Are you concerned about making the right decision?

I totally get what you are going through. I am 33 and have pretty severe endo... so theoretically i could do laps etc but given my history etc my Dr (who is FABulous) thought this was a better long term option. She said in her expereince women with as severe a condition as I have will get a few years of relief with a lap but then the endo usually comes back and I would end up in same boat in about 5 years... So why not just get it done. I could also do Lupron (my 2nd opinion thought this was better option) but after doing research there is NO WAY I am goign to try that - my Dr agreed with my history of reactiosn to hormones.... I know a hyst isn't a "cure" for endo, it may come back but my Dr's experience and track record with endo is excellent...

My mom was really nervous about me getting such an extreme treament but the more we discussed it the more she saw the positve side and now is fully on board.

Am I nervous? Absolutly but no more visits from Flo is a HUGE bonus!!!! If soem endo does come back we'll deal with it but my Dr has a very low % of this happening so why not??!!!

Your posts are so comforting! I am going back and forth about this being right. What is a vaginal cuff? And what makes the decision to keep the cervix or not?
"A sub total hyst is easier for the surgeon". My doc does the TAH. Would the sub total be less then? What's the difference? And how do adhesions affect the recovery? Is it much worse? Anyone know?

I am going to pre-op today and have my trip scheduled for Monday. I have, at times, had thoughts that perhaps it wasn't bad enough for surgery, perhaps I was pushing things, etc.

When my period came a week early and the pain was so bad along with the clotting it was like a reassurance that I had made the right decision.

Lesley

After all the options were explained, I opted for hysterectomy, which will be done in 1/07. I have 3 fibroids, 2 med. size and 1 very large one. I have tried birth control pills and have 2 courses of Lupron, with no help. Fibroids acutally grew and heavy bleeding is worse! I am terrified of an embolization and I have the fear that the fibroids can return. I am 46, have a great husband, 21 yo daughter and 17 yo son...I have no plans for more children! So, the hysterectomy is for me. I have to think long and hard on it, but due to the restrictions of not being able to leave my house for 2 days a month, it is the best choice.

A sub total is less surgery as the cervix is left behind. 100 years ago they didn't remove the cervix because they hadn't worked out how to do it. The less you remove the less invasisve and simpler the surgery is although a sub total is still major surgery. Now obviously keeping the cervix is not an option for everyone so if you need it removed then nowdays that is not a problem for the surgeons at all. TAH is now the standard procedure. If you can keep the cervix then the surgeon dose not have to reattach the various ligaments that are attached to the cervix to the end of the vagina and he does not have to create the vaginal cuff. The cervix supports the end of the vagina and is a buffer. If it is removed then the end of the vagina needs to be closed off carefully. All gynecology surgeons are capable of performing either surgery and will often leave the decision to the women if there is not an overiding medical reason to opt for a particular procedure. Most surgeons have their own particular preference and will sometimes try and persuade you one way or the other but if their is no medical reason to remove it then you should do your own research thoroughly before you make your own decision.

Powerful arguments for removing the cervix are endometriosis, cancer history or abnormal paps and prolapse. Each woman is different and you should make the decision based on your own medical condition and history.

My personal opinion is that we should give equal consideration to the decision to remove the uterus, cervix and ovaries as there are long term implications for each of them and you can't change your mind after they have been removed. Also medical opinion keeps changing on this but you have to live with the surgery you have.

50questions,

Sorry I meant to point out that a total hysterectomy removes the uterus and cervix and a sub total removes the uterus only and leaves the cervix behind. As the cervix forms the end of the vagina then removing it means you have to sew the end of the vagina up. This is often referred to as the vaginal cuff. The uterus is like an upside down pear. The bulbous part is the uterus and the thin neck is the cervix. In a subtotla they will remove the bulbous part and also part of the neck to ensure that no uterine tissue is left behind. It can be difficult to determine exactly where the uterus ends and the cervix begins which is one reason why they don't like doing a subtotal in women with endo as there is a risk that some uterine tissue will be left behind.

To let you know what I know about adhesions - these will inevitably form with any abdominal surgery. Generally they will not cause a problem and they are usually mainly formed in the first few days after surgery. Severe adhesions can cause problems if they join organs together or cause an obstruction. Even an appendectomy will cause some adhesions as will pelvic infections. Adhesions are often more of a problem for the surgeon in subsequent surgries than they will be for you.

Now I am not a doctor and this information is the result of many months of research I did prior to my own hysterectomy. You should discuss any worries with your doctor and if you are not convinced by what he says then seek another opinion. One thing that came out of my research is that you should always have at least two medical opinions before having surgery.