Which is better: laparoscopic hysterectomy or vaginal removal method? Have had c-sections

My preop appointment is coming up Monday April 20th. My Dr has recommended removal of my uterus and cervix by laparoscopic surgery but I have seen some who have used the complete vaginal removal method. Which options is the best and is there reasons one option is used over the other? I've had two csections is that a factor in the choice? Of course I will consult with her but wanted some insight from the ladies here. Confused.

Hi Melne72 to HysterSisters!

Different surgeries are done for different reasons based on many factors, including your doctor's preference or skill, your particular health situation, your hospitals situation, etc.

I am not sure there is a "better" method as it varies so much from woman to woman, and situation to situation.

Here is some information on hysterectomy types and definition. Do talk to your doctor about your concerns.

Hi there! I've had 2 c sections as well, my Dr is doing the single site laparoscopic. I have an enlarged uterus but obviously every person is different. It's probably best to let your doctor decide what's best for your situation. Mention your concerns and see what he has to say. Hopefully he takes your wishes into consideration. Best of luck!!

I was scheduled for a vaginal hysterectomy. I have had two c-sections and an additional hysterotomy which is a bit like a mini c-section. (I had a son with a terminal birth defect)

My ob/gyn told me from the outset he would take a look and try for vaginal but if he couldn't do it, it would be an abdominal hysterectomy. I knew I was at a high risk for adhesions because of my surgical history and had, had a surgeon tell me I had a lot after an appendectomy a couple of years ago. When I saw him after the surgery he said he didn't have a hope of doing it vaginally as he couldn't even see my cervix properly.

I had a LOT of adhesions from my previous surgeries and my uterus was adhered to my tummy wall. He normally removes the tubes to lower the cancer risk but he said there was just too much scar tissue so he left mine along with my ovaries which I was keeping.

I have had way more pain from where he cut away the adhesions from the main incision itself. My upper tummy seems to bother me more than my lower tummy. Anyway, I digress, I think it is worth going with whatever the surgeon feels most comfortable with. They have their own specialties and they know what to expect with your history. They may well be advising a LAH due to your previous c-sections and the risk of adhesions. Having said that it can't hurt to get a second opinion, but in my case I have full confidence in my ob/gyn because he delivered my kids and is a very good surgeon.

Melne,

I agree with the others. Your doc should know which method is best for you. Consider that if you have adhesions a skilled surgeon is very important. Go with what the best surgeon you can find advises. Second and third opinions and referrals are very useful. Docs are not all equal in their skill sets. Adhesions make a any hyster more difficult, lap assist can be very helpful with the vaginal route. Talk to your doc, ask about her skill and experience with adhesions. Don't be shy about wanting the best doc for your particular situation--you won't get a second chance once the surgery is done.

and.

Keep us posted on your decision.

I guess maybe getting a second opinion would be good if you are not comfortable with the decision. I would personally want surgery that has the least risk of adhesions, especially if you already have scar tissue inside. Just because one doctor says you are not a candidate, it could just mean he/she is not skilled enough to do the surgery, whereas another surgeon may be able to do it.

Thank you ladies for all your insight and advice! I will keep you posted and await freedom from my pain!

Melne, we have the same pre-op date! my DR has told me that she will attempt to go vaginally but be prepared for just in case it has to change to abdominal. I have had three other laparoscopic procedures so I guess that is why it was never an option to me. Good luck with your surgery