TAH vs. LAVH

I go for my pre-op today, and my DH and I were talking last night and my Dr. wants to do a TAH, and we would rather have a LAVH because of the scarring left from a TAH. Did anyone have a choice as to how they wanted this done? Does anyone think that my Dr. will give me a choice? If not, how long is the scar from a TAH?

Thanks everyone!!!

Trina

i did not have a choice my uterus was to large for anything but a TAV. my scar is 7 - 8 inches right above the hair line. after 4 months it is still a little pink but in time i don't think it will be noticable
jane321

Trina,
One factor in whether someone has an abdominal or vaginal hysterectomy is whether or not the doctor has been trained to do it, and whether or not s/he is comfortable doing it. Some doctors ONLY do abdominal hysterectomies and, in that case, you have the choice of having an abdominal surgery OR switching to a different doctor. . . . But there are also other factors which enter in. Sometimes the uterus is too large, sometimes endometriosis or other conditions make a vaginal surgery impossible, etc. Unless this is an "emergency" hysterectomy, you might want to talk with your doctor about why s/he wants to do an abdominal surgery. I think that the recovery from a vaginal hysterectomy is usually easier than for an abdominal surgery, but sometimes an abdominal surgery is the only way it is possible. Good luck !

Barbara

As Barbara said there are a lot of reasons for having a TAH rather than any other kind of surgery for your hysterectomy.

The doctor decides what is best for you in terms of what your situation is, the risks, and the doctor's experience/training.

I wanted to have a LAVH or at least a vaginal hyst also, but my uterus was too large and the dr did not think it would work.
I trusted him to do what was best for me medically.

My scar is right at the hair line, and is practically invisible - even right after surgery it was not very obvious.

By all means ask more questions about your options, but to be honest, I would not insist on one type of hyst if my doctor really had good reasons for another choice and explained them so that I could see his point.

If you are not happy with what your dr is saying, by all means get another opinion - or find a dr who has more experience with the type of surgery you'd like and see if you qualify for it.

best wishes

HI Trina,

I got two opinions. My 1st Dr. reommended a TAH due to the size of my fibroids. She said I was not a candidate for a laparoscopic surgery. In my heart, I decided I needed to talk to another Dr. My 2nd Dr. recommended a LSH after I did (3) months of lupron shots to shrink my fibroids enough for the less evasive hyst.

The difference in the Drs?? I agree about medical training. Laparoscopic surgery is fairly new and a lot of Drs are not trained in the procedure. My 1st Dr. was more "old school" and I found out later she did not recommend laparoscopic hysts. My 2nd Dr. ( my present Dr. ) is younger and trained in lap procedures.

And, a patient's medical history is included. Some ladies are candidates for certain hysts and some aren't.

Your Dr. might due both a TAH and a LAVH. If not, I can suggest getting a 2nd or 3rd opinion. It helped me gather information so I could make a good choice for myself.

Best wishes,

Mary

Hi (((Trina)))

As the others have pointed out, there can be a variety of reasons as to why your doctor is opting for a TAH over other hyst procedures. Some of those do include the doctor's ability to perform other types of hysts, the condition that is leading you to a hyst and the size of your uterus. It certainly pays to ask as I know only too well: originally, my doctor had a TAH due to the size of my uterus. However, after I enquired about the possibility of TVH, he reviewed my case and ended up attempting a TVH, because I'd successfully delievered two relatively large babies: he was successful

One thing I wanted to point out is that there is an increased risk of hemmorrhagic bleeding with a TVH. In fact, I ended up loosing so much blood that I becaming anemic after my hyst and almost ended up needing a transfusion!!! I would think that with a veinous uterus there would be an already high risk of uncontrolled bleeding and might explain why your doctor is recommending a TAH.

That's why it's important to be informed and to look at all the issues involved when going into this surgery

i had huge fibroids, so had to do a tah. my doc said his skill was good enough for a bikini cut (most docs required a vertical incision for a 17 to 20 week uterus), a little more difficult for him but do-able. I have a 10 inch bikini cut. you can just barely see it, it is so thin and fine, he and his intern did plastic surgery stitches to close, very fine and internal. scar will vary from person to person and surgeon to surgeon. if you tend to keloid you can try 5-fu or radiation. if that is important to you, you may want to shop around for surgeons. safety was my primary concern ( a small scar was a nice secondary option)