New option from my GYN

so i saw my GYN a while back and she suggested a Hyster leaving one ovary... fun times right? I thought it over and decided if a Hyster is the right answer then i'm fine with it. My general Dr. thinks there should be more options on the table and suggested a 2nd opinion. I opted for a 2nd opinion and a 2nd visit with my GYN to talk about the surgery and her reasoning (and more options)

so i talked to her about all my concerns:

Would she take the cervix?
first she said she wants to do a partial hyst but only leave one ovary, take the cervix.
due to my bleeding issues she said it makes more sense to remove it than leave it and run the risk of more bleeding due to residual tissue.

i asked her about non-invasive tests or procedures to see what is going on. she basically said there is no "test" for endo... i get that... and that a CAT, MRI or Ultrasound would only give us ideas of what "might" be going on and symptoms of problems but no definite answers.

i told her my fears for recovery, caring for my daughter and being on my own at 2 weeks post surgery.
she agreed my fears are very valid

i asked her if she could do a lap with the left ovary removed. she said no. due to the fact that the ovary is probably enlarged due to endo (we know its enlarged but don't know why)
she said its too risky to remove it via lap without running the risk of spilling endo fluid back into the cavity and causing more problems.
but what she CAN do is a smaller scope bikini cut, remove any endo, remove the ovary and see what is going on. then close. its a 1 week full recovery so i'd still need help but not 6 weeks worth.
and if she gets in there and its just a huge issue we've agreed that she can convert it to a hysterectomy if its the better option than just band-aiding the situation.

I am still scheduled for a 2nd opinion on Dec 8th but I feel like this is a much better option.

If I am understanding correctly, your doctor thinks you have endometriosis but as of yet you do not have a definite diagnosis? Does your doctor feel that the ovarian cyst might be an endometrioma? What symptoms do you have that has lead your doctor to believe that endometriosis could be a possible diagnosis for you?

Endometriosis is only definitely diagnosed via surgery and is not cured with a hysterectomy or oophorectomy. Thus, I would not consider nor recommend a hysterectomy for an endometriosis diagnosis until there was a definite diagnosis. Even then, I would not have a hysterectomy simply for an endometriosis diagnosis and I would not recommend having it done with a general OB/GYN who did not have exceptional skills and an extensive track record when it comes to treating endometriosis.

I did have my hysterectomy for endometriosis after being diagnosed via a laparoscopy. Because we couldn't stop my bleeding and my uterus was found to be covered in endometriosis, my next step was the hysterectomy. Both the lap and hysterectomy were done by my local OB/GYN, an excellent surgeon.

However, as with most OB/GYNs, he used a coagulation method to remove the endometriosis. Unfortunately, this method can leave endometriosis behind and is not safe to use on all areas. So, if endometriosis exists on the bowels, as it did for me, coagulation cannot be used to remove that endometriosis.

Consequently, I continued to live with endometriosis issues for several years until I finally made my way to an endometriosis specialist for excision surgery.

Before you make your final decision, consider your surgeon's ability to remove endometriosis. Any of it that remains can continue to cause issues whether or not you have a hysterectomy. The key for treating endometriosis is the complete removal of the actual endometriosis implants. Unfortunately, that isn't as easy as it sounds and many doctors do not possess skills necessary to offer optimal success rates.

Also keep in mind that a hysterectomy is a major, irreversible surgery with plenty of side effects. Besides the continued endo issues, I was also one who had surgical complications from the hysterectomy. I had a very long recovery and my health was compromised for several years.

I think you are wise to consider a lap rather than a hysterectomy and I also commend you for scheduling a second opinion. If endometriosis is on the table, I would highly recommend an endometriosis specialist in order to obtain the best outcome.

Everything you have said is definitely something that has been on my mind.

Thankfully my GYN specializes in Endo and she's been treating my sister for more than 10 years now.

None of the ultrasounds that I have had showed any indication of the ovary cysts being caused by endo. I know she is concluding that the pain I have in my ovaries are caused by cysts but inflamed due to Endo which makes sense due to the irregular bleeding.

Unfortunately my ovaries are cystic but not PCOS. Just very painful. Her suggestion for a hyst is not just to treat endo but to treat the irregular bleeding and severe pain in my cervix before and after menses (it makes me stop and unable to function till it passes, literally takes my breath away). All paps have come back clear and i've never had any other "positive" indication of any other problems. Just a very severe history of Endo and Cystic ovaries in my family.

I'm really happy i'm seeing a 2nd opinion, and very interested in what he has to bring to the table.