What would allow me to keep cervix?

I am new to this. Do I have the option of asking my doctor to leave the cervix? My issue is in my ovaries and I was quite surprised when he said he was going to remove my uterus. My regular ob/gyn said removing my uterus was not an option but the gyn/onc he referred me to said that removing my uterus would definately be part of it. I was also quite shocked
when I was told that draining the cysts or taking pieces thru bx were not an option for fear of spillage. I have not been dx with anything, except complex bilateral ovarian cysts. My left has a solid mass with papillary projections that they fear may be malignant. The right they hope to resect because it measures 7.7cm with debris. Can anyone offer some insight? I appreciate everyone's comments.

Hi Xrayu,

I can suggest you get a 3rd opinion. It sounds like your two Drs. have very ~different~ views on how to proceed. I am not a Dr. and if nothing is involved with your uterus, why remove it?? I think the more opinions you get the better it will help you with your decision.

A co-worker of mine had a laparoscopic surgery on her ovary only. She had her ovary removed since they found a growth. And, her uterus was not removed.

I can suggest you check out the ~ovaries only~ forum area, if you have not already. Some great ladies over there that may be able to help you with your question.

http://www.hystersisters.com/vb2/forumdisplay.php?f=218

On your cervix question, I was a good candidate to keep my cervix since I had had normal pap smears for years and I had a sturdy cervix.

Best wishes,

Mary

If you do have a malignancy, they need to remove everything, including the omentum (fatty lining of the intestines) and sample some lymph nodes. Otherwise, there could be potential recurrence sites, and that's not a risk you want to take. Also, it's often the case, when complex cysts are present, that they are adhered in some way to the uterus and it all must be removed as a block to avoid spillage (which was true for me).

You're in good hands with the GYN-oncologist, but it might be worth your while to ask for a second opinion with another oncologist if you can. Just the visit doesn't cost that much, if the doctor is out of your network, and for peace of mind (since it sounds like you've been given conflicting advice) it would be worth it.

Also, I was able to keep my cervix, since I'd always had normal Pap smears. However, I developed dysplasia and pre-cancerous conditions afterward, and now must maintain close follow-up visits. It also didn't keep me from developing some intestinal prolapse and rectocele . I still do not regret my decision. My surgery was done by a GYN-oncologist who did it also for a giant, complex cyst that was presumed to be cancerous (it was an endometrioma).

Hope this helps. This decision-making is always painful, isn't it? But you need to have trust in your GYN-oncologist, for if your problem turns out to be malignancy, you'll be working with this person for a long time to come. If you're not happy with this doctor, perhaps another one in the same group or within your hospital community might be the way to go??



Audrey

Thank you for your reply. I like my gyn/onc-I have only seen him on the consult and will see him again a week before my surgery for pre-op. My ob/gyn first said Endo,but all talk of that went away after my first u/s was done. The second u/s made every think malignancy because of the characteristics of the solid area inside my left ovarian cyst. Was endo a topic of conversation before they found your cyst? Again, thanks for the info.

I did have a significant history of endo, and so my elevated CA-125 (200) wasn't much of a surprise -- in fact, the only surprise, in the end, was that it wasn't higher, as I had stage IV endo ("the worse I've ever seen," in the words of the GYN-oncology fellow who assisted at my surgery). If you have endo, you may also have adeno, and in that case, removing the uterus might be the best option for you.

Apparently, you can still get endometrial cancer after surgery for endo, since bits of endometrium continue to exist and can continue to be fed by HRT, if you take unopposed estrogen. My doctor kept me (by my wishes) off estrogen for a period of some months; however, I took -- and continue to take -- Prometrium, a bio-identical form of progesterone.

BTW, endo can also cause extensive adhesions and extra vascularity in the pelvis, which again can necessitate taking the uterus as part of what promises to be an extensive surgery in your case. I don't remember, have you had a CA-125? It's not a good marker for everyone, but it is a starting place. Certainly I understand your nervousness about "papillary projections" on a complex cyst!

Keep posting; I see you've been over in Cancer concerns as well. There's so much shared experience there, there's almost no question that someone can't help and support you with!



Audrey

No, I have not had CA-125, the gyn/onc said he only uses it in women my age after there has been a malignancy found. That gives him a starting point on how to monitor individual levels. Had I been postmenopausal or even perimenopausal he would have done the test to see. My uterus on u/s has no abnormal thickening, does not feel enlarged on exam and I do not have abnormal bleeding. Thank you for your help-this website is great! The women have so much knowledge and knowing more keeps me sane .