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Vaginal Cuff Questions (kids mentioned) Vaginal Cuff Questions (kids mentioned)

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Unread 01-23-2012, 01:10 PM
Vaginal Cuff Questions (kids mentioned)

Hello Ladies!! I was told by my provider that I will not be able to keep my cervix as they remove everything when they do the surgery. My cervix is perfectly fine by they way. So with this being said what is the vaginal cuff like? I mean *TMI* I used to love getting the bottom knocked on lol. But have started to have painful intercourse due to the adeno. Will this change anything for me or for DH... I mean honestly I think he doesn't care. Having to be told it's hurting 5-10 minutes into intercourse I know is driving him crazy, even though he is the one that chooses to stop. He gets totally freaked out at the thought of hurting me. I guess I just don't know what to expect. Our sex life is not frequent, maybe 1-2 a month if that. My 2 and 5 year old girls smell it I think and immediately ****block lol No matter the time. They are the best birth

Then I would have to wait longer than 6 weeks to have intercourse as I could only imagine it would be sore and could burst maybe. I don't know I usually wait 3-6 months after having kids to start intercourse again.
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Unread 01-23-2012, 02:34 PM
Re: Vaginal Cuff Questions (kids mentioned)

Hi, couple of questions - how do you know your cervix is completely healthy? When you say remove everything - does that include your ovaries?
Adenomyosis diagnosis based upon what testing?
Having a surgeon who is confident in their surgical technique is critical but having a surgery based upon surgeons surgical proficiency may not be in your best interest. Many techniques exist but not all can be the best option for each individual patient. At times surgical/medical intervention is determined and limited by surgeon experience/comfort level and not patient needs.
The more extensive the surgery the higher the risk of complications. Recovery time is also impacted. Supracervical hysterectomy is less traumatic, fewer internal areas to heal etc., resulting in a shorter recovery timeframe. Is surgery going to be abdominal, laproscopic or vaginal? Vaginal hysterectomy = removing the cervix. (a few exceptions exist to this rule).
Removal of cervix increases recovery time significantly. It also alters the normal functional anatomy & support of the pelvic floor. Some women find changes post op others do not. Not all changes are negative. Some are positive some just different.
Research is key to making the choices that are best for you. Many different opionions exist, not all are based on current, reliable research. Use muliple, reliable sources. With exception of cancer, hysterectomy is an elective procedure reserved as an option of last choice. Effects of hysterectomy are irreversible.
In my opinion it is better to chose conservative treatment and assess outcomes overtime as opposed to more global "take it all" approach. Can never undo removal of organs. The more involved the procedure the higher the potential risk of complications. Complications that can range from life threatening to life changing. The side effects of surgery also increase with multiple procedures. Whether abdominal, laproscopic or vaginal - hysterectomy is still a major permanent surgery.
Have you considered a second opinion? Even if you love your doctor, a second opinion can help ensure the choices made are bet for you.
Wish this post was a more concise representation of my thoughts. Hope it isnt iverwhelming and helps a bit. Best wishes
Unread 01-23-2012, 02:50 PM
Re: Vaginal Cuff Questions (kids mentioned)

Hi Hope09,

I don't love my doctor, I barely even know her. This is all her suggestion based on my adeno. She says I am the poster child for Adeno. My cervix is fine based on paps and ultrasounds. I asked about keeping cervix and she said no it's their formality because per their research it does nothing for enhancing sexual pleasure and it increases the risk for cervical cancer. I also have this overwhelming fear for prolapse after removing the cervix, although I have read that removing the cervix does not increase or decrease the risk for prolaspe. I am going through the VA and she is the only Gyn available at the facility. I have no private insurance so this also limits my options for a second opinion. I have very little information to base her capabilities on since she is only affiliated with the Veterans' Hospital.

I am trying to stay positive about this but I am totally uncomfortable about having this procedure. Of course I have looked into alternatives and none cover all my symptoms (heavy bleeding, labor like pains during menses, painful intercourse, PMDD). The Mirena was the 1st choice but I did horrible on Depo so I chose not to do the Mirena since it is the same medicine. Ablation could help bleeding but not pain. These were the only two options presented based on my symptoms.
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Unread 01-23-2012, 07:23 PM
Re: Vaginal Cuff Questions (kids mentioned)

If you're totally uncomfortable with the surgery I suggest slowing down and seriously consider your options. Remember no one can tell you definitively that you have adeno until your uterus is removed and sent to pathology. I was told I had probable adeno. My pathology report stated I had minimal adeno. Until then I had no certainty that the surgery would relieve my pain. You do not want to come out from the surgery with regrets and remorse. There is no undoing it once it's done and there are no guarantees on your outcome. As for sex post op, I have no issues with my vaginal cuff other than its still tender 6.5 months post op. We avoid positions with deeper penetration. DH notices no difference whatsoever. The orgasm is definitely not as good without the uterine contractions. For me, the only thing better about sex post op is DH doesn't bump my cervix anymore, as I always found that painful.
Unread 01-23-2012, 07:58 PM
Re: Vaginal Cuff Questions (kids mentioned)

Hi SugarandSpice,

I'm totally uncomfortable because of her not with the idea of the surgery, as if that is any better, right? lol I just do not get a warm and fuzzy from her. I have been going through this since 1997 with biopsies, hysterosalpingogram, and D&C's. In '98 it was stated after the hysterosalpingogram that it was fibroids, adeno, or both. I do have fibroids and an uterus about 8 weeks in size. She says with my symptoms and test everything else has been ruled out (Arghhh). I have been calling around and they all have to be paid upfront $500 or better for 2nd opinion.

I feel like stepping back but then I think of how my health is at this moment. It sucks for us to have to make this decision and not feeling 100% about it.

So with your patho stating minimal adeno was there anything else found to have been the culprit?
Unread 01-23-2012, 08:12 PM
Re: Vaginal Cuff Questions (kids mentioned)

I'm sorry you're uncomfortable with your doctor. I am also sorry you're limited to the VA and they only have one gyne. I can't imagine dealing with pain and fibroids and trying to decide on a doc who doesn't make me at ease or having to choose out of pocket costs. Sometimes I forget the different medical systems in different parts of the world. I love my gyne and feel he's been my partner in this long difficult journey. He's held my hand while I cried and assured me we'd get me better. I really wish that for you also. Although the adeno was minimal, he believes it was the cause of my pain. I also have lupus and that seems to make me very sensitive to pain. I also had cervical dysplasia and that was another reason for the surgery. I hope you come to a decision you're 100% comfortable with. I'm sending you a hug for strength and comfort.
Unread 01-23-2012, 08:24 PM
Re: Vaginal Cuff Questions (kids mentioned)

SugarandSpice, Thanks so much for the hug. It's so needed right now. I am either getting one extreme or the other in responses from family and friends nothing in the median. Yes it's sad when you have to choose between healthcare or dinner for your family. I would feel so much better if there was someone else beside her available to at least run this by. I am sure this is probably the best option for me but it sucks not being able to confirm that with someone else.
Unread 01-23-2012, 08:32 PM
Re: Vaginal Cuff Questions (kids mentioned)

It does sound like you've explored all your options. And hysterectomy also sounds like a reasonable response to your medical issues. I wonder if you make an appt with this doctor and speak with her about how difficult this decision is for you maybe she'll come around, woman-to-woman? Afterall only a woman can really fatham how hard this is to do. Perhaps that may open the lines of communication somewhat. I wish you luck hon.
Unread 01-25-2012, 10:54 PM
Re: Vaginal Cuff Questions (kids mentioned)

Does sound like you have worked your way through the process. Your symptoms also are similar to my presurgical adeno related issues. At last minute my surgeon decided to remove my cervix, I wasn't very happy about it but pathology came back + cyst within the cervix, so it worked out. It is doubt full you will be successful using quality of sex to support keeping your cervix. However from a support angle maybe. Are you at risk for cervical cancer? Unless she only knows how to perform single type of hysterectomy maybe presenting her with peer reviewed research articles supporting retaining cervix is best option for you will persuade her or justify a second opinion.there is a strong possibility she has little experience performing hysterctomies goes with what she knows. Many doctors stick with what they learneded in school for diagnosis/procedures they do not frequently treat. Just some thoughts.
It may be possible to have a records review maybe through a university based doctor. Maybe worth looking into, sending all your records without physical exam/ tests may be less expense up front. Also many hospitals and doctors will work with you. I have seen many doctors out of net work and no insurance. None charged $500 for first visit, most discounted base rates and were very patient in billing/collection. Medical fees can be very complicated, going by what the front desk says about pricing is usually highest case. Explaining your situation to office manager might be helpful. Can you travel to a different VA? Have you investigated nonVA based support groups? Maybe there is some benefits available in the community? Many non-military people are happy to support military families. Wish I had specific resources for you.
As mentioned already, please do not rush and agree to surgery until you are more comfortable with the plan. Have you be told taking Motrin starting a few day before your period is due helps to decrease the inflammation caused by progesterin fluctuation? I use to wait until symptoms began but then learned it was to late to really help. Is your doctor managing the pain well?
My thoughts are with you
Unread 01-26-2012, 08:35 AM
Re: Vaginal Cuff Questions (kids mentioned)

My surgeon suspected adeno based upon my symptons and the size of my uterus (10 week pregnancy size) and pathology proved him correct. I had two good sized masses and a lot of adeno. He took my cervix which I was okay with since I have had some abnormal paps from HPV. I had my first post op sexual experience this week and the orgasm was better than before.

My concern for you is you are not comfortable with your surgeon. I loved my surgeon even though I only saw him twice before surgery. He really put me at ease and I knew his reputation from friends and the hospital staff. I KNEW I was in skilled hands. Sending you hugs, this is never easy.

The recovery time is a minimum of 6 weeks and it was 7 weeks when my doc released me for normal activity. Even then we are going very easy to avoid bumping the vaginal cuff for now. It is a relief for me not to have pain during intercourse.

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