that I cannot remember what it is called but was filled with a benign fluid that ruptured during laparoscopic surgery in 2004) I had a laparoscopic surgery July 26th 2014 to confirm endometriosis. My exploratory surgery also showed an enlarged globular uterus consistent with adenomyosis (although this won't be confirmed until I get the pathology results after the TLH-BSO), polycystic ovary, and adhesions. Unfortunately for endometriosis, surgery is the only way to confirm the presence of the disease in the body even though there may be a suspicion of the disease through ultrasound (mainly of the ovaries) and MRI findings.

My OBGYN has experience with endometriosis and I trust her judgment. She advised me to remove my remaining ovary because I can receive the hormone treatment through HRT that would provide enough estrogen to counteract the risks of cardiovascular disease and osteoporosis from premature menopause, but not enough to fuel the endometriosis I have in my body. The hope is for me that the endometriosis will die off, but if not, I will have surgery in the future to remove the endometriosis that is remaining after the October 2014 surgery.

I was told that my endometriosis would most likely not be able to be fully removed due to the location of where some of the disease is (such as certain places on my bowel-will have to be done by a different specialist after more testing-and on the peritoneal cavity) and where the disease may not be visible to the naked eye. So I am going into this surgery knowing that it is not a cure for endometriosis, and it may not remove all the pain I have been having. I am hoping for a reduction in pain, increase in quality of life, and of course I don't like bleeding for 20 days a month either.

This is of course one person's journey and I wish you the best of luck in making this difficult decision in conjunction with your doctor/surgeon.

	Quote:
Originally Posted by lowatson I have been diagnosed with fibroids and enlarged uterus. I haven't been diagnosed with endometriosis, my doctor told me the only way to know if you have it is during my hysterectomy. I'm not sure if my symptoms are only from fibroids or if I possibly have endometriosis as well. Symptoms are heavy/frequent bleeding Back pain Extremely bloated, to the point where I feel like something is pushing my ribs out Fatigue Bladder issues (hurts/pressure when trying to pee) Abdominal pain (all the way up to my belly button) Does any of this line up with endometriosis or could ask of this be caused by fibroids?

I have all of that, and don't, per the ultrasounds I've had, have fibroids....