Ultrasound result: ablation or vaginal hysterectomy

I finally heard back from my doctor from my 12/30/11 ultrasound to see what was going on. At my initial visit, the doctor was already promoting a hysterectomy because I am finished having children and this way I do not have to worry about birth control anymore(I do not have my tubes tied). She said then I wouldn't have to be miserable anymore.
I have started to have heavy, painful periods and that led to this ultrasound.
The medical assistant told me that I have a small fibroid and the doctor said my two options were ablation or a complete vaginal hysterectomy. I'm 35.
Is a complete vaginal hysterectomy worth it for a small fibroid? I'm leaning towards the ablation for now.

Dear jenn:

You are smart to ask questions before agreeing to major surgery! Here is a video about getting a 2nd medical opinion: http://www.givemeasecond.com/

I hope that you are able to find the right answers soon. I am sending huge cyberhugs

I would certainly research other options if you aren't totally sold on a hysterectomy. I had my hysterectomy mainly for preventative reasons more than anything. Mom had uterine cancer in her early 20's and I made it to 33 without. I had a uterine biopsy a few months ago and it came back as abnormal cells (hyperplasia without atypia.) I have PCOS which cause me to have only one or two periods a year that are really bad (pain, clotting, and bleeding.) The lack of periods is what caused my hyperplasia. I could have went on provera to give me more periods which would take care of the hyperplasia problem but I didn't want the hassle of dealing with the periods.

I felt that it wasn't a matter of IF I get uterine cancer, it was a matter of when. I didn't want to deal with the provera treatment. Since I'm diabetic with no complications it was a better idea to go ahead and have the surgery now. I would rather not deal with gyno complications and the chance of diabetes complications if I was to wait on the surgery.

If I were you I would take into consideration what you current medical condition is and how it might be better to have the surgery now with fewer complications instead of waiting till your health is worse later. Also the fibroids might not be bad now but in a few years they could be worse. I have heard that some people have to have a second ablation done also.

I do know that when my pathology result came back it showed everything was fine and the hyperplasia was gone. I took provera right before my surgery and had a period which cleared it up. I didn't -need- to have the surgery. Knowing the hyperlasia was not severe was great news but it didn't change my feelings about my surgery. I knew I would end up with hyperlasia again and possibly cancer later. Not worrying about horrible periods, pregnancy, cancer, and any other surprises in the future was worth it for me to go ahead with the surgery. I can live a much more stress free life now.

Why ablation vs myomectomy?

I know, for some types of fibroids, myomectomy is not feasible, but I understand that ablation doesn't have a great success rate.

I suffered horrendously heavy, irregular and painful periods for a long time before I got a diagnosis. A hysteroscopic myomectomy solved those problems for quite a while before I had a recurrence. If you are close to menopause and your doctor thinks the ablation has a good chance of being successful, then maybe I would go for that, but if menopause is nowhere close, I might consider the hysterectomy. There are so many factors to consider.

Get a second opinion. My current gyn was my second opinion doc and she provided me with far more information and options than my first doctor and no pressure from her in any one direction.

I waited for a long time in misery before I finally came to my own conclusion that it was time for a hysterectomy - too many fibroids of too many different types for any other procedure to be worthwhile, plus abnormal pap results. To my doctor's credit, she didn't push to me make a decision, but monitored my health and waited until I was ready. When I finally scheduled my surgery, I was more than ready. I have my life back and wish now I hadn't waited so long. But that's me.

I wish you all the best.

Once you have a hyst you can't reverse it. If you do something like myo or ablation you can still have a hyst if it doesn't work. If your dr. won't really talk to you then you should get a second opinion. For some people, birth control pills help the bleeding, others have success with the IUDs. If you only have one small fibroid there may be other options to alleviate the bleeding without having a hyst. It is worth taking the time to find out.

Thank you for the advice! My doctor has always pushed permanent birth control on me and I get that feeling again.
I will be calling today for a second opinion.

A surgeon I know from another field says if a doctor pushes one option above all others without offering you a real choice it is often b/c it is what is best for them. Not saying that is the case here but definately worth a second opinion. For what it is worth I am getting 2 additional consults even though I probably will not change surgeons. Every consult yields info you may not have gotten with the initial one.