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vaginal vs. abdominal hyst vaginal vs. abdominal hyst

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Unread 06-15-2006, 11:57 PM
vaginal vs. abdominal hyst

I am just popping in to say that my cervix was removed during my LAVH almost 6 years ago. I have had no problems what so ever with not having a cervix. I have plenty of vaginal moisture. Sex is fine. My bladder works just as well as ever. So, if you are looking for some good news from someone who is minus a cervix, here it is!

Talk to your dr about what is best for you. The LAVH was best for me and I have no regrets.
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Unread 06-16-2006, 01:01 AM
vaginal vs. abdominal hyst

I guess you and your Doctor has to decide which way is best for you. I work in the medical field and I do know that they shouldn't take something that is not damaged, and you will here different opinions about the cervix I just stated what I read and talk to Doctor's about the peeks of having a cervix. But of course if you have had lots of problems with the cervix they are going to take it.
Unread 06-16-2006, 02:21 AM
vaginal vs. abdominal hyst

Originally Posted by historylady
In my personal experience on Hyster Sisters, I have rarely seen anyone comment about keeping their cervix and having sexual dysfuntion and /or bladder issues.
Well, there have been many. And there have also been many women who've kept their cervix and then had to go back in later to have a trachelectomy (cervix removal), often because of either bad endo, fibroids on the cervix, or cervical cancer, among other problems.

I found this in our Resources directory:

In fact, symptoms related to the cervical stump requiring further surgery frequently occur following a laparoscopic supracervical hysterectomy. Twenty-five percent of the patients continued to menstruate, and 10% had symptoms of discharge. Careful long-term analysis of results demonstrates a high complication rate reporting symptoms related to the cervical stump in 24% of patients, all requiring further operations. Adhesions, especially between the bowel and the cervical stump, endometriotic lesions, cervical pathologies ( chronic cervicitis, SIL, mucocoeles), myomas and prolapse have been reported at long-term follow-ups.

I'm always interested to read the wide range of answers women have gotten from their DRs when they've asked about the relative pros and cons of keeping the cervix. This thread in the Sexual Dysfunction forum is great because it indicates that we need to ask our DRs very pointed questions on this topic before deciding on surgery, and even if we do, not all DRs are aware of the possible range of outcomes:

Do keep in mind when reading that thread that (1) women posting in that forum are there because they are having problems with sexual dysfunction after a hyst -- not all women fall into that group; and (2) that forum is only open for posting to women who are more than six months post op and having sexual difficulties as a result of their surgeries. Still, it is an *interesting* read.

There is no conclusive evidence that keeping the cervix helps with pelvic floor support. If prolapse is going to happen, it's going to happen, cervix or not. Risk factors for prolapse include having delivered large babies vaginally, lifting heavy weights, constipation and straining to have bowel movements, heredity (a weak pelvic floor tendency can be inherited) and the hormone changes of menopause, which tend to allow the ligaments holding up the pelvic floor to lengthen.

My understanding is that sexual dysfunction and bladder problems post op have much more to do with the loss of ovarian hormones than with removal of the uterus, with or without the cervix.

... how would you know what its like not have something if its always been there in the first place??
I have wondered the same thing every time I have seen members say they can 'feel the difference' in keeping their cervix. Often this seems to be members who had fibroids pressing on their bladders pre-surgery, so of course they're going to feel an improvement afterwards, whether or not they keep the cervix. But it is impossible to know that things are better keeping the cervix if one has not experienced having it removed.

I had my hysterectomy (TVH) for severe prolapse. If I had wanted to insist on keeping my cervix, the DR would have had to go in abdominally, tunnel way down to the entrance of my vagina, and pull the cervix back up through the vagina and then reattach the ligaments that were no longer supporting it to other structures. Even then, chances are it would have dropped again. So, my cervix was removed, and I don't miss it one bit. I still have PAP smears every year, although they are now called vaginal vault smears, and still have never had a bad one. Sexual response is still the same, and I don't leak when I sneeze the way I did pre-hyst. Yes, I could still have a vaginal vault prolapse some day, but I could if I'd kept my cervix, too.

(((MSflowerlady))) I remember reading in one of your earlier posts that you'd been seeing a urologist for bladder problems already. Does that mean your bladder has dropped? Do you also have uterine prolapse? If so, most DRs will only do vaginal hysts on prolapse patients, so keeping the cervix may not even be an option for you. If you aren't having prolapse problems, and the main concern is possible scar tissue from your prior surgeries (five, right?), the DR may decide to do a TAH to make sure he/she can see everything well.

IMHO, the important thing is to have a DR whose judgment you trust, and even then, get at least two opinions. Once these important body parts have been removed, they can't be put back.

Good luck with your surgery!
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Unread 06-16-2006, 06:01 AM
vaginal vs. abdominal hyst

Surferbabe,the possible scaring, spotting, and fibroids appearing on my cervix is one reason I am comfy with it's removal. After 3 c/s and my upcoming hyster, I don't want to have to go thru another surgery if I can help it. Besides I know of MANY women who had their cervix removed decades, even a century ago, and to this day have NO probs mom, and mil included.
Unread 06-16-2006, 08:20 AM
vaginal vs. abdominal hyst

It's kind of weird,but I'd rather the abdominal hyst! I've had 4 c-sections and have never had a baby vaginally, so at least that's one area of my body that hasn't been messed with! I haven't been a bikini candidate for a long time now!
Unread 06-16-2006, 08:33 AM
vaginal vs. abdominal hyst

Here's my experience. My Dr. wanted to do a TAH because my uterus was severely tipped back. He said that there was no way to do a good reconstruction laproscopically because of the angle at which he would have to work. I agreed that I didn't want surgery again in a few years for prolapse. Then when he got in there, my endo. was so severe, he would have had to do an abdominal even if it had started with a lap. He took the cervix because with endo. and adeno. he said most women he has seen have continued to have problems if the cervix remains. I am at almost 4 months post-op and the only difference I can notice when intimate is that it is a little tighter fit. The "O"'s are the same, actually stronger and quicker than before. The muscle contractions that I thought were cervical must be vaginal because I still have them. So far when it comes to sex, all of the changes have been for the better with me.
Unread 06-16-2006, 09:27 AM
vaginal vs. abdominal hyst

thanks so much surferbabe... that was an excellent explanation and helped put me at ease! I owe you a big hug for that!

I was beginning to think I was doomed in some things...

Again, I so appreciate you taking the time to explain that woman who lost their cervix have just a wonderful life as those who dont and that we can still beat the odds of bladder problems and sexual dysfunction. My opinion is this... there are a lot of woman that have never had a hysterectomy that have those problems and have all female parts left!

you are our hero today!!!

Unread 06-16-2006, 11:11 AM
vaginal vs. abdominal hyst

I had LAVH with no problems. I did have my cervix removed. I have had no problems yet. Sex is good. No real sensation changes. Good luck to you!
Unread 06-16-2006, 12:06 PM
vaginal vs. abdominal hyst

It is best to have a trust factor with your Dr. and decide on the ~hyst type~ that best suits your medical needs. Whether one has fibroids, heavy bleeding, endo, adeno, cysts, pre-cancer, cancer, etc. As we can see from our signature lines and profiles, we all have varying surgery types.

The cervix is only part of the hyst question - in addition to the uterus and ovaries. As my Dr. told me in pre-op, the most important thing with the cervix is to be a ~good~ candidate to keep it. Granted, some ladies are advised by their Drs to keep their cervix even if they had recent abnormal pap smears. My Dr. told me that he had to see "at least 10 years of normal pap smears" to make a patient a candidate to keep the cervix.

And, SurferBabe does make a point about the mini-period. A small % of ladies who retain one or both ovaries and the cervix can have a mini-period in post-op. I had my cervix cauterizied during my hyst and I have not had a mini-period in post-op.

So...pre-op ladies, just make sure you LISTEN with your head and heart when planning a hyst. Then your hyst decision will be what you want and what you can live with in the future.

Being 2 yrs. post-op, I am still pleased with my LSH results. And I am glad I went along with my Dr's advise to keep my cervix. I do respect and understand that other Hyster Sisters have or will make another choice.

Unread 06-16-2006, 12:41 PM
vaginal vs. abdominal hyst

I'm scheduled for a TAH-LSO on Monday and we are taking the cervix as well. My doctor's rationale is that since I have severe and abnormal bleeding problems, endometriosis and I am keeping one ovary, that I might still experience bleeding problems associated with any uterine tissue attacted to the cervix. he says there is often very little distinction between the cervix and the uterus.

personally I don't ever want to bleed again. I have been bleeding 60-80% of the time for the last two and a half years! I realize that the sensations may not be the same, but I have pretty much no sex life as it is (which is a real bummer at less than one year of marriage, but my DH is wonderful) so anything will be an improvement over nothing.

Also, I have to have the TAH as I have never had children, and since there is family history of both ovarian and uterine cancer, I have endo and cysts on the left ovary I definitely want the doctor to be able to get a good look around.

But everyone here is right in saying that the choice is very individual and that you need to make the decision with your own doctor.

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