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Supracervical by lap-assisted vaginal ? Supracervical by lap-assisted vaginal ?

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Unread 12-31-2001, 11:13 AM
Supracervical by lap-assisted vaginal ?

Hi all. I've just been diagnosed with a 6 cm (approx 2.5 inch) diameter pedunculated fibroid attached to the back of my uterus. It is causing me to have back pain and spasms.

My gyno wants to do a total, abdominal hysterectomy. Total because I am 47 and "close to the average age of menopause" and abdominal because "the fibroid is big".

I first freaked and then started doing reasearch. After reading everything I could find (and finding this board), I have decided that I want to keep my ovaries and cervix. I also want to try to reduce the size of my fibroid with estrogen reducing drugs so I can (hopefully) get a lap procedure instead of abdominal surgery.

My questions to anyone who may know: is it possible to get a lap-assisted vaginal hysterectomy while leaving the cervix intact? What size would the fibroid have to shrink to to get just the lap procedure? Can Uterine Artery Embolization be done on a fibroid attached to the outside of the uterus?

Thanks to all
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Unread 12-31-2001, 05:03 PM
Supracervical by lap-assisted vaginal ?

There is currently a post here titled uterine artery
embolization with responses, opinions, and websites
for further research. Any vaginal hysterectomy would
require the cervix to be removed. You can have a total
laproscopic hysterectomy and keep the cervix which
is called supracervical laprascopic hysterectomy. Your
uterus will need to be a certain size or smaller for the
SLH. My uterus was the size of an 18-20 week pregnancy,
and that was pretty much the limit for a laproscopic
hyster. In fact, the nurse I spoke with said that they would
recommend lupron to decrease it in size. Please also
research lupron with possible side effects.
There have been sisters here who have kept the
cervix and ovaries, and later found that they have
mini periods. I just want you to know that is a possibility
when keeping both the cervix and ovaries.
I ended up having the TAH/BSO. Good luck with your
Unread 12-31-2001, 08:26 PM
Supracervical lap

Hi, thanks for the reply.

I really want to keep as much of my internal structure as possible. I'm afraid of the side effects (prolapse) that can occur with total hysters. I just have the one fibroid. But, it on the outside of my uterus on the back. It's causing me some pain and spasms. My Chiropractor believes it's probably starting to press on some nerve bundles in my back.

I definately want to keep my ovaries. I'm 47, but my mother didn't reach menopause until she was 57. So, if it runs in the family, I have another 10 years of active ovaries. I'm also against HRT do to moral reasons (I hate what they do to the horses).

I'm going to try to find a gyno/surgeon who is tops in his/her field in lap procedures. I live near Manhattan, so that shouldn't be too difficult ( I hope).

Thanks again and happy new year to you and all.
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Unread 12-31-2001, 09:27 PM
Supracervical by lap-assisted vaginal ?

Dear Barb,

Welcome to HysterSisters Regarding your question of lap-assisted vaginal hyst: the *vaginal* part refers to the parts being *delivered* thru the vagina. If you wanna keep your cervix, you can't have the vaginal exit during surgery.

What you are seeking info on is a supracervical laparascopic hysterectomy (keeping your cervix & ovaries). The procedure would be using lap instruments only. Here is a link with a princess story about lap hyst: As for the size of the fibroid, the removed parts can be *peeled like an apple* and removed thru the little incisions. I used to work for a company that developed laparascopic surgical instruments.

The other option, procedure-wise, would be a supracervical abdominal hsyterectomy (keeping cervix & ovaries).

The type of procedure you have would depend on your symptoms AND your doc's level of skills in the OR. If your ovaries are healthy and you have no family history of ovarian cancer, you should certainly consider keeping them. The ovaries will continue to dribble out good stuff for your eyes, bones, heart, skin, etc. even after menopause.

Only YOU must live with your pre-op symptoms and your post-op results, good or bad. Get smart about your symptoms and your options, and make the best choice for YOU.

I am sending huge cyberhugs
Unread 01-02-2002, 11:38 AM
Supracervical by lap-assisted vaginal ?

Hi, thanks for all the wonderful info.

I've decided to have a supracervical lap procedure. My doctor better agree with me :-)

My reasons: According to my research, prolapse and incontinence are potential problems when the cervix is removed. Leaving the cervix leaves important ligaments which help support the other organs. I also have no family history of cervical cancer and all my pap smears have been normal. So for me, leaving the cervix should be no problem as long as I continue to get pap smears.

I also want to keep my ovaries. I'm 47 and my mother reached menopause at 57. Hopefully I have another decade of hormonal production. My sonogram showed normal ovaries and again, no ovarian cancer in my family. I'm also against taking HRT because of moral reasons (the poor horses).

I'm planning to see a doctor that is tops in his/her field and is not so eager to cut everything out for the sake of convenience and/or ignorance. If this darn fibroid wasn't so unconfortable, I would probably just leave it in.

Hopefully, I'm making the right decision.

Thanks again !
Unread 01-03-2002, 03:39 AM
Supracervical by lap-assisted vaginal ?

I just wanted to add something about HRT. The horse urine
is used in the synthetic estrogen such as premarin. There
are bio-identical estrogens that are not made from horse
urine. They are more similar to the estrogen your body
produces. They come in patches, oral form such as
estrace, or compounded form from a compounding
pharmacy. Often your ovaries may temporarily shut down
after surgery, or maybe permanently from the blood loss.
There are sisters here who kept their ovaries, and still
needed to go on HRT. If you have any questions about
HRT, please go to the Hormone board here. There are many
caring and well informed women there.
Good luck with your decision!!!!!
Unread 01-04-2002, 11:35 AM
Supracervical by lap-assisted vaginal ?

Hi all...Well the merry-go-round never ends, but at least they're playing better music.

I saw my Internist for a second opinion yesterday. He looked at the sonogram report and told me that a total hysterectomy is NOT AN OPTION. He told me that he does not aggree with my gyno (and for that matter, doesn't agree with most of her decisions) and told me to see another gyno that his surgeon friend goes to. He said that lap would be the best way to remove the fibroid and that because of the location, it may be possible to remove it and leave everything (even the urerus) in me. What wonderful music!!!!

So, I'm seeing the new gyno on the 14th and we'll see if she agrees.

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