I am glad you have found the site and I hope you are finding the information and support helpful!
I cannot tell you whether or not you should have a hysterectomy, but I do want to reiterate that it is not a cure for endometriosis and it is not a risk free surgery. And with endometriosis in the picture, a hysterectomy isn't necessarily a final surgery. I and many others have required surgery for endometriosis after our hysterectomies.
Endometriosis doesn't really care if you have a uterus or not. It can be quite content to flourish and spread, reproductive organs or not! Instead, the key for treating endometriosis is the skillful excision of the actual implants themselves, not the removal of our reproductive organs. Granted, if there are symptoms and health issues involving the uterus and ovaries, it can make sense to remove them. But removing them because of an endometriosis diagnosis may have no effect on overall symptoms caused by the implants themselves.
I would strongly recommend looking for a doctor who specializes in treating endometriosis, especially with the extensiveness of your situation. You may also want a urologist involved to be sure the ureter is not damaged. In some cases, a urologist will place stents prior to surgery for this purpose and can be in the OR to help.
As far as your UTI's. Have you had a urinalysis every time you have been diagnosed with one? Has infection shown up with each UA? I ask because many women with endometriosis are also being diagnosed with Interstitial Cystitis (IC). IC can feel like a UTI but there is no infection so the antibiotics are ineffective and a flare may clear up on its own rather than an antibiotic finally helping. Using antibiotics frequently can compromise your health and could be a contributing factor for your fatigue.
The hormone side of the story is a serious one. Estrogen can be an essential part of our overall health. Finding the right HRT balance can be very difficult and confusing, especially with endometriosis in the picture! Too much estrogen could fuel any remaining implants. Too little could cause too many menopause symptoms. To further complicate the picture, endometriosis can create its own supply of estrogen messing up the whole picture. And keep in mind, while a steady dose of HRT sounds nice, it might not be practical. Our bodies don't necessarily require the exact same amount of hormones every day. A stressful day can require more estrogen. A day playing with your DD and exerting yourself on her behalf can require more estrogen. But with HRT, you can't adjust accordingly as your ovaries automatically did.
No ovaries and no hormones does not equal no endometriosis. From there, the variables abound so we each have to weigh our own pros and cons to determine what is best hormonally. For me, I have both ovaries even with a stage IV endometriosis diagnosis.
I know this can all be confusing and frustrating. There is no black and white solution. Many of the choices depend on your circumstances, your symptoms, your overall health risks, etc. But, one must also consider the skill of the surgeon. In general, an OB/GYN is simply not going to have the exceptional skills needed to offer the best excision choice and that can affect our decisions.
goes out to you and I hope you can come to a comfortable solution for you! Don't forget to check out the stickies at the top of this forum and feel free to post any questions and concerns you might have!