myomectomy vs hysterectomy, am I being a wimp?

I turned 39 today. Should be old enough to know better, but in my wisdom of indecisions, 2nd opinions, etc, I ended up with two surgeries scheduled: either a myomectomy on July 29 or a hysterectomy on Aug 7. I need to cancel one, but which one?

I had my 1st myomectomy (vertical incision) two years ago and really suffered through the recovery. Eight large fibroids removed, 25 weeks of physical therapy and pelvic floor therapy, and I still deal with pain. Worse, now the fibroids are back. I live in pain most days, 21-to-24-days of heavy periods, even with birth control pills, and maybe a few days rest before starting again. It has completely changed my life, from extremely active, physically fit, outdoors person to inactive and pain.

If I choose myomectomy now, it will be myo #2, and perhaps I'll suffer through the recovery again. The dr says that it will just "buy me some time," because since the fibroids are back so soon with a vengenance, then they'll be back again in another couple of years. And then she said surgery #3 must be hysterectomy.

If I choose hysterectomy now, it will be abdominal, keep the ovaries. Not sure about the cervix, had a LEEP last March plus three previous cryo-treatments. The dr wants an abdominal hysterectomy because he is worried that I may have adhesions from the first myomectomy, so wants to be able to evaluate and deal with those if necessary.

I am SICK of pain and bleeding. Fibroid pain, uterus-healing pain, possible adhesion pain, and bleeding from *$#&(% Mars. I think I am ready for the hysterectomy, and some days I can't wait.

But. And there's always a but, isn't there? But I have no children. Too many years kissing non-marriage-worthy frogs. Too many years struggling to build a career to maintain/support a life as a single woman, buy a little food, car, little house, get a dog....and then later, at 36, meet a guy who isn't a frog and marry him. But. Myomectomy #1 six months later.

So, I should be brave and have myomectomy #2, keep the uterus, try to heal, stop staring at other women's beautiful children, and get busy. Except that I don't have the GUTS to keep dealing with this pain and bleeding. Husband says my quality of life has been too bad to keep trying, to just get the hysterectomy. Dr #1, my regular gyn, says he has no problem doing the hysterectomy for me, that there are too many good reasons to do it, and lack of fertility is the only bad reason. Dr. #2, surgeon specilializing in myomectomy, says another myo will not be a big deal. She also works in a fertility clinic. Says she won't do a hysterectomy.

I scheduled the myomectomy with her because her schedule was extremely tight. But then, after a lot of thought, I changed my mind, scheduled the hysterectomy with my regular gyn. After that, I felt like a weight was lifted off. Called the myo surgeon to cancel, and guess what? She won't cancel. Wants me to come in and have another consult face-to-face, wants to make sure I understand the finality of this decision.

So here I am, back on the fence. Sorry, I wrote a lot. Thanks for listening if you got this far. Does anybody think I'm wimping out if I choose hysterectomy? Anyone had both surgeries? Can anyone compare recoveries from abdominal myomectomy (laparotomy) vs abdominal hysterectomy?

Hi Rheqnut,

I would say instead of wimping out...you are being very brave.

You are doing your research and analyzing the situation from all angles. Sounds like a very good decision to me. A myomectomy and a hysterectomy are both major surgeries so it is a smart idea to really think both of them through.

In my case...I did have a hyst for my fibroids since I was 46 at the time...and I had a biological and a step-daughter.

That being said...my younger sister had an abdominal myomectomy several years ago for a grapefruit sized fibroid. She did go on to have my two nieces and she only had a hysterectomy last year for returning fibroids.

I would say...do what is in your heart ...and as my signature says...~Trust Your Inner Voice~. Do what makes the best sense to you. Drs give us options...and we make the final decision when it comes to our bodies. Having a baby can be important...yes...and your quality of life should be just as important. Just don't worry...you will make the *best* decision for yourself.

Sending best wishes~

Mary

You need to do what is right for you and be secure in your choice. I would meet with the myomectomy Dr again and see what she has to say. It doesn't sound like a hyst would be a "bad" choice. But you need to be 100% sure that your decision is the right one. Maybe a 3rd opinion? Also, if you have the myomectomy, would you be able to get pregnant?

I can only share my experience, but here goes....

I had a myomectomy when I was 37. I had only been married 2 years and we were still trying to have children at that time. Like your sister, I had a grapefruit-sized fibroid that was removed. Unfortunately for me, the surgeon put a goretex patch over my uterus to try and help me conceive, but it only caused problems (which is another story).

It was a tough recovery, but not as tough as yours was. The following year, I had a laparoscopy after signing up with a fertility specialist who was trying to help me get pregnant. The lap was to treat an endometrioma that they found. When inside, they found widespread endometriosis (and never reported even seeing that crazy goretex patch).

I never did get pregnant, but I went on to have 2 beautiful dc by means of adoption. In fact, I held my first child in my arms just one month before turning 40... so turning 40 was very easy for me!

I never had the huge amount or crazy growth of fibroids that you have had. I was able to last until the age of 46 before noticing lots of pain and problems again. I had an LSH/BSO one month before turning 47, and I am at great peace with this decision. I cannot believe how much better I feel now than I did before. I had a great surgeon who took care of the endo, the adhesions, the fibroids, and the crazy goretex patch that had adhered to (and almost perforated) my bowel. And, in case anyone is really interested, my s*x life is hugely improved now because I finally do not have any more pain at all during those intimate moments. I had not even realized how much pain and discomfort I really had until it all went away!!

No one can make this decision but you. It does sound like you might be gaining for yourself only a little bit of extra time (since you have fibroids that seem to grow back so quickly, and at the expense of a possible tough recovery again), if you choose to go with the myomectomy. I would be interested in researching just how many people have even had 2 successful myomectomies, or does it get harder and more complicated with each additional one?

A hysterectomy has plenty of issues, too, as you have to decide about HRT. However, it sounds like you would be keeping your ovaries, so you maybe wouldn't have to worry about HRT. You will need to be at peace with whatever decision you make, and know that you are just as much a woman who is special and beautiful in God's eyes whether you have a uterus or not. And there are lots and lots of children out there who need a family and the love that comes from being a part of a family, but no one else can make that type of decision for you, either. I can tell you that my husband had to wait a whole year for me to be on board with the idea of adopting... as he was ready to do this way before I was. But now I am so thankful that we formed our family this way, and I am even thankful now that I was barren... so that God could ultimately lead us to the children that we now have!

God bless you and guide you in this big decision. He does care so much for you!!

Brenda

To Mary, thank you for saying that I am being brave. I feel pretty wimpy and weepy at the moment.

To morgainec, in answer to your question, if I have the myomectomy, would I be able to get pregnant....well, I don't know. I've been told that there is a high risk of miscarriage due to multiple scars on my uterus, and a risk of being on bed rest for the last months or longer. I would hate to endure a miscarriage.

To Brenda (tandbs1), Thank you...that helps me a lot. I have been thinking a lot about adoption these days. I wish I could have lasted longer until the pain and problems came back, but here I am. I didn't mention that the s*x life has been miserably painful. It would be nice to have that good life back. Anyway, it would be interesting to know if anyone has been through a 2nd myomectomy, and if it was successful or not, if easier or harder, and if it was worth it?

I had to make a similar choice (myomectomy vs. hysterectomy) so here is my story.

I am 32 and married but childless. We never really planned on having biological children since I have been plagued with gynecological and fertility issues for the past decade. When my fibroids grew to enormous proportions this year I know I would have medical intervention to deal with them, but I was not sure what I should choose.

After my second opinion I decided on hysterectomy (TAH) for two reasons. First, since my fibroids had grown so aggressively in such a short period of time there was a good chance that new fibroids would grow and they would need additional intervention if I opted for myomectomy. Second, even before the fibroids I was having extremely painful periods (no one was exactly sure why) and myomectomy would most likely not have given me any relief from that. In fact, one of my two opinions believed I could be in worse shape pain wise after myomectomy. I thought a TAH was going to give me the best quality of life once I recovered from surgery.

My only advice to you is to do whatever you believe will give you the best quality of life. There are so many personal factors that go in to deciding something like this only you can know for sure what is right for you.

I wish you all the best and that you find a decision that brings you peace.