Abdominal or Vaginal ?

My GYN referred me to this site, which has been a great help to me
so far. It's great to be able to connect with others who are contemplating
surgery or have already had it done.
I have had problems with heavy bleeding, cramping and long periods
all my life. As I have gotten older, this has only gotten worse.
I had a laproscopy and D&C done in 12/93, which helped this
problem for about 8 months - but then back to the normal !
In 1999, during my annual checkup, an anterior uterine fibroid
was found. After finding this (and with my prior history), I had
an internal ultrasound to verify size and such.
Anyway, I recently had my GYN visit. Thermal balloon ablation and
hysterectomy were discussed. She (my GYN) has left the decision
up to me (whether to even have surgery - and if so, what type).
She is very open and encouraging about me researching all this
first also. I THINK I have decided to have a hysterectomy.
I feel that the ablation might help the bleeding, but most likely
won't have any affect on the problems that the fibroid is causing.

The question I am posing is: what made each of you decide on
the type of surgery to have done? In other words, for those who
had it done abdominally, why that way & not vaginally ?
Those that had it done vaginally - why not abdominally ?

I am scheduled to have another internal ultrasound done on January 4, 2002.
I would like to have more info to discss with my GYN and of course,
and more questions to ask her !!
Your comments would be appreciated.
Thanks,
Dawn

Hi Dawn!

It sounds like you are doing your homework. It's good to see that you are weighing your options and researching alternatives!

If you do choose hysterectomy, you may want to discuss in further detail with your DR which method would be best for you overall. I probably won't be much help, as I did not have a choice in the matter. I had a large tumor on my ovary; typically when cancer is suspected, an abdominal surgery with a vertical incision is indicated. Further, I have never given birth; it is my understanding that, for this reason, vaginal still would not have been an option for me anyway.

If I had to pretend that I had it to do over again and did have a choice, I would not have changed anything. I am fine with my abdominal with vertical incision. If I had to face any complications, (which I did not, and most women don't) I would much rather those complications be with the incision rather than vaginal. Just my point of view.

I hope you continue to find your best options by the research you are doing. Best wishes!

What a great question. In my case my Dr who I love does not due Vaginal hysterctomys! This took me by surprise as that is what I had always thought I would have. He is of the old school that you can see more by doing it abdominally. Also the surgery is shorter that way. I trusted him completely so I went ahead with the TAH. My scar is so low that the hair will cover it eventually I recovered nicely from the surgery.

It is an individual decision that only you can make. Make sure you are comfortable with your decision as it is permanent!!!!!

Take care and Merry Christmas

	Quote:
Originally posted by Dawn19 The question I am posing is: what made each of you decide on the type of surgery to have done? In other words, for those who had it done abdominally, why that way & not vaginally ? Those that had it done vaginally - why not abdominally ?

Dear Dawn,

You may be able to find more fibroid info at this website: http://www.fibroidcorner.com/

Whether you have abdominal or vaginal surgery depends on your symptoms AND your doc's level of skills in the operating room. Any of the less-invasive hysts could turn into an abdominal hyst, depending on what transpires in the O.R.

This is major surgery, and you owe it to yourself to get 2 or 3 medical opinions. My doc #2 had much more cutting & pasting in mind for me than doc #3 (my eventual surgeon). If you are able to get relief from a less-invasive non-hyst procedure, you should certainly consider that carefully. Only YOU must live with your pre-op symptoms and your post-op results, good or bad.

Get smart about your symptoms and your options, and make the best choice for YOU.

I am sending huge cyberhugs

I did not have a choice. My fibroid and uterus were too
large for a vaginal hysterectomy, so I had an abdominal one
with the verticle cut. If I had a choice, I would have opted
for a vaginal one since there is no external stitches or
scar, and the recovery is a bit shorter. Before you think
about which method of surgery, you need to talk with your
doctor about which is practical in your case. Even less
invasive is a laprascopic hysterectomy with three or
four very small incisions. It is more difficult to find doctors
skilled in this latter procedure.

Well ladies, went to my appointment today for the internal
ultrasound. Looks like 5 ovarian cysts (don't look cancerous)
to add to my troubles. Scheduled surgery for Tues.
Feb. 12th for a LAVH/BSO. Not really happy about having
everything removed, but I feel that it is necessary.
Might as well do it all now and not have to go back
in later.

I am alittle bummed as I had hoped to keep my ovaries.
But just seeing those cysts on the ultrasound screen
made me turn white with the fear :tongue2: of having ovarian
cancer. I don't ever want to have that awful feeling again.

Good news is that my bladder looks good and healthy !!

Thanks again for your concern and support. I truly
appreciate it.
Dawn

Hi Dawn!

Thanks for the update! February 12th will be here before you know it! (But we'll be right here with you the whole way)

Have you discussed the situation with your ovaries at length with your DR? I have heard of cysts being removed and one or both healthy ovaries left intact. Sometimes this could be an option - but it's certainly your choice - could you at least tell the DR to leave them intact IF they (or one of them) looked good and healthy? Just asking; you sound disappointed to lose them, and I don't blame you. But you must do what's best for your health overall.

Again, thanks for the update - My best to you as you prepare for your castle visit! Meanwhile, keep reading, keep posting!

s,

Thanks for the encouragement Toonces.
Yes, I did discuss the ovary situation thoroughly
with the dr today. She advised me that she could
attempt to remove the cysts from the ovaries, but
there is no guarantee that they wouldn't be damaged
in doing so. Hard to tell how severely they are attached
until she gets inside ! She also told me that cysts most
likely grow back. I know this to be true from personal
experience with my brother and some other people.
This would mean more surgery at a later date or possibly
removal then. Third factor was that there was no sign of
any of these cysts 2 years ago when I had an ultrasound
then. Fourth factor - no chance of ovarian cancer !!

I am still bummed about losing the ovaries, but I know that
it really is the best thing for me to do. The whole
"surgical menopause" things scares me, but as usual,
I'll be a trooper and get through it. It really helps to
have such great support from my hyster sisters too !

Thanks again,
Dawn

Dawn--how old are you? That makes a difference.

In my case, I had pain for about a week (not horrible, but not right) and it turned out to be an ovarian growth. I've had them before. They aren't simple cysts--they look kind of bad on the ultrasound (and I did my research, so I know my doctors weren't just being pessimistic). I have a family history of reproductive cancers, and I cannot STAND to be worried about this.

The doctor told me at the very least we'd remove just the ovary. I told her to take it all out (I had a fibroid in my uterus, and had precancerous cervical cells previously). I did NOT want to go back for more surgery in a year.

She told me that she'd take the one ovary out very carefully through my abdomen (I have about a one inch scar!). She then sent it to path for a preliminary report. If it came back okay, she'd take the rest vaginally. She even took extra cells and everything was fine. It was a follicular cyst which exploded and then went bad. Since we don't know how cancer starts, I don't want to go through that again!

From what I can tell, it may be better to go vaginally if possible. BUT--I will 'warn' you that since you have no real scars, you may get up and be far too active, far too soon (wanna know how I know THAT??).

Bookoholic,
I just turned 45 on Dec. 29th. Sounds like your problems are about like mine are !

During my ultrasound yesterday, we also saw what GYN said looked like the remains of a cyst that might have ruptured. I had told her during my regular exam on Nov. 16th that I had had unusual exruciating pain on the left side one day about 3 months ago. The pain was so bad that I couldn't even stand up. I also was sweating bullets during this time because the pain was so bad. Almost went to the emergency room but the pain finally started fading away. I think that the other cyst she saw was what happened to me that day - cyst must have burst or something. I know that I don't want to go through that again! Besides, I know that these cysts (and my fibroids) are the cause for most of my pain.

My GYN is very conservative, yet agressive, with treatments.
She is very down to earth and lays it all out on the line for you. She told me that I can still keep my ovaries if I wanted to, so she isn't the type to push me into something I don't want to do.
She tells me the pros and the cons of everything. She even encourages me to do research on my own to reassure myself
(which I do alot of!).

Besides, it would only be a few years yet before my ovaries would naturally quite working. I really don't want the hassel of having more surgery in the future regarding my ovaries.
Also, like you, definitely don't want that fear of cancer.

Thanks for your thoughts and concerns,
Dawn