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LEEP Procedure or Hysterectomy? LEEP Procedure or Hysterectomy?

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Unread 12-28-2007, 03:47 PM
LEEP Procedure or Hysterectomy?

Hi! I'm new to this board, so I hope that I'm posting this in the right spot.

I had a cervical biopsy on Dec. 20th. I received a phone call from my doctor (never good when the doctor himself calls!), and he said that my biopsy did not show actual cancer, but that I had precancerous cells that were stage 7 of 7 right before cancer. I'm in shock! There's been no symptoms - I do my annual pap smear every single year without missing.

Anyhow, he gave me the option of doing the LEEP procedure, which may or may not get everything as the cells in question are found on the inside of my cervix, or doing a hysterectomy.

Just a little background - I have had a few "abdominal" surgeries - a laser surgery 12 years ago to remove stage 4 precancerous cells, a c-section, and a laparascopy for Endometriosis. My doctor said that even if I have the LEEP procedure done, it may very well affect my cervix to the point that achieving pregnancy would not be possible, having already had so many previous surgeries.

He told me that if I chose the LEEP and either the pathology reports showed that the cells had spread or that if I had another irregular pap test come back that he would recommend a hysterectomy anyway.

I'm so torn right now. I am in the early stages of researching all of this - I have checked out some websites and talked to a few different people, but I just wanted to get some differing perspectives.

I'm leaning toward the hysterectomy just to have it all over and done with. I'm 32 years old. What would you do if you were me? Is it, in your opinion, more beneficial to have one over the other? If I did have the hysterectomy, should I leave the ovaries in or have them removed as well?

I'm sure I'll have a million other questions, but that's for starters. My husband and I are going to sit down with my doctor to discuss everything more in depth next Thursday, and I just want to be prepared with as much information as I possibly can be by then.

Thanks so much in advance for whatever insight you can lend!

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Unread 12-28-2007, 04:02 PM
LEEP Procedure or Hysterectomy?


I was in your position myself and after thinking about it long and hard I realized that a hysterectomy was the best option for me. I was sick of the painful attempts at treatment for bad paps and my periods were beyond horrible to begin. The thought that it could have turned to cancer scared me and made me seek the more radical treatment option available.

One thing to keep in mind is your ovaries. If I had not been able to keep at least one of the ovaries, I doubt I would have had the surgery, I was prepared to not be able to give birth to my future children but menopause was not something I would have been ok with.

While waiting for the surgery was hard and I swear I changed my mind on a daily basis, it was the best thing I have ever done for myself. I have had a rough recovery and I still would do it again if I had to. I honestly don't think I would have been ok with living with the thought "what if those cells finally became cancer today?" I would have feared every spot on my underwear and every off period cramp I had.

Take care and feel free to contact me if you have ANY other questions.
Unread 12-28-2007, 04:59 PM
LEEP Procedure or Hysterectomy?

mimi, i'm sorry to hear that you've got cervical dysplasia, and it sounds like you also had it 12 years ago (?). first of all, i would recommend you consult with a gynecological oncologist, if you haven't already done so - they're the experts with dysplasia/cancer. secondly, please keep in mind that a hysterectomy is major surgery, and with it come risks and a long recovery. i had 2 leeps before i had a hysterectomy, and if i could have had another procedure other than the hysterectomy, that's what i would have chosen. and, keep in mind that having the hysterectomy does not guarantee that the dysplasia will not return; it's unusual but not rare to get vaginal dysplasia after you've had cervical dysplasia. it's hpv that causes the dysplasia and there is no treatment nor surgery that removes the virus. so, you'll always need/want to keep up with the follow up paps, even if you have the cervix removed.

it's a major decision, and it's good that you're thinking about all the options. best wishes with whatever you decide.
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Unread 12-28-2007, 05:51 PM
LEEP Procedure or Hysterectomy?

I had a LEEP done back in 1995 for dysplasia, although my dysplasia wasn't at as high a stage as yours. As others have suggested, I'd recommend consulting with a gynecological oncologist for their expert opinion as to whether or not they think hysterectomy is necessary. I firmly believe in making as informed of a decision as possible.

Whichever option you choose, I wish you all the best!
Unread 12-28-2007, 06:28 PM
LEEP Procedure or Hysterectomy?

I agree with others. Please consult a gynecological oncologist. I went to one a couple of years ago just after my 2nd LEEP procedure. I was just scared of having cancer and wanted to get his opinion. He assured me the LEEP had gotten everything. It is not a pleasant procedure but WAY easier than a hysterectomy and the recovery. He did paps every 3 mos for a year for my peace of mind. Now 2 years later, I had my hysterectomy for other issues (enlarged uterus, cysts on ovary, endometriosis). This was a better time in my life for major surgery. I'm sure an expert opinion or second opinion would help ease your mind.
Unread 12-29-2007, 04:17 PM
LEEP Procedure or Hysterectomy?

Thank you all so much for your replies! You've certainly given me a lot to consider.

[quote=ekkorose]I honestly don't think I would have been ok with living with the thought "what if those cells finally became cancer today?" I would have feared every spot on my underwear and every off period cramp I had.
See, this is where I am. I'm a worrier by nature, so I KNOW that I would be constantly obsessing.

I just wonder, being at the final stage and all, what the likelihood is for the cells to have already spread to other areas. I would really really really hate to go through the LEEP procedure and then have to turn around and do a hysterectomy anyway.

Just thinking outloud (but if you have anything to add about that, please do by all means!).

I'm so glad to have been pointed to this board. Your prompt replies were awesome! Thanks so much!

Unread 12-29-2007, 07:46 PM
LEEP Procedure or Hysterectomy?

mimi, you're right that it would be frustrating to have the leep and then find out that you need a hysterectomy. but, looking at it from another perspective, what if the leep is successful, and you don't need any further treatment? after the leep you can return to work the following day. after the hysterectomy, you need 4 to 6 weeks before you can return to work. and yes, the leep hurt, but was quite manageable with ibuprofen. in comparison, the hysterectomy pain required narcotics to manage, and even then still hurt - and the pain wasn't for a day, but for weeks. the leep is relatively low risk. the hysterectomy is major surgery. neither procedure guarantees that the dysplasia will be gone for good. the choice is yours, of course, and you need to decide what you think is best for your situation. yes, having the leep first might be frustrating if you need the hysterectomy, but are there other down sides of doing it that way? and what does the gynecological oncologist recommend? that's the doctor you want to make a recommendation for you - and to do the leep, if that's what you opt for. there's lots to think about and only you and your doctor can determine what's best for you.

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