Hysterectomy booked for 1/2019. Colposcopy first?

I had a uterine ablation five years ago and it was great for a couple of years...until it wasn’t. Pelvic pain, irregular bleeding (some months it’s almost every day, other months it is less - but completely unpredictable), itching, pressure, lower back ache (most of the month) and shooting pains in my mid back that seem to be cyclical in nature and last for an hour or two...but this month lasted for two full days. My ablation was due to heavy bleeding and anemia.

Multiple ultrasounds (two yrs ago and earlier this year) were normal, with the exception of my uterus showing “patterns of Adenomyosis”. My gyno thinks blood is pooling in pockets of scar tissue and then leaking out whenever it feels like it. My RBC is on the lower side of normal now. (3.9 & 4.0) and I am low on vitamin D. All other bloodwork was normal.

I have also tested positive for HPV16 for three years in a row. I had a negative colposcopy two years in a row and I refused to let them do one this year (in February)...as my father had just passed away unexpectedly and I didn’t have the mental energy to go through another colposcopy at that time.

I am tired of feeling awful. I am active (runner, triathlons, etc)...and I can’t tell if my fatigue is due to depression or tied to the fact that I am dealing with discomfort and feeling dirty on a pretty regular basis.

I tried going back on the pill two months ago and I bled more. This sealed the deal for me...so my gyno booked me today for a vaginal hysterectomy - including tubes and cervix but leaving ovaries. (She booked me over a year ago, but I chickened out. I am ready now.). I will be 45 on Saturday.

Should I have the colposcopy before the hysterectomy? There was no mention of it today, but my reading tonight has suggested that tests to rule out cancer should be performed before surgery - as it could impact the type of surgery performed?

I am I doing the right thing?

Any words of wisdom would be great!

Hi FullOfGrace2017 to HysterSisters!

I am sorry you are going through all of this, but I am so glad you found this site. First off, though, I am sorry about the loss of your father.

I cannot answer your questions, but we do have many women on this site. Hopefully, ones with similar experience to your own will see this post and respond.

You may want to ask you doctor about having a colposcopy before your surgery, given your condition. Whether or not you are doing the right thing, only you can answer - no one else. Having a hysterectomy is MAJOR SURGERY. You have to weigh the pros and cons of this surgery against your current health condition.

Just know that you are not alone in any of this. We will be by your side throughout this process.

Do you recall what your recent pap result was, aside from the positive HPV? That could make a difference as to whether or not your doctor feels a colpo is necessary, as well as the fact that your previous colposcopies were negative and that you've been keeping up with things. The difference in types of surgery as far as cervical cancer goes would be a total (simple) hysterectomy versus a radical hysterectomy. Since you have been vigilant, even if pre-cancer or cancer were to be found, it sounds like things would likely be at a point where a simple hyst would be the recommended treatment. As a matter of fact, depending on cell type and the individual patient, sometimes even a conization can be considered curative. Here's a good page on treatment options: https://www.cancer.gov/types/cervica...dq#section/_85

All that being said, it certainly wouldn't hurt to discuss this with your doctor to be sure everyone is on the same page and to understand her reasoning as to why or why not she feels a colpo is necessary. Even if she doesn't feel it's necessary, you could request one be done, if it would make you feel more comfortable.

Thank you for the info and kind words! My pap was normal with the exception of the HPV. My only abnormal tests have been HPV and two ultrasounds showing suspected Adenomyosis. I will discuss the missed colposcopy over w my ob/gyn. The fact that my 2017 colposcopy was normal probably means I am fine for the procedure. I would like this all to be behind me now. The pain, the bleeding, the anxiety. I still have to have my pre-op mtg to discuss what is involved with the procedure and sign the paperwork. It can’t be done until a month before the procedure (1/10) - so I will ask when I go in for that.

Thank you!

Sounds like a good plan and fingers crossed for a smooth procedure and recovery! You're going to do fine!