hyst. diagnosis without an ultrasound?

My friend is having a hyst. in July due to a tumor on her uterus. Her periods are not heavy but are almost non-existant. She has constant back pain with pressure that her insides are falling out through her vagina. Her doctor put her on birth control, (she is 39) but has decided she needs a hyst but will not remove her ovaries. My concern is that th dr did not due a Lap or an ultrasound to diagnos this.
Is this normal procedure and should we be concerned. I advised a second opinion.
Please give me your thoughts....
Thank you

I believe whenever there is any uncertainty at all, or even the smallest lack of faith in a doctor, there should be a second opinion.

I thought an ultrasound was standard for determing the need for a hyst, but I could be wrong. Other ladies will surely share their stories and be able to give you more info about that.

Still - I say your friend should seek another opinion. If you're concerned enough to post about it here, then I say go for it. You'll both feel so much better.

And...you're a really good friend to show such care and concern.



HollyG

However, I did not have any fibroids or tumors. Are you sure that is the only reason he recommended the hysterectomy? Is she also suffering from a uterine prolapse? That would give her back pain and that "falling out" feeling.

My prolapse was diagnosed (other than the obvious visual cues ) by an internal exam. The doctor does certain physical tests to determine uterine, bladder, and/or rectal prolapse (the bladder and uterus often prolapse along with the uterus). In my case my bladder was slightly prolapsed, but I passed the incontinence test with flying colors and we opted to have the hyst (since my uterus was "falling out") and a rectal repair, since I WAS having serious symptoms associated with the rectum.

Hope this helps. I think from what you describe that your friend should probably get a second opinion, if she doesn't have 100% confidence that this is the right course of action for her.

I have a bladder prolapse (grade 2 almost falling out), uterine prolapse (also grade 2) and rectocele (grade 1). This was diagnosed through pelvic exam. I did have an ultrasound which showed "tiny" fibroids. I am having the hyst due to the prolaspe not the fibroids. Dr is also going to rebuild the "playpen" so it doesn't prolapse again.

Dede:

An ultrasound is not the way to diagnose prolapse...as you see from the replies here, prolapse is a physical finding on the manual exam.

That being said, I wonder how your friend's doctor knows that there is a "tumor" without ultrasound, CT, or MRI? I would be concerned about the BCPs without some form of biopsy or visualization. A lot of disease processes can create the "feel" of a uterine tumor, some of which are not well-treated by BCPs.

I always think a second opinion is a wise move when hyst is recommended for a lot of reasons. There are choices that a woman often can make, such as retaining the cervix or ovaries, etc. Also, in your friend's case, if there is ANY possibility that this "tumor" is cancerous, she really should have that second opinion with a GYN-oncologist. Should it prove to be "nasty" the oncologist is the best qualified to do whatever surgery may be necessary.

Ultrasound isn't perfect, but could at least define if a mass is present and where it is. MRI and/or CT might also be advised. A laparoscopy would not do much for intrauterine pathology, but hysteroscopy along with biopsy might help define the problem a little more clearly, and give your friend and her doctors a bit more guidance as to what they are dealing with.

Does she have internet access? Please do urge her to register herself here, so she can be supported and read through the wealth of information that is available to her here...

to you for being such a good friend...and to your friend. This has to be such a difficult time for her!

Audrey

I had an ultra sound last fall, they didnt tell me anything was too bad but that I had fibroids.... pain got worse and worse, finaly gen prac, refured me to gyn, who felt the fibroid. My hysterectomy is mostly for pain,dr sais no sence in being in this pain (like labor ) 36 hrs a month, for the next 10-15 years till menopause hits. not to mention the pressure and general discomfort and tiredness. Dr also said its not the size, but the symtoms that can warrent a hys. Im keeping my overies if they are ok, I have a feeling I might loose the right one, as 15 yrs ago I had a uterin suspention for right sided pain, and thats where most my pain is now!!
sorry for rambling!!
hope my experience helps a bit!!
Sheila