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How large is too large for LAVH? How large is too large for LAVH?

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  #1  
Unread 02-25-2007, 06:28 PM
How large is too large for LAVH?

How does a Dr. determine what size uterus is too large for a vaginal or laproscopic vaginal hysterectomy and decides to switch to an abdominal hyster? I have read many posts where the Dr. switched because the uterus was too big. Mine is approximately 16 week pregnancy size and she's planning a LAVH.

Any input from you wonderful ladies?

Renee
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  #2  
Unread 02-25-2007, 07:53 PM
How large is too large for LAVH?

Hi - my doctor is doing a SAH, my uterus is 20-weeks size. Plus the 3 fibroids the size of a grapefruit & 2 softballs. She told me 2 things: the location of my fibroids are the reason for abdominal incision, she feels she can't adequately get to them otherwise. She also told me with the size of my uterus, abdominal was the way to go. Maybe it depends on the doctor's experience? I didn't take Lupron to shrink my fibroids, again, with their location, she said it wouldn't matter. I'm in Chicago with a very experienced gyne surgeon, anyone else have an idea?

one week away, oh my, march 6 is the day!
  #3  
Unread 02-25-2007, 08:09 PM
How large is too large for LAVH?

I had a very large uterus (670 g) and several fibroids. A normal size uterus is 40 to 80 grams. My doctor was able to do it vaginally. He said several factors were involved, the skill or experience of the surgeon being one. He said the main tradeoff was time. They can cut the uterus up into smaller pieces so they can be taken out vaginally, but that takes longer. That means longer on anesthesia and greater blood loss. He also said that an option was doing an episiotomy (sp?) to gain some extra room. I've never had children, so no vaginal delivery, and he still was able to do a LAVH, without an episiotomy.
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