Scheduled TAH Lrg. Fibroid around uterus; sched. TAH but want Lap. | HysterSisters
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Lrg. Fibroid around uterus; sched. TAH but want Lap. Lrg. Fibroid around uterus; sched. TAH but want Lap.

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Unread 08-25-2009, 11:04 AM
Lrg. Fibroid around uterus; sched. TAH but want Lap.

Hi hyster sisters,

New to the board... a year ago logged on when thought I would have a hysterectomy, but Doctor tried something else for a year. Had a laparoscopic exploration about 6 weeks ago. They drained a large right ovarian cyst and took pics of an "angry" fibroid wrapped around my uterus. She also said my uterus is slightly prolapsed. (not sure why as I never had children). They can't see the back side of the fibroid. So they want to do a TAH but keep my ovaries as they are basically healthy regardless of the cyst. They said they can't get it with laparoscopic. They will also take the cervix. Very confused as I don't want to deal with a TAH. I am still in pain from the lap exploration 6 weeks ago (not a good experience; woke up from surgery in terrible pain, and still have tugging and pain on one side so an abdominal incision really is terrifying for me to think about.)

Has anyone else had a hysterectomy for similar conditions done by lap versus abdominal? Also, this is a very weird question, but when they take the cervix, do they sew the top of your vaginal canal up? Does it make it shorter and more difficult for sexual relations? Women never have problems in my family so I know of no one to ask.
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Unread 08-25-2009, 12:15 PM
Re: Lrg. Fibroid around uterus; sched. TAH but want Lap.

Depending on the size and position of your fibroid, the doctor may not have a choice in the type of procedure you receive. In order to properly see and assess the pelvic area as well as make the necessary cuts without damaging other organs (bladder, bowel...etc...), she may have to perform a TAH. You want your doctor to perform the procedure that will be safest for you and in your best interest, and that decision may go counter to what you desire...

And yes, when your cervix is taken, the top of the vagina is sewn shut and a vaginal cuff is created. Does it make your vagina shorter? I don't know the answer to that as I'm only 10 weeks out and haven't had an opportunity to test the equipment, if you know what I mean. I think you'll find that there will be answers on both sides of the fence regarding that issue.
Unread 08-25-2009, 01:20 PM
Re: Lrg. Fibroid around uterus; sched. TAH but want Lap.

I don't believe the vagina is significantly shorter but have no evidence to base my opinion on other than knowing women who have no postop sexual problems. Will test it out myself in a few weeks. I'm 3 weeks post my TAH and recovering well. My fibroid was big and crushing my uterus so no other option. No regrets so far!
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Unread 08-25-2009, 02:07 PM
Re: Lrg. Fibroid around uterus; sched. TAH but want Lap.

I had a vertical incision SAH due to the size, shape and position of my uterus (the fibroids caused it to grow up towards my ribcage). I really would have preferred a horizontal but after expressing my wishes, the doctor explained why he didn't feel it possible. I trusted his judgment (he also does laparoscopic and robot-assisted surgeries so it wasn't an issue of experience in my case) and I'm happy with the outcome.

If there is no pressing reason to have the surgery immediately, you might want to seek a second (or even third) opinion. I met with three GYNs before finding the one I felt I could trust.
Unread 08-25-2009, 02:44 PM
Re: Lrg. Fibroid around uterus; sched. TAH but want Lap.


to HysterSisters!

I definitely agree that seeking at least a second opinion would be advisable. You might find that another physician would have a different recommendation for you!

Also, some women with fibroids have used Lupron prior to surgery in order to shrink the fibroid(s) enough to all for a less invasive hysterectomy type. Would this be an option for you?

As others have mentioned, a vaginal cuff is created at the top of the vagina when the complete uterus is removed (the cervix is the bottom portion of the uterus, not a separate organ). We have an article about it you might find helpful!

Vaginal Cuff -- What Is It?

We also have an article that explains how the vagina is not usually shortened following a hysterectomy:

Vagina -- Hysterectomy Make It Shorter?

Unread 08-25-2009, 07:12 PM
Re: Lrg. Fibroid around uterus; sched. TAH but want Lap.

My gynecologist said I would need a TAH too because I had a bladder taping a few years ago, but I told him I really wanted to explore either the Da Vinci surgery or a laparoscopic surgery instead, at least see if I could have it that way. He gave me a surgeon recommendation and it turns out it was the same surgeon who had done my ablation and bladder taping. I went to see him and he examined me and said I could do either one but the Da Vinci would take longer to schedule, so I opted for the laparoscopic surgery and it's scheduled for 9/01. Despite several fibroids and a bad right ovary, I'm having the TLH. So I guess it doesn't hurt to get a second opinion. It's your body
Unread 08-26-2009, 01:56 PM
Re: Lrg. Fibroid around uterus; sched. TAH but want Lap.


I agree with the other Hyster Sisters and get a 2nd opinion if you can.

I got two opinions myself and it is still one of the *best* things I ever did. My 1st Dr. wanted to do a TAH due to the size of my two fibroids. She told me I was *not* a good candidate for a laparoscopic hyst. I decided to get a 2nd opinion and he recommended a laparoscopic hyst (LSH) after I did (3) months of lupron shots to help shrink my fibroids for the surgery type.

In pre-op, I learned really fast that Drs can give varying options on how to proceed with fibroids. So do all the research you can and keep asking your questions.

Best wishes~

Unread 08-26-2009, 03:50 PM
Re: Lrg. Fibroid around uterus; sched. TAH but want Lap.

Thank you all for your replies! Very helpful in that I don't feel alone. :-) During my exploratory lap there were 2 Dr's there... my OBgyn and then another OBgyn from the same practice. The second doctor was the younger one and supposedly more versed in Lap and he said he also didn't think he could get it without doing a TAH. Would that be considered a 2nd opinion or do I need to go to a different practice? Sorry, I have never had anything done my whole life so am very new to surgeries, 2nd opinions, hospitals, etc... (I am 47)... so these may be very dumb questions.

No one has mentioned Lupron to shrink the fibroids. I will ask them about that and read up on it.

Also great info on the whole "vagina shortening" question. That put me at ease.

I wish we had a Da Vinci near me, but the closest facility is over an hour away. Does insurance cover that or do they balk?

thank you all SO SO MUCH!!!
Unread 08-27-2009, 08:31 AM
Re: Lrg. Fibroid around uterus; sched. TAH but want Lap.

hi...did do the Lupron but all that did was give me terrible hot flashes. When I went off the Lupron I had no period for 11 months and then the floodgates let loose and I wound up in ER. The happy ending is that I had a successful TAH three years ago with a great recovery and do not miss the large fibroid uterus I carried around for too many years. I had very little post-op pain, great pain management is key. If you do go TAH, don't be a martyr. Take all the pain meds you are offered. By the time I arrived home, three days post op, I took nothing stronger than what one would take for a toothache. Advil, motrin, maybe twice a percocet.

However, if you would feel more comfortable with a second opinion you should go ahead and do that. Good luck in whatever you decide.

Love, Ruthie
Unread 08-27-2009, 01:13 PM
Re: Lrg. Fibroid around uterus; sched. TAH but want Lap.

Hi Flbeachdweller,

I am replying again. I might suggest you get a 2nd opinion from another practice. A 2nd opinion that way would either agree with what your current Dr. is suggesting or give you other options to think about.

About the distance of more than an hour to a DaVinci facility...I drove an hour to get to my LSH Dr. and the outpatient facility where I had my hyst. I have been on Hyster Sisters five years now...and I have seen several Hyster Sisters post that they were driving some distance or even flying to a Dr. and hosptial they wanted to have their hyst with. So...even though an hour or more seems like a might be worth pursuing an appointment to see if you are a candidate for the DaVinci surgery. Just my opinion.

In the end...just do what is *best* for you. That is what is most important.


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