Need help in decision on type of hyst.!

Hello!
I am brand-new to this board today, although I have lurked a little before. I am scheduled on 18 May for an abdominal hyst. with surgery for cystocele and rectocele and pelvic prolapse. I asked my doc why we couldn't do an LAVH, and she 1st said b/c of my enlarged uterus, then she found out the hospital can do it with morcellation of the uterus (although she would only assist, as she isn't skilled in that type). My question is, should I just go ahead a get it all over with on May 18th, with the abdominal or suffer through the summer until I can get the LAVH in August? Does it really make that much of a difference in recovery? My Doctor prefers the abdominal, but I think that is because she is more comfortable doing that. Any help is appreciated in helping me make my decision. I am driving my friends, and doctor crazy! Also, I could get a referral to have a Da Vinci hyst. about an hour from here, also in August. Too many decisions! I will keep my ovaries, btw. Thanks!

Hi Jkk47,

I had two Drs. give me two ~different~ opinions. One wanted to do an abdominal hyst and the other a laparoscopic hyst. In my case I had a window of opportunity for the less invasive hyst (LSH). I did (3) months of lupron shots before my LSH to shrink my fibroids enough for surgery. So, I too was looking at a wait before surgery. Also, in my research, I found a laparoscopic hyst generally has a shorter recovery time.

In the end...do what is ~best~ for you. Your quality of life is what is most important.

Sending best wishes~

Mary

i had two different opinions. the first dr only suggested what technique he was capable of doing (vaginal, which i wouldnt agree to since i wanted to keep my cervix, or abdominal so i could keep my cervix). i traveled two hours to a big medical university for a second opinion and was offered an lsh. i had it in october. the recovery is usually easier with the lap, as long as there arent complications. i had a very easy recovery.

if you have doubts or feel that your dr is only offering what shes capable of, when easier techniques are available, you should get another opinon for your own peace of mind. you sound like you arent sure or have doubts. since your hysterectomy isnt an emergency, you have time to research your options. good luck!!

While the laproscopic hysterectomy is less invasive and a touch easier to heal from, I'll be very honest with my opinion: Go with the doctor you trust the most and go with the procedure he or she is best at. Given a choice between an experienced surgeon and inexperienced, I'll take the experienced one even if it means a more invasive procedure. Every route has pros and cons -- laproscopic is less invasive but you *must* go the general anesthetic route. abdominal is more invasive, but you can have regional anesthetic plus a sedative. Abdominal has extra options for painkilling as well.

I wish there was an easy answer for you, but there isn't. Weigh all the factors and go with the option that makes *you* feel the most comfortable. *hug*

jkk, I didn't have a choice. My dr. specializes in laproscopic surgery but felt it would be "too dangerous" for me to have anything but TAH. I had an easy recovery compared to some others on this site. I was cleared to return to activities at my post op appt. after 5 weeks and started exercising including abdominal workouts ever since then. The dr. said I'd be in surgery too long with any other procedure, the TAH took about and hour, 45 minutes. I still have some fatigue but feel better than I have in years!! I have not regretted my decision to have surgery for one minute. Best of luck with your decision. Lorri

My regular gyn who has been my gyn for 20 years only does TAH and LAVH. She is highly respected and I trust her implicitly. That said, I knew I wanted a TLH and I wanted it performed at one of the top teaching hospitals in my country. I came to this decision after much much research on the procedure and the surgeon who performed it.
I was lucky in that I was put on their cancellation list and had my surgery 4-5 months sooner than expected. I was, however willing and prepared to wait if I had to.

Even though I am so soon post op I can tell you that I am so glad I did this. I really had no choice as I had zero quality of life due to my gynae issues. I feel better each day.
Good luck on whichever you decide.

Thanks for all the support and suggestions. I truly have not decided what I should do, and I think since I feel that way I should wait and continue to research and get another opinion. If I could get this uterus to shrink, get rid of large fibroids and maybe go with a pessary of some type I could get by without doing a hyst. at all. Then get my cystocele and rectrocele repaired at a later date. I'm a little worried about the Lupron and bone loss, which is why I'm not going that route to shrink them. I am 47 and have some arthritis. I did try it ab. 15 yrs. ago and I was symptom-free, no menopausal symptoms at all. I recently read that if you are close to menopause and use Lupron, you can have up to 2.5% bone loss that doesn't come back. I have also had a Uterine Artery Embolization for fibroids 9 yrs. ago ( I was one of the first in our area!). That has worked well but now I have calcified fibroids and UAE doesn't take care of that which is why I am not repeating that procedure. I will post in a different area to answer any questions I can about UAE if anyone needs help. Thanks again for the advice!

When I talked to my doctor, I told her take EVERYTHING NOW. I didn't want to have to go back into surgery at a later time to get removed whatever else was causing problems.

I have gone through so many surgeries. I knew there was no way we could do the hyst vaginally due to my many surgeries, plus the size of the uterus and fibroids.

Do what you makes you most comfortable. Good luck.

Hi jkk.... we are castle day buddies! I'm having an LAVH on May 18th and I also have an enlarged uterus. Mine must not be too bad though because they never even mentioned a TAH. Though I was warned that once they get in there it could be changed to a TAH, but as of right now, it's LAVH. Really it depends on what you are comfortable with and how much more you can take. Personally, I just want it over with any way they have to so that I can enjoy the rest of the summer pain-free!