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how do the doctors decide what type of hysterectomy you'll have? how do the doctors decide what type of hysterectomy you'll have?

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  #1  
Unread 10-01-2002, 07:55 AM
how do the doctors decide what type of hysterectomy you'll have?

Hi Ladies,
I am schedule for a appointment on Dec 3 to get this process started.
I have no idea how the doctor will do the surgery. I have never had children. I have been reading that usually a vaginal is done with women who have had kids.
The doc said that he can do tests. Does anyone know what these tests are?
I find such great info here.
Have to have surgery for endo
thanks!
  #2  
Unread 10-01-2002, 11:18 AM
Types of Hysterectomies

Hey there! I'm new to the site but I have severe endo and am having my hysterectomy on Oct. 31st. I am having a TAH (Total Abdominal Hysterectomy) and a BSO (Bilateral Salpingoopherectomy---Removal of uterus and both tubes and ovaries.) I don't think (from what I've researched) that it's a difference of whether or not you've had children. I have a 9 year old son and they're doing mine abdominally because of the endo. My friend is having a hysterectomy to remove fibroid tumors and her's is going to be abdominal as well. I hope this helps!
  #3  
Unread 10-01-2002, 11:30 AM
how do the doctors decide what type of hysterectomy you'll have?

Hi,

I don't know the answer to the vaginal vs. abdominal question. But I do know that most Dr.s like to do an abdominal on those who are having endo removed. They prefer the abdominal because they can see better and remove endo better that way. Also sometimes there is time consideration, it would take longer to remove endo any other way.

Take care and good luck to you

  #4  
Unread 10-01-2002, 11:32 AM
Hi hon

I had my TAH/BSO on the 4th of Sept. I have had 4 kids all vaginally. I had asked my Dr. about doing a TVH/BSO and she said that she was personally more comfortable with doing it abdominally. I just went with the procedure that was the most comfortable for my surgeon. Hope that helps a little! God Bless!! Betsy
  #5  
Unread 10-01-2002, 11:33 AM
how do the doctors decide what type of hysterectomy you'll have?

I had a laproscopically assisted vaginal hyst (LAVH), as well as having both ovaries and tubes removed (BSO). I never had children. I had the surgery because I had a large ovarian cyst that was suspicious, as well as 15 fibroids in my uterus, one of them the size of a tennis ball. My surgery went fine. I'm not sure why doctors decide to do it one way or the other, but my doctor told me she prefers to do them vaginally if she can so that the patient does not have a large incision to recover from. She is also very experienced at doing hysterectomies vaginally. Talk to your doctor about the options, and feel free to ask your doc how much experience they have with vaginal hysterectomies, if you would prefer to have it done that way. You may or may not be a candidate for it, depending on your particularly physiology. I guess some women prefer to not have it done vaginallly, but I'm not sure why that is so. My went fine, and my recovery is going very well (five weeks post-op). Good luck in making your decision.
  #6  
Unread 10-01-2002, 11:42 AM
how do the doctors decide what type of hysterectomy you'll have?

LaaLaa:

I also have severe endo and am having TAH with probable BSO. I have 2 children (1 csection, 1 vaginal delivery). I have had 3 laparoscopies, 2 rounds of synarel, been on birth control pills and depo provera.... all in attempts to control the endo. Well, I am done with this.... come November, it's bye, bye uterus!!!!

Hopefully, I can help you with some of your quesitons. I am not a medical professional, just a 22 year endo patient. So, I only can speak from my perspective.

RE: TVH vs LAVH or TAH.... The endo typically leaves behind adhesions (scar tissue) which can tie your organs together, so I don't think they can deliver the uterus through the vagina when the uterus is not free to go. Thus the abdominal hyst is needed.

Also, your doc will probably need to do a good general cleaning out of any current endo implants and scar tissue while they are in there and abdominal gives a clearer view than LAVH or TVH.

RE: Tests.... If your endo has not been confirmed via a laparoscopy, he may need to do that first. That is an outpatient surgery where they make 2 incisions. One is near the pelvic bone and one in the navel. They insert gas into your abdomen and insert a scope. In the other incision, they insert tools if they need to do any "cleaning" or "removal".

He may also want to do an ultrasound to check for fibroids.

Can't think of any other tests....Hope this helps!!!
  #7  
Unread 10-01-2002, 11:43 AM
how do the doctors decide what type of hysterectomy you'll have?

Hi, LaaLaa,

I've never given birth, and I had a TVH/BSO. My doctor decided to avoid a TAH because I'm overweight, and he didn't want to do an abdominal incision, because I heal slowly.

Have we confused you yet? I think doctors consider the size of your uterus (if it's too large, a TVH would be too difficult,) whether you have endometriosis (a TAH makes it much easier to see the endo, to remove it,) and the final choice of type of surgery also depends on the doctor's personal preference. Some prefer TAH's, some like LAVH's, etc.

By all means, ask your doctor about the various options. Although the doctor, who will be performing the surgery, gets the final say in choosing the type of surgery, you have every right to know how your doctor makes that decision.

Good luck to you.

Best wishes,
Helen
  #8  
Unread 10-01-2002, 11:47 AM
how do the doctors decide what type of hysterectomy you'll have?

I had a TAH/BSO and my Gyn siad he had to do it that way because he thought in my case it would be easier to get the uterus out that way. He also said he felt there would be less bleeding that way and because I was severely anemic he wanted the least amount of bleeding possible. I have to agree that each Dr probably has their favorite way of doing things and they tend to do it the way they are most comfortable with. I wanted an epidural and my Dr had a million reasons why that wasen't a good idea. I have read about many Sisters who had one with absolutely no problem. If I had it to do again I would have pressed harder, I did not like the morophine pump. I was up sick all night from the morphine the night of surgery.
  #9  
Unread 10-01-2002, 12:09 PM
how do the doctors decide what type of hysterectomy you'll have?

LaaLaa:

I am 43 and have two children. Both were delivered vaginally. My Dr. chose to do my TAH/LSO with an abdominal incision rather than doing it vaginally. His reasoning was that I have a lot of "support" in there. I really never asked him to clarify just what that meant but if support is a good thing then I didn't want to disturb that. I totally trusted my Dr. to do what was right. My surgery was 18 days ago and I am up and doing really well. There is still some discomfort at the incision sight but nothing that Tylenol can't handle. Good luck to ya Sis and glad you found us.

Janet
  #10  
Unread 10-01-2002, 12:19 PM
how do the doctors decide what type of hysterectomy you'll have?

thanks Ladies,
I knew this is the place to go for all the stuff I need to find out.
You gals are awesome!
Thanks for all the responses!
LaaLaa
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