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Did anyone have a choice of what type of hysterectomy you would have? Did anyone have a choice of what type of hysterectomy you would have?

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Unread 08-28-2008, 06:54 AM
Did anyone have a choice of what type of hysterectomy you would have?

What I mean is basically I have to have a TAH because that is all my surgeon does!! He said he didnt want to do one Vaginally as my uterus wasnt far down enough where in some ladies who have a lot of kids it is further down and easier to remove. In the UK we cant really pick and choose our docs and if I did request a different surgeon who could do it LAVH iT would probably take another year on the waiting list, I am pleased I am having the op but I think it would be better for a less invasive procedure? Anyone else felt like this?
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Unread 08-28-2008, 07:22 AM
Did anyone have a choice of what type of hysterectomy you would have?

i was offered a vaginal hysterectomy first but i didnt want my cervix removed. i researched all the different types, knew i wanted an lsh and found a dr who did them. luckily i qualified for it and i was able to keep my cervix and ovaries. like you, my first dr didnt offer the lsh because he didnt know how to do them. we're lucky in the u.s. to be able to get as many opinions as we like and can choose our surgeons. good luck with your surgery..i wish you a quick recovery.
Unread 08-28-2008, 07:48 AM
Did anyone have a choice of what type of hysterectomy you would have?

I had mine done vaginally because I had uterine prolapse very badly. I didn't get a choice but I heard that vaginally has a much easier recovery time than abdominal. If your doctor has never done a vaginal hysterectomy, maybe you wouldn't want him trying it out on you anyways. I'm sorry you can't go to another doctor for another opinion. Good Luck with everything.
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Unread 08-28-2008, 08:04 AM
Did anyone have a choice of what type of hysterectomy you would have?


We are all different, have different histories, different problems, and our surgeons have the training and knowledge to choose the surgery type that is best for our situation.

It is true that not everyone is a good candidate for a vaginal surgery. I know I was not.

If you aren't sure though, that you trust your Dr's abilities or judgements, then maybe waiting a little longer for one you can trust would be a good idea.

s and Best Wishes,
Unread 08-28-2008, 12:00 PM
Did anyone have a choice of what type of hysterectomy you would have?

Hi Mrskeidis
I am also in the uk and having an LSH, which having researched it would be my choice - were it not that's what my surgeon happens to do! If you are going private, you should be able to find a surgeon who can do this and not wait. If you are an NHS patient, there are surgeons who do this on the NHS (mine is one) but you need to know who they are and get a referral from your GP or existing consultant. They may also not be local.
You need to decide if this is what you want and then be prepared to stick to your guns. There are a few cases that are not suitable for this type of surgery - those with cancer, very large fibrioids and lots of adhesions are the main ones. There are far more sugeons who are not trained in this type of surgery.
Also LAVH and LSH are not the same surgery - you get a much faster recovery with LSH.
Good luck with whatever you decide.
Unread 08-28-2008, 12:35 PM
Did anyone have a choice of what type of hysterectomy you would have?

My doc said from the beginning that she thought we could do a LAVH. She said it could not be done only vaginally without the laparascope, however, because of the previous surgeries I have had and the scar tissue. She also said that LAVH's can always turn into TAH sometimes. However, I have done 3 months of Lupron to try to shrink things to make the surgery easier... So, I am praying all will go smoothly.

My doc will not do a total laprascopic hyst. She recommends removing the cervix. She feels that too many complications result from leaving the cervix. I don't have a problem with this, but I know some people do.

My doc also does not do the DiVinci procedure, as she has not been fully trained on it, and it is only being offered by gyn onc in our area for cancer surgeries.

However, my doc has no problem consulting with other docs and referring to other docs as needed. She even recommended that when I had my myomectomy 10 years ago.

I trust her and her abilities. So, I'm comfortable with moving forward on my surgery.

Good Luck!!!
Unread 08-29-2008, 02:51 AM
Did anyone have a choice of what type of hysterectomy you would have?

Thanks for all your help, I have thought about waiting and seeing if I can get referred to a different doctor but it has taken me 7 years to get to this stage, I have changed consultants once as my other one said my problems stemmed because I was over weight and it was my hormones, he was wrong as my new doc has proved this, he totally missed the fibroids etc... I am in a lot of pain each day now again since stopping the zoladex injections so I dont think I can wait any longer, I am happy I am having the op but I am quite impatient and just wanted to recover quicker!!! Anyway I am sure with lots of rest and TLC and frequent visiting to this site I will be fine xxx
Unread 08-29-2008, 05:16 AM
Did anyone have a choice of what type of hysterectomy you would have?

Now I'm really paranoid that I have a trigger-happy consultant, giving me a TAH without exploring any other options! Never had Lupron, or Zoladex. Never had the option of a vaginal or laprascopic

Basically, started having gushing periods in Feb 07 - fobbed off with "It's your age" - it wasn't until I burst into tears in May 08 with the doctor that he sent me for a USS, where they found a fibroid. The USS was a bit humiliating - I was actually on my period when I was sent for an external USS, but she ended up having to stick the wand up my hooha

MRI confirms that it's 12cm x 5cm x 4cm (5in x 2in x 2in), which they say is fairly large

Do you think I should be pushing for further options? Or is TAH the only reasonable solution? Luckily, I'm going private under husband's insurance, so I don't need to worry too much about waiting times

Any thoughts?
Unread 08-29-2008, 10:29 AM
Did anyone have a choice of what type of hysterectomy you would have?

Hi welshtuppence
12cm is indeed a large fibroid and that may well be too big to go for a lap procedure. If the surgeon is trained in lap procedure he will probably offer this and if not he may not discuss the option. i don't think you have someone being trigger happy, its just how medics seem to work. If you are happy getting another opinion and perhaps delaying things while you get it then speak to the consultant about LSH and find out if you are a candidate. But you may find that your fibroid is too big and you then have to decide if you want to delay things while trying to shrink it or just get it out?
Celtic Lass
Unread 08-29-2008, 11:37 AM
Did anyone have a choice of what type of hysterectomy you would have?

OB/GYN's don't get much training in residency in either TVH or laparascopic procedures. They do lots and lots of open abdominal procedures, like c-sections, and so most of them are very well trained in TAH. There is a fellowship (an extra year of training after residency) in Advanced Laparascopic Surgery, but it is not recognized by the two accrediting boards, and that's kind of a dis-incentive to do the fellowship since the doctor can't get board certified in the subspecialty. There are lots of articles in OB/GYN journals complaining about the lack of training, and the slowness of the specialty to adopt laparascopic surgeries as compared to other types of surgeons.
I'd go with whatever surgery the doctor feels the most proficient in. Also, don't be shy about asking a surgeon about their outcomes. Esp if you are getting a lap or TVH procedure - how many have they done? What percentage had complications? They know all these numbers because hospitals track it for QA/utilization review. I asked mine that stuff. He didn't bat an eye. Then again, he knows I recruit doctors for a living.

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