Upcoming hysterectomy 1/28: Do I need a pre-op biopsy?

Hi,

I'm scheduled for a TAH on January 28th with a surgeon who comes highly recommended but who is not an onco-surgeon.

I have large fibroids (well, largish, at 8cm and 5cm) and am having postmenopausal spotting.

I'm 57 and started the menopause late. Perimenopause with periods every few months or every 6 weeks, or whenever, happened along with hot flashes in between. However, I think I am classified as postmenopausal now so we'll just go with that.

I've had these fibroids for over 10 years. Other than making my belly bigger than I liked, they didn't often bother me, strangely enough.

Anyway, ultrasound shows a 5.7mm endometrial lining, though with so many fibroids he can't easily measure the lining everywhere.

Bloodwork is good with a C-reactive protein under 1 and no other elevated inflammatory markers.

I do have backache on one side that may be related to the uterus or (argh) ovaries, but nobody knows. That's gone on for a long time.

I've been offered the surgery which I desperate want in order to avoid endometrial cancer, but I'm worried I have a cancer, of course, despite the consultant who did the ultrasound saying he didn't see great cause for alarm. He said if we didn't do the surgery, he would order a hysteroscopy, but of we are doing the surgery he'd just go straight to that.

Does this sound safe from a cancer perspective? I'd hate to have to go back in and get nodes but I'm sure the surgeon who has decades of clinical practice has thought of that?

I was in touch with him about these concerns and he said we could talk the day before the surgery about it. I don't think he worries too much if we have to adjust it to a biopsy. Meanwhile, I'm DESPERATE for the hysterectomy but don't want to rush in if I really do need an onco-gyn. surgeon.

Have others had to wrestle with such questions and issues?

i had to have a hysteroscopy witth biopsies before my surgery. if it's something you'd feel more comfortable doing, you should contact your dr. way before the day before. i personally would want it done.

Why not look into UFE for the fibroids? Hysterectomies can cause a lot of health issues, mental and physical not limited but including loss of sex drive, weight gain, bowl movement issues, bone density loss...