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size of uterus or fibroids requiring abdominal hysterectomy? size of uterus or fibroids requiring abdominal hysterectomy?

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Unread 01-23-2011, 01:15 PM
size of uterus or fibroids requiring abdominal hysterectomy?

I know I need to have a hysterectomy after the discovery of 5 fibroids. 2 are 5cm and the other 3 are 3-4cm. I was told by my regular gyn that I would need an abdominal hysterectomy because of their size. I have been looking for a general maximum size of fibroids or uterus that indicates laparoscopic surgery is possible. When I saw my urogyn, she was not able to adress my questions beacuse the gyn had not sent the reports from my pelvic ultrasound-- I will be going back for urodynamics (yipee) in a few weeks, and I will discuss it with her then, but I was just curious if anyone knew of a guideline. I will be a&p pelvic repairs as well. I have a history of appendectomy & a bowel resection from adhesions, so I'm pretty concerned about the surgery....
Thoughts anyone??

Best wishes to you all!
Unread 01-23-2011, 01:21 PM
Re: size of uterus or fibroids requiring abdominal hysterectomy?

My largest fibroid was the size of a grapefruit and I had laproscopic surgery and the uterus was pulled out through the vagina (forget the name of the procedure). I will warn you, though, my fibroid blocked the DR's view of the uterine artery, due to its location and size. He couldn't get the artery caterized and I bled out. I was 3 minutes away from him moving into abdominal surgery so he could stop the bleeding. The heavy blood loss prolonged my recovery. I still feel fatigue 3 weeks out, but it's not horrible. I'm just so thankful I didn't end up with abdominal surgery.
They can try to shrink the fibroids with Lupron shots. It did not work on me, but it works most of the time.

Hope this helps,
Unread 01-23-2011, 02:40 PM
Re: size of uterus or fibroids requiring abdominal hysterectomy?

My fibroids were shrunk with Lupron injections. My LAVH was this past Friday. I'll have exact measurements after my post-op, but the fibroid that was on the outside was the size of a typical uterus and my uterus, which had fibroids in the walls, was 3x the size of a typical uterus. Thankfully everything was healthy and the fibroid hadn't attached itself to anything else.

Everyone's body is different and every Dr. is different in what they feel safe doing.
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Unread 01-23-2011, 03:15 PM
Re: size of uterus or fibroids requiring abdominal hysterectomy?

Wow. Thanks for sharing. how are you both feeling? I know I will have to just wait for my consult to find out what she believes is the best procedure for me, but I like hearing about what others have experienced. it has been almost 30 years since my bowel resection, and it was a difficult recovery for me then! I really like the idea of her being able to see any and everything that they will need to so nothing is left undone- adhesions wise. I would rather have one difficult procedure, than face the potential for more surgeries if they miss something.
thanks again for sharing, sisters!
Unread 01-23-2011, 09:42 PM
Re: size of uterus or fibroids requiring abdominal hysterectomy?


You are wise to seek out answers to your questions. If you prefer to have a minimally invasive procedure, you should get a second or third opinion.

My fibroid uterus was the size of a 24 week pregnancy and I was able to have a LSH, laparoscopic supracervical hyster. Four tiny incisions. Size isn't the only factor in the type of surgery you can have. Previous surgeries which could have caused adhesions or the need for additional procedures may be limiting factors. Laparoscopic procedures don't compromise the ability to see well enough to get everything done. The doctor's skill and experience doing laparoscopic surgeries is a big factor, not all docs do them. Sometimes the only reason a TAH is offered is its the only way the doc knows how to do a hyster.

Its a good idea to talk to someone skilled at the type of procedure you want. I hope you get all your questions answered and are comfortable with your decisions.

Unread 01-24-2011, 04:35 AM
Re: size of uterus or fibroids requiring abdominal hysterectomy?

I had a hysterectomy 10 years ago. My larhest fiberoid was the size of a football. I also had 3 others the size of grapefruits and 2 the size of lemons. I had to have my hysterectomy via an insision through my abdomen as they were so big. I looked like i was 6-7 months pregnant as my womb was so big.

I recovered well and had 12 weeks off work. Unfortunately my scar is a large one and goes from hip to hip!
Unread 01-24-2011, 04:52 AM
Re: size of uterus or fibroids requiring abdominal hysterectomy?

Hi ccd,
Like you, my fibroid specialist gyn told me my uterus (size of a 20 week pregnancy) was too large for him to do laproscopically. I asked him about DaVinci surgery and he suggested I see a surgeon experienced in that. So I cancelled my SAH which I was due to have today, and I've booked an appointment with a Dr with some DaVinci gyn experience (not that common I'm Australia yet). I'm also going to see a urodynamics Prof. to see if my stress incontinence can be addressed at the same time. When I had my first appointment with the fibroid gyn I was so distressed by the heavy bleeding that I was willing to do anything to have it stop ASAP, but thankfully it abated sufficiently over Christmas that I was more prepared to think it through and look at the options before rushing in. I'm hoping that I can either a) find a Dr who is able to remove it laproscopically or robotically, or b) if it has to be done abdominally, then find someone who'll co-operate with a plastic surgeon so I can have a tummy tuck at the same time and get some more mileage out of that scar!
Unread 01-24-2011, 11:25 AM
Re: size of uterus or fibroids requiring abdominal hysterectomy?

Oh how I wish I could afford to do a tummy tuck with my surgery! Good for you! I hope you get all the answers you need, with the best possible outcome. Keep us posted on your progress!
Unread 01-24-2011, 02:09 PM
Re: size of uterus or fibroids requiring abdominal hysterectomy?

How effective is a tummy tuck being done at the same time if your belly is so swollen from the gas they pump in?
Unread 01-24-2011, 10:27 PM
Re: size of uterus or fibroids requiring abdominal hysterectomy?

I will be having an LSH done next Monday. My uterus is the size of a 16 wk pregnancy and the fibroid is the size of a large orange. Everything else (except right ovary- unknown because they couldn't see it due to fibroid blocking view) looks good and healthy so at this time my Dr feels he can easily do a lapro.

Good luck to you!


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