Let's discuss your options and your choices.

When my doc told me that I'd be off six weeks with my hysterectomy, I assumed that I'd be having a total abdominal hysterectomy. I still might, but there may be options.

I sent him an email asking what kind of incision I'd have and if he planned to remove my cervix. I got the following reply, which leads me to believe I have some options to choose from.

He wrote:
"Regarding the incision it is either going to be bikini line and or we can try removing your uterus vaginally. If the vaginal approach is used then the cervix is also removed. If abdominally then you have a choice of removing the cervix or not. I usually recommend my patients to have a complete cervical removal. Also you have the option of complete laparoscopic hysterectomy. Everything depends on the size of the fibroid and the size of the pelvic outlet."

According to the sonogram, my uterus is enlarged with an irregular contour. The measurement I got doesn't sound terribly enlarged. It is approx 12x7x6cm. I have "multiple" fibroids in my uterine wall (myometrium) and the largest is about 6cm. I have also delivered two children vaginally, but that was two decades ago.

He said that we can sit down and discuss my options. I don't know this doctor very well, but my first impressions are good. He appears very knowledgeable, compassionate and patient. During the exam, he talked to me about what he was doing and he was as gentle as a man with biopsy tools in his hand could be. While I trust his opinions, I want to go into our meeting with as much knowledge as possible.

I am somewhat familiar with the technical aspects of my options. What I'd like to know is what options your doctor gave you, which one you chose, why and how you feel about that decision now that it's over.

So glad to hear that someone is as worried about making the right choice as I was!

I had recurrent ruptured ovarian cysts and a mass in my uterus that lead to my hyst. I found an amazing doc that was extremely gentle and extremely empathetic to what I was going through.

My doc suggested that I undergo LSH with bilateral salpingo oophorectomy. I researched all the different types of surgery and agreed that this was the right procedure for me. We opted to leave my healthy cervix intact - he said that it may provide extra support for the vaginal walls and pelvic floor. I also opted to start on estrogen the day after surgery (estradiol 2 mg pill) because I am only 40 and did not want to be thrown into surgical menopause.

I have been extremely pleased with the outcome of my surgery. I do feel that I made the right choices. I am 12 weeks out now and am back to teaching martial arts full time as well as my other daily activities. If I had gone the more invasive route, I know that I wouldn't be teaching yet. The hormones have been good so far....no hot flashes or other problems at all. I haven't had any trouble with my cervix (no mini periods) and no trouble with vaginal dryness (probably a combo or keeping cervix and hrt).

I hope this helps!

I had my hyster done with the daVinci robot and my recovery has been amazing. No real pain to speak of and I am healing up nice. If I could go back and change the way it was done then I wouldn't for anything.

There don't seem to be many dr's trained on the robot so you would have to ask about that.

As far as a choice between a TVH and a TAH I hear most of the time that vaginally offers a faster healing time.

Rosie, it hasn't even been two weeks for you and you sound great. I wish that DaVinci was an option but it doesn't appear to be available. I have one of those HMOs where the doctor, hospital and insurance are all part of the same company.

I watched a video on the LSH and thought I could be interested, provided my doctor has experience with that method. In the method portion of the email (see original post), he seemed to mention it as an afterthought. Since he recommends taking my cervix, the LVH would be my second choice. But as he mentions all this depends on various factors.

I was lucky to find a doc that specializes in LSH. There aren't too many just yet in my area. I was in the hosp overnight (b/c my surgery was at 3p) and I actually went for a short walk when I got home from the hosp on Saturday afternoon. The only problem with this was that I had to be careful b/c I wasn't in much pain and I could get around pretty easily after the first few days, so it was easy to overdo it. My scarring is so minimal...one incision in my belly button (can't even see it) and a small inch long incision a few inches in from each hip. They were healed within two weeks. Very cool. Let me know if you have any other questions.

I was also lucky enough to have LSH/BSO, but as you say, with a very experienced surgeon -- actually a pioneer in this procedure. It's definitely the way to go if it's an option for you (with a skilled surgeon, of course). I was back at my hotel (out of town surgery) by 2PM the day of surgery and out and about that evening! Back to work in 10 days. I had no pain that required narcotics -- just a little Ibuprofen to help me relax when I got a little sore. Please feel free to PM me if you have further questions.
Best of luck

i was offered a vaginal hysterectomy, which i didnt want because i didnt want my cervix removed. i found a different dr who did the lsh..and i had that. it was a very easy recovery and i am so happy that i had it that way. its so minimally invasive and i was able to keep my cervix and ovaries.
good luck making your decision

I too had a moderately enlarged uterus with multiple fibroids and my GYN referred me to a surgeon who specializes in laparoscopies. I kept my ovaries but not my cervix as the surgeon said the latest studies show no advantage in keeping the cervix and so I decided to just eliminate the small cervical cancer risk. I spent one night in the hospital, had no actual pain, just discomfort, and was able to go back to work in three weeks. I am very pleased with the results and encourage anyone contemplating a hysterectomy to explore the possibility of a laparoscopic procedure. Good luck with your decision.