Help! Partial Hys vs. 5th LEEP/Cone

Hi, I'm 28 yrs old. I had my first abnormal pap 7 yrs ago. Severe Cervical Dysplasia. I had 4 LEEP/Cone procedures done in a period of 3 yrs. Now, 4 yrs later, it's back again. I've had a colpo/biopsy and an ultrasound and now I have to decide between a 5th LEEP/Cone or a partial hysterectomy. The ultrasound showed that there's enough of my cervix left to do one more LEEP/Cone procedure, but it's a guarantee that if it comes back again the only option will be a partial hysterectomy. I don't know what to do, I partly feel like having one more procedure is just prolonging the inevitable, this is the 3rd time now that it's come back (just to be clear, I haven't been out sleeping around, contracting HPV, I've been married to the same man for 7 yrs and neither of us have been with anyone else) It is possible that I could have one last procedure and it would never come back again, but my dr and the 2nd opinion dr both said there's a very good chance that it could come back. I am fortunate to have an excellent gyn-onc, who I very much trust, but he's left the decision up to me, for one reason...we don't have any kids. When I asked him what his professional medical opinion would be if we had a couple of kids, he said, without any hesitation, in fact he somewhat cut me off, "I'd be advocating for the partial hysterectomy". So, I'm confused. I don't know what to do, here's why...my husband and I made a decision yrs ago, to not have children of our own. After the 4th LEEP/Cone procedure my cervix was not in the best of shape for me to carry a child, the risk of miscarriage is very high, I know there are ways to decrease the risk, I can have my cervix tied and I'd most likely be on bed rest for my last trimester if not longer and many women like me carry almost to term that way. But there's another huge factor in our decision not to have our own kids...I'm manic-depressive. I've been able to keep things in control (as much as possible) with medication for awhile now. If I were to get pregnant I would have to go off of all my medication. That is not an option. Especially b/c I would be very prone to severe post pardum depression. It was not an easy decision to make, to not have kids, but all things considered, it is the best decision for us. For awhile we thought we would just adopt, but about 6 months ago God put a little thought in my head (yes, I'm sure it was Him, he's the only one capable of creating miracles) I have perfectly good eggs and my husband has perfectly good sperm and I have 3 sisters! So I asked my older sister if she would carry our baby for us and without hesitation she said absolutely! Word travels fast in my family, so by the next day my younger sister called me and said she'd carry a baby for us too. So there you go, we now can have at least one, maybe even 2 kids of our very own! And all of this occurred 6 months ago, before this cervical stuff came back. My dr is concerned that I might regret having the hysterectomy if I change my mind about having kids, but at the same time he told me that after a 5th LEEP/Cone it will be very difficult to be able to carry a baby to term, but he says he thinks it's possible. This may sound harsh and I DO NOT mean to offend anyone, but it's just not an issue for me. I have no problem with not being able to carry and give birth to my baby. There's too much at risk. Just going off my meds alone is a HUGE risk. I realize that I do at least have a chance to be able to have a baby, and that a lot of women here are grieving tremendously over the fact that they don't even have that chance, I'm not discounting that in any way. I just need whoever's reading this to try and take into account everything I've said and understand that the decision we made to not have kids was not easy, at all. And I've been okay with that decision for a long time now and it's recently been reinforced by my sisters generous offers. So I'm asking for help b/c I don't know what I should do. When I think about why I should go through with the partial hysterectomy now, as opposed to waiting to see if it comes back, I actually think about having kids. If it came back within the next couple of years, no problem, but 4-5 yrs or longer from now and it comes back, we will have at least one child by then. Right now and for the next couple of years it's just me and my husband, I don't work, if I had the hysterectomy now my husband only has to worry about taking care of me, 4-5 yrs from now it would be hell for him trying to take care of me and a baby or toddler all by himself. I'd feel horrible knowing that I could have prevented that. And I don't just mean post-op care, my dr told me there is a risk, depending on how my ovaries fair, that the hysterectomy could cause hormonal changes in my body that would definitely cause a shift in the balance of the meds I'm on. It took me years to find the right medications and the right doses to balance me enough to be able to function and have a somewhat normal life. How would my poor husband be able to handle working, taking care of a baby and taking care of his crazy wife all by himself?! It would be so much better to handle something like this when it's just the two of us. My dr doesn't want me to regret giving up my chance to have a baby, but I don't want to regret choosing to wait. My husband is perfectly fine with whatever decision I make, he is extremely supportive in every possible way and we see the pros and cons of both options the same way. When I think about why I should go the conservative route and have one last LEEP/Cone I think about all the bad stuff I've heard and read about having a hysterectomy. It sounds very painful and very uncomfortable and I've heard there can be a lot of complications with hormonal problems and ovarian failure and the bladder dropping and organs shifting and pelvic structure, etc, especially in young women, I'm 28. I know I've said a lot here, I'm looking for some honest advice and information and I felt in order to get that I needed to just "lay it all out there", so I did. Any and all responses are much appreciated. Thanks.

Hi Garner,

What a heartfelt post.

I think you touched upon one of the most difficult aspects of being a Hyster Sister.

~Deciding what to do~.

To have a procedure or to have a hyst. It is a VERY big decision and we Hyster Sisters are here to help if we can.

Sending best wishes~

Mary

The decision to have a hyst is a big one. It is a major, irreversible surgery that can affect us in many ways. And a hyst is not a complication free surgery. As with any major surgery, things can go wrong. We have women on the site very pleased with how well their hyst went, and we have women on the site who regret it with every fiber in their being and the complications they have are life long and never ending. So, you are not alone in trying to decide what is best and right for you. It is hard. If you could look into the future and see your hyst went off without a hitch and you never had another problem because of it, the decision would be more simple. But we can't look into the future.

Have you had a second opinion with another doctor about what might be best for you? It is wise to seek a second medical opinion, no matter how great your own doctor is, before consenting to a major surgery.

And to clarify, by partial hyst are you actually meaning your ovaries will be left behind? A partical or supracervical hyst actually means the cervix is left and only the top portion of the uterus is removed. A complete hyst is when the entire uterus with cervix is removed. Having your ovaries and tubes removed is a seperate surgery called a bilateral salpingo oophorectomy. If you retain your ovaries then you should have the hormones you need, but some women do find that their ovaries do fail after a hyst. Thus, if you are considering surrogacy, you would need to check into having your eggs harvested prior to a hyst in case your ovaries would fail.

I wish you the very best and you decide what is right for you and your situation. Know you are not alone in having to make such a tough choice and the ladies here on the site will support you as much as possible!

s

Hello Garner...Welcome! After reading your post, I can see why you are so torn in your decision...My heart goes out to you...It sounds like you have a wonderful husband that supports you, which is the number one thing you need...I think the first step in making any big decision is to weigh all of your possibilities...It sounds like you are already doing this...I know the importance of finding the right meds to treat your depression, my mother has struggled with depression and anixety issues for as long as I can remember...And she did have to change her meds when she started going through menapouse...The most important thing is to keep yourself healthy mentally and physically...You cannot take care of others if you are not well...It sounds as if your sisters are of wonderful support as well...I think it is great that they would carry a child for you!! Do they live close? If you were to have your hysterectomy do you have others to help you recover so your husband can work? A hysterectomy, as you know, is major surgery, but it sounds as if you have tried all other possibilities...Before you make your decision, just make sure that you know its the right thing for you...It sounds like you have many "angels" looking out for you...And you always have us for support if you need to vent...I will keep you in my prayers as you go through this journey...Whether you decide to do the leep to gain some extra time before you have your hysterectomy or just go through with the surgery, please remember to take care of yourself...