pos and cons

hi everyone, hope you all are doing well. i am going to start my list of pros and cons to having a TH. i would like as much input as possible from the ones who have been there. if anyone has their own list or info. it would be greatly appreciated.

i will be having a cyst (fibroid or teratoma) removed in two weeks from my ovary. doc figures he will have to take the ovary because of size of cyst. that will leave me with no ovaries. he also said he would take everything if i want him to, even though uterous and cervix look fine.

thanks to everyone and take care

fortmacdog

I had a TAH-BSO on 8/23 due to adenomyosis, fibroids, complex ovarian cyst. Having a hysterectomy is a major surgery with a long recovery period and potential serious complications. If you are not having any problems with your uterus or cervix, I'm not sure what would be the reason for going through a total hysterectomy. From what I have heard, having an ovary removed is a much easier procedure with about a 2 weeks of recovery. (My surgeon had said that was an option but didn't recommend it because of my heavy bleeding which turned out to be from adenomyosis.)

Debbi

Hi,

If your cervix and uterus are healthy organs why remove them? How about your family history? Any cervical or uterine cancer? Sometimes, close family ties with cancer (or not) can help you to make the decission.

If it were me, and all tests proved my cervix and uterus was healthy, I'd keep them.

On the other hand...if he did the lap and saw extensive endo and adhesions around the uterus, I'd have a back up plan to remove it too. You'll most likely be on HRT for years, and the endo could continue to grow. However, I'd hang on to the cervix as long as I could.

Because sometimes the doctor doesn't know exactly what he'll find, it might be good to have a back up plan...option number 2 and be mentally prepared for it.

I had it all removed and I'm very, very, very happy, but my case of different from yours.
Best wishes,
Maralyn

If your uterus and cervix are normal, why would you consider having them removed? Did your doc really say he would even though there is nothing wrong?
In my opinion, I would leave well enough alone! If given that option, I am sure most of us here would have just had the ovary removed.

Assuming you have not yet gone thru menopause and will be replacing your lost estrogen and possibly testosterone.

If you keep your uterus you will have to take progesterone with the estrogen to maintain some shedding of the lining. If you don't your risk for endometrial cancer will be very high.

No uterus means no progesterone with the estrogen. Makes replacement a bit easier.

Hysterectomy increases the risks of surgery. Approx. 2/100 will suffer damage to bladder or ureter. Doesn't sound like a lot untill you become one of them. These injuries can result in chronic-permanant changes affecting quality of life. Read the risks carefully (and discuss with your doctor) when you make your decision. These risks are listed because someone has suffered each and every one of them. If you are not having any problems why would you want to take on any extra risks?

Read the Bladder Matters and Road Less Traveled forums here to get a feel for how a persons life has been affected.

?? effect on sexual response. Uterus does not trigger climax but is part of the response. Some women miss this -others don't. If you are not aware of it now it may not be a factor for you.

There are many studies that list hysterectomy (removal of uterus )as a risk factor for incontinence later in life. Thought to be related to loss of nerves????? Who knows?

Cervix is loaded with nerves and is very vascular. Some feel it offers pelvic support and enhances sexual response. Both of these make some sense to me. Why not? Cervical cancer may be more common than ovarian cancer but it is also far easier to diagnosis and treat. It is considered to be curable in the earlier stages. The same goes for endometrial cancer. Both are diagnosable in the earlier stages with inexpensive test and regular exams.

The American College of Surgeons recommends against prophylactic hysterectomy for cancer stating that the risks outweighs the benefits. I don't know if the American College of Obst. and Gyne. has a similiar policy. I doubt it-for a variety of reasons. Might be a good one to ask your doctor about. How does the pathology report of the cyst affect this decison might be a better question in your case. Did you get a second opinion on best way to remove the cyst?

Will you be having this done laprascopically or abdominally? Is the doctor willing to leave your ovary if cyst looks benign and ovary looks ok. How large is the cyst? Is it attached to the ovary? Mine was thought to be on ultrasound, but turned out it was not. We wondered after the fact if it could not have been looked at laprascopically prior to the surgery? Would have saved me the ordeal I ended up going through.

yes, my gyn said he would remove everything if i wanted. he also said he would try to save the cyst if he could and leave everything else alone. i do have heavy bleeding and large clots for a couple of days with my period, and also hemorraged, to the point of transfusion, with all three of my kids. my gp is encouraging my to have TH because it eliminates future problems as well as cancer, and hrt can be less complicated.

my cyst is approx. 3cm x 4cm, if i remeber correctly. i had an ultrasound and an mri. i can have either lapro surgery or abdominal, as well as regular anesthetic or epidural. i don't think they will do lapro if i want an epidural, not sure?? the cyst is on the inside of the ovary. my last ovary was removed because of fibroid when i was 16. there is no history, that i know of, in the family of cancer, but i did have an abnormal pap after i had my first child at age of 22. i had a biopsy done and everything was clear.

i am leaning towards "less is better", but want to make my decision on as much info as possible. i was the one that asked for hysterectomy, but am now rethinking.

sooo many decisions. any more input would be greatly appreciated.

thanks a bunch
fortmacdog

Hi fortmacdog I've moved your post over here to the Hysterectomy Options and Alternatives board, which is the place to post questions if you're not yet scheduled for a hysterectomy and still trying to decide.

Just my ... as someone who's had a boatload of troubles since her (necessary) hyst 3 years ago... I'd avoid it as long as possible. Some women do just fine and have no problems at all afterwards, but there are quite a few of us around here who turned out to be one of the "rare" ones who didn't do so well... and to us, it doesn't matter what the odds were, for us they were 100%. Why take the chance if you don't have to?

Good luck with your decision.
s,
-Linda

thanks for the reply linda. i am leaning toward keeping what isn't broke. my biggest fear is having more problems with uterous after ovary is removed. i want to make sure i make a decision based on as much info as i can get. this site is very good for that. i am scheduled to have cyst and ovary removed on feb 22, so i am feeling the pressure and getting a little anxious. hope you are doing better.

take care
diana

Hi diana. I had a dermoid (mature teratoma) that measured 3cmx3.5cm removed three weeks ago. I was worried that they might have to take the whole ovary and more, as my surgical schedule said, "laparoscopy with possible laparotomy," "possible salpingo/oophorectomy,"with"and other indicated procedures" thrown in at the end. My doctor was pretty sure they would have to take the whole ovary, but I reiterated 3 times that I wanted her to try to save it. My situation was a little different in that I still had both ovaries. She wanted to take the whole thing out because I still had one healthy ovary, and I think maybe the surgery is easier if they just take it all out (and fertility is not an issue for me as I am done having kids), rather than having to cut around the tumor and save the ovary. My reasoning for her was that I was worried that if something went wrong with the other ovary, I would be down to none.

In the end, she was able to save about half of the ovary. My other ovary was enlarged, but everything else looked pretty healthy, so I was able to keep it. I do have a history of cervical dysplasia and carcinoma in situ of the cervix, so who knows what the future will hold.

Recovery from laparoscopy was not too bad. I was pretty sore from the gas they pump in to separate the organs, and I did get a bladder infection from the catheter they used during surgery. My belly button scar is still a little sensitive, but the other smaller incision holes healed very nicely. I felt better at around 4 days, back to completely normal within a week and a half to two. I thought recovery would be quicker, but I guess everyone is different. I think my recovery may have been prolonged by the bladder infection.

Keep doing your research! Best of luck!
betsy

hi betsy, thanks for the reply. hope you are doing well. i am considering trying to keep the ovary, but my fear of having to go back in for more surgery is huge. i haven't always done well under anesthesia and am considering epidural. how long before you knew if teratoma was mature or not?

take care
diana