Scheduled TAH Cervix: To Keep or not to keep? | HysterSisters
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Cervix: To Keep or not to keep? Cervix: To Keep or not to keep?

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Unread 12-14-2011, 03:21 AM
Cervix: To Keep or not to keep?

I had a conversation with my gyn/surgeon yesterday and am more confused than ever. I asked why my cervix was being removed if it wasn't necessary. She told me she counsels her patients to remove it to avoid other problems down the road. I asked her about prolapse. She said it was unlikely but she wouldn't guarantee it. I told her that I was doing a lot of reading and couldn't decide what to do. She said she didn't know what I was reading but she assured me that there is enough information in the medical journals that debunk the necessity of keeping one's cervix. My TAH is next week. I have stage IV endo and multiple large fibroids. She said I have right up to the beginning of surgery to decide. I know each one of us is unique, however, I would appreciate feedback on the pros and cons of keeping or removing. Many thanks! PS. I have read the archives regarding this issue.
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Unread 12-14-2011, 04:15 AM
Re: To Keep or not to keep?

Before I had my TAH I agreed with my gynecologist to have my cervix removed. In recent years I had abnormal paps, and while further testing produced negative results, I decided to have it taken to avoid problems in the future. I was worried initially about not having a cervix - prolapse, intimacy, etc. I had my surgery almost a year ago and I do not miss having a cervix. I confess I cannot even tell the difference. I do kegels on a regular basis. I wish you well in whatever decision you make.
Unread 12-14-2011, 04:20 AM
Re: To Keep or not to keep?

I can relate to your confusion. She is have the right to decide. I was confused about everything I read before my surgery. I decided to keep my cervix and I feel it was the best choice for me. I did not want to remove anything other than what was necessary, not a fan of the what if something happens later debate. Anything can happen to any body part at any time...should we remove everything just in case? My final decision maker came when I had my pre-op and asked the nurse practitioner what she would do if it was her. I was already pretty sure I was going to keep it but she reassured me it was the right decision. My surgeon did tell me that he could not guarentee he could save it depending on my fibroids but everything worked out ok.
Many people have said that you if keep it you may experience spotting but I have not had any at all. My surgeon did tell me that a lot of surgeons prefer to take it the first time because many are not skilled in the removal after if by chance it does need to be removed later (I love that he was honest and straight forward about everything). I was also told that I will still need exams so having to have a pap isn't an issue. Another deciding factor for me was not having a cuff and the longer recovery with that.
I hope this helps you in some way. Be confident in your decision and whatever you choose will be right for you. Best of luck to you!
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Unread 12-14-2011, 05:39 AM
Re: To Keep or not to keep?

All of the research i have read has not convinced me of any benefits to keeping cervix. I have decided to remove cervix to avoid issues later. I cant take the pre op anxiety as it is and to have to do it twice....... no thanks. Jan 17 lavh with bso. Good luck to all.
Unread 12-14-2011, 08:05 AM
Re: Cervix: To Keep or not to keep?

my surgery is in 13 days, and I'm still undecided. My Dr. told me I can tell him right before the surgery of my decision. I've had ablitions to my cervix twice over the past 20 years, and I consistently get abnormal pap results, I think I'm leaning towards having it removed
Unread 12-14-2011, 06:19 PM
Re: Cervix: To Keep or not to keep?

There is a lot of controversy regarding the cervix. Some doctors and patients are adamant that it is should be kept, others are just as adamant that it should be removed.

Something to keep in mind when making your decision, the cervix is not a separate organ. It is actually part of the uterus. So whatever is causing the removal of the rest of the uterus can be a reason to remove the entire organ.

Endometriosis and fibroids can both be reasons to remove the cervix. Both can implant on the cervix pre and post hysterectomy.

Since endometrial lining can be left with the cervix as it is the neck of the uterus, mini periods can occur if someone also keeps at least one ovary. Also, if you believe the theory that endometriosis originates with the endometrium, then keeping the cervix and some possible endometrium could allow for new endometriosis.

Prolapse can be an issue with or without the cervix. The cervix itself can prolapse for one.

If you have not had a second opinion yet, you can ask this question at that appointment and it might help with your decision.

For what it is worth, my entire uterus was removed at the time of my hysterectomy 11 years ago and I have not missed it a bit.

Unread 12-14-2011, 07:01 PM
Re: Cervix: To Keep or not to keep?

For what it's worth, when I first came on this website I didn't even realize that keeping the cervix was an option. I got a little freaked reading all the debates, so I read some actual medical studies (there are a lot out there). According to study after study, there is no evidence that keeping the cervix makes any difference (in terms of sex, bowel or urinary issues or prolapse) except that up to 20% of the women who keep their cervix need to have them removed at a later date, there's a small chance the cervix could prolapse, the need for continued pap smears and, of course, the chance of continuing bleeding.

It's really patient preference unless there's a compelling medical reason to remove it.
Unread 12-23-2011, 08:00 PM
Re: Cervix: To Keep or not to keep?

I have the same concerns about whether to keep my cervix or not. I am scheduled for LAVH on Jan . 24th. When I asked my doc about it, she said that she has seen quite a few women who opted to keep their cervix have to come back later to have it removed anyway. She also told me that there are ligaments that connect from the tailbone area to the vaginal area that are not severed during laparoscopic surgery....those ligaments are what prevents the pelvic floor from dropping. Also, she recommended I visit the ACOG website where I could read about studies regarding the removal or retention of the cervix. From what I've read thus far, there is no medical evidence that keeping the cervix is any more beneficial than having it removed. So, I am leaning towards having it removed.

It is certainly a lot to think about... I think we all want to do what's best for our bodies but sometimes it's difficult to know what that is!
Unread 12-23-2011, 08:24 PM
Re: Cervix: To Keep or not to keep?

I chose to have mine removed. I've had several abnormal paps, pain with sex, and endometriosis. I hope you come to a decision that you are comfortable with.
Unread 12-23-2011, 11:01 PM
Re: Cervix: To Keep or not to keep?

i struggled with this decision also. i was scheduled for an LAVH and then my husband went to my pre=op appt. with me. I had given him the booklet I received from this site to look at. at the appt. he started asking about the benefits of keeping the cervix. my Dr. gave reasons as quicker healing time and some other reasons. so, we changed the surgery to an LSH. but, I continued to read the pros and cons and the day before surgery, I changed back to the LAVH. I did not want to think about any problems down the road, or chance of spotting or bleeding, etc. it has just been 8 days since my surgery, but I am happy with my decision. my recovery does not seem that bad at all and I just feel good about not having that to worry about. hope this helps you!

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