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Keeping Cervix? Your Decision or Dr's? Keeping Cervix? Your Decision or Dr's?

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Unread 05-28-2002, 08:03 PM
My Doctor's Decision

When I asked about keeping my cervix, my doctor basically told me that he always takes them to prevent any future problems from cancer. He said it would not make a noticible difference in support or sex.

This was fine with me. I didn't want to take the chance of having mini-periods anyway.


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Unread 05-28-2002, 08:05 PM
Keeping those organs like your cervix

First, I am going into the hospital tomorrow to get a simple vaginal hysterectomy. it took me a long time to accept this psychologically. I am not premenopausal at all, so I would have enjoyed having another baby (I already have grandkids) if the right man was around and he and I wished to produce life. I have to get my cervix removed because I have *precancer* cells in it that get deeper as time goes on. They are the result of having the form(s) of the Human Papilloma Virus (HPV), of which there around 72 (forms) that cause women to get these squamous precancerous cells of the cervix (they should appear elongated, always). This condition is known as severe dysplasia. 80% of our US college population now has HPV, and I heard that the spread of this STD cannot be stopped via using a prophylactic, either, so it is rather scary. I'm 49. I did not like to learn that the doctor COULD give me a THIRD cone biopsy to again try to get rid of the ugly cells for once and for all, but a woman should not get more than one cone biopsy all her life, since those cells do not grow back. The cervix becomes thinner and thinner, and if you get too many, you may have to get an emergency hysterectomy because you may begin to hemorrhage during your cone (then). So, in reference to keeping parts of your body that do not show any problems, I want to say this:

First my doc proposed a simple hysterectomy. Little did I know that even then, it's a major operation since he intended to go through my abdomen to remove the cervix and uterus. Later, I saw a letter that he had written to my referring family physician that said he was going to do a complete, not simple, hysterectomy, meaning that he intended to take out my fallopian tubes and ovaries, which have no evidence whatsoever of having any problems at all now. I flipped!

When I asked him why he wrote that in the letter, he told me that many women who get a simple hysterectomy return in about 20 years to get their either deadened or cancerous ovaries removed, but think about it: who says that YOU will be one of them? In addition, if nothing is WRONG with a part of your body that our good G-d meant for you to have, then why take it away? I mean, what is the point? To make it an easier surgery for the staff? Just why do docs want to take out more than is necessary? Why do they also make assumptions of YOUR future health based on the few or even up to 80% of woman who MAY, not always, have additional problems a way huge 20 (!!!) years down the road?

I am only concerned right now with preventing getting invasive cancer, a true and honest threat due to the precancer cells in my cervix. Why should I allow the organs that produce my own type of feminine hormones to be removed simply because SOME women later have problems with them??? (I get many bad reactions to modern, synthetic drugs anyhow, so I figured, why take Hormone Replacement Treatment (HRT) drugs when my own body is able to give them to me anyhow?

Therefore my own opinion (though I am not a doctor) is that I think that one day, they may see that it is not prudent to cut up and/or away every part of a system (the feminine reproductive one, in this instance) simply because it may NOW be *standard* procedure to do it.

Recall all the foolish reasons for hysterectomies around 30+ years ago, how many women never had to have one. And just look at how many women were *advised* by the *experts* to get one anyhow, and who did get one, and who did not really need it. Was that wise? I do not think so.

Your cervix is a part of your vaginal tract. Rather, really, it is the lower end of your uterus, however, where it lies up at the top of your vagina is the natural part of your body where a man's penis lands (hits) when you have sex. I simply cannot see the reason for taking that out of your body with nothing that indicates any disease or dysfunction of it.

If you were to tell a man who had prostate cancer that you thought that it was wise to then chop off his penis (and let us in this example imagine that the man is a physician, a doctor), because then, somewhere down the road he may get cancer of his penis (or, for example, his testicles), what do you think he may want to do? What most men say when I ask them that question is that they would rather take a gun to their heads and blow themselves up than get their penis and/or both testicles removed.

Do doctors not realize that the hysterectomy in and of itself is hard enough for us to handle without removing parts of one's whole reproductive system that show no indication of disease?

And what about the men in our lives, our brothers, our fathers, our boyfriends, our sons, our husbands? How many of them realize the seriousness of a hysterectomy and its attendant mental ramifications? Their attitude, largely, is one of, *Oh, well, the darned thing is giving you a problem, so get it chopped out, get right back up on your feet, and feed me.* Also, men simply do not have the same feelings about having children as we do: to many of them, having kids is just a task, not a pleasure, so it is so easy for that type of man to entirely detach himself from the suffering we as women experience with this surgery.

What so many people fail to realize is that reproduction is the name of the game on this whole wondrous planet of ours. They also do not understand, often, just how serious it is to have a piece of your body cut out of you. So when I think of the nonchalant attitude that I have sometimes faced recently, in regard to my feelings about my own hysterectomy, which I HAVE to get tomorrow, it annoys me that quite a number of people around us just do not *get it,* not until a surgery of this magnitude is required on their own bodies.

I don't think, kind sister, that if nothing is wrong with your cervix that it should be so nonchalantly removed, as though you are removing debris like when you brush your teeth. It is an inherent part of your feminine makeup, so who are *they* to shrug and tell you, *why not?* Why not is because nothing is amiss with that part of your body, so, I believe and maybe I am wrong, I think you should put your foot down *punch* and demand that unless it is proven to you precisely WHY it MUST be removed, that you go ahead and keep this precious part of YOUR OWN (not someone else's) body.

I send you all my best support and wishes that you do what is right for you. Good luck from me here in Chicago. Kiki :
Unread 05-29-2002, 06:12 AM
Keeping Cervix? Your Decision or Dr's?


All I can say is WHOA!

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Unread 05-29-2002, 06:38 AM
I agree with ml

I chose to gid rid of my cervix since it had no real use and could pose a threat for cancer. No more paps. Also, doctors now attach the vagina other organs in the body. There is no danger of anything falling down because your surgeon will secure it.(be sure that this is the way he does it) Also, after reading about a lot of women that have had babies and stress on their bladder, I had my bladder tacked. It is great. I used to lose a little urine when I sneezed but not any more. It is a relatively easy thing your doc can do along with the hyst that will save you an operation later (if you are prone to leakage)
Unread 05-29-2002, 07:04 AM
Keeping Cervix? Your Decision or Dr's?

I am 9 days post op and went through some of the same questions that you are. My Dr and I had many long talks and he basically said it was my decision. But he did give me his thoughts on the matter.

The cervix is part of the uterus. He doesn't feel that the argument of support of the bladder or pelvic floor is a valid one, as in his practice he has seen an equal number of patients with bladder, uterine and vaginal prolapse that have kept their cervix either with surgery or without (my mother is one of those, no hyst and has severe prolapsed bladder). He belives that the cervix does provide lubrication for the vagina, but that can usually be achieved with HRT or external lubricants. He also said that cervical cancer is slow growing and can usually be detected early with yearly paps. But he also added that removal of the cervix after a hysterectomy has a 10 fold risk of injury to the bladder, bowel, and associated nerves and ligaments because of the normal scare tissue that occurs post hysterectomy. He said it was totally my decsion, but he recommended removing it, even though when going abdominally it is a much easier surgery to leave it.

As for my ovaries, we discussed that also. He was concerned about my family history of cancer. Yes it is still a rare cancer, but it is also one of the rapidly invasive cancers that is rarely detected until it is too late! My ovaries were shutting down anyway. yes, I probably still had a couple of years left on the, but not many more. I was to the point where I would have had to go onto HRT now anyway due to symptoms. Again I was told it was my decision, but he recommended removing them.

My decision was to take the safe route. I am a nurse and see cancer patients in the ER frequently. I have in the past several years lost three friends to gyn cancers. And currently have a friend dying of endometrial cancer. So that was weighing heavily on my decision. I opted to have everything removed. As it turns out I had grade IV (severe), yet undiagnosed endometriosis covering everything. He said it was quite a mess. He had to scrape the ovaries off the ureters, and the uterus off the bladder and bowel. I am sure I will feel much better in the long run. So far my recovery is geat!

I don't feel that reproduction is the "name of the game" on this planet. There are many people who have either by situation or choice not reproduced and contributed greatly to this planet. I have no emotional loss to having my uterus removed. It is an organ and does not make me more or less femine. My DNA does that! I have had some hormonal response to having my ovaries removed, but that will be taken care of soon. ( Thank you God for giving our Drs the knowledge to be able to help us along in that fashion. ) And those effects have been minimal since my ovaries were probably almost completely shut down by their general appearance (I am 44). (sorry for getting on my soap box, but I hate the implication that since I never reproduced my life was useless and that I am less femine because of loosing a few organs)

But the choice is YOURS. You have to make the choice that you are comfortable with. I am comfortable with mine.

Just my thoughts.

Unread 05-30-2002, 09:48 PM
Keeping those organs like your cervix

To Amy S:

Why say WHOA? Please explain, for I do not know why you say that.

I think that a big problem exists with the medical professionals since it is so hard to get a straight answer from many of them. It is as though because they were taught things in medical school (who knows how long ago they went, and how interested they truly are in staying current and up-to-date in their chosen specialty, which indicates whether they are truly sincere about being doctors, which shows how devoted they are to helping us truly maintain our health, since we, not they, are their patients), that the things that they could have been taught a long time ago or which are still supported inside of the medical community by more of their ilk (I sure do not think that all doctors are careless, not at all) are those things that they simply do on a *routine* basis when taking out body parts.

I am one to question the whys and wherefores of all that doctors propose, particularly when it comes to surgery. Most doctors do not like that I ask a ton of questions. Usually, though, I've gone out on the Net very thoroughly on my own and therefore learned enough to form intelligent questions (related to whatever it is that I am asking about).

In fact, I see that generally in our society, those who have positions that are considered to be *above* whatever our positions are, such as on the job, get annoyed if one is curious enough to question any procedure that is considered *standard* or *normal* if the procedure is old hat, and that we notice that it can be done in a more streamlined or precise manner, in a different manner. People do not tend to like CHANGE.

Maybe it takes an open mind to *change* the opinion that perhaps because cervixes were always removed in the past (based on the poster's particular set of circumstances and not on any other patients' circumstances who are told to get their cervix removed as a part of their hysterectomies), that in some instances, there is no call to remove it. Such questioning requires mental energy. All questioning of anything that is assumed to be TRUE in ALL instances requires not only mental energy, but courage. It took a lot of courage for Darwin to explore evolution, and to expound on it, when the rest of the world that he then lived in assumed arrogantly that G-d placed us on this planet in His image, and that such a thing as natural selection would then be totally impossible. It was courageous to even listen to the theory that the world was round and not flat. It was courageous to state that our planet revolves around the sun, not the other way around.

What I am trying to get across here is that we are the subject of our own surgeries, because we live inside of the bodies that we were born with, and no one else lives inside of them. I cannot allow myself (if I do not entirely understand what is happening to my body and why the doctors propose doing one thing or another to my body to help me live better) to take one doctor's opinion as absolutely, positively correct when it comes to how my own health is handled. I believe in getting second and even third opinions, and yes, indeed, I ask many, many questions to see if the first and second opinion (at times) have any reasonable basis. I do not want medical procedures performed on or inside of my own body without good reason. I am in control of my own decisions, so I go out and learn enough in order to *question authority.*

Basically, I am also stating that we too often allow ourselves to be led around as though we are sheep.

Kindly tell me why you stated the word "whoa" to my response to the sister who asked why or why not her cervix should be removed.

BTW, I just got home tonight after the simple vaginal hysterectomy I got yesterday, sooner than the doctor had originally thought I would be able to be released from the hospital. I am happy to be home, yet I am tired and am paying very close attention to my own body, so that I truly recover. However, if I had not questioned him as to his reasoning behind a later decision (that he had already said to me about not taking out my tubes and ovaries), namely, a later decision in a letter to my referring physician to go ahead and remove them, I would probably now have to take HPT, when I think it is best that if possible, we let our own bodies manufacture our own hormones. I was also the person who questioned why he suggested that he do the hysterectomy through the abdominal wall rather than through the vagina. If I myself had not gone out to the Net and done some research, I would blindly have thought that all women get a hysterectomy by having their abdomens cut open, which would not have allowed me to come home so soon, and which may then have led to complications that we simply do not need.

I want to say here that we as women, as intelligent creatures, owe it to ourselves to ask why a doctor proposes performing any surgery on us, and the method s/he will perform it. I say that we are the subject of the surgery and they are objective outsiders, but it is our health, now and in the future, that we should be concerned with, because our own bodies are at stake, not anyone else's.

Love to all of you, Kiki, May 30, 2002, in good health, thank G-d!
Unread 05-30-2002, 10:18 PM
Keeping Cervix? Your Decision or Dr's?

Hi, Ladies,

Please note that you will need to have pap smears done in the future. This is true whether you kept your cervix or not.

Even without a cervix, it's still possible to get vaginal cancer. The pap smear checks for vaginal cancer, as well as cervical cancer.

My doctor advised me to schedule a pap smear every three years. Other doctors recommend having a pap smear yearly. Please check with your doctor to learn how often you need to have a pap smear.

Best wishes,
Unread 05-31-2002, 12:37 AM
Keeping Cervix? Your Decision or Dr's?

Hi sister
according to my research it is a really good thing if you can keep your cervix, as long as it is healthy. The recovery seems to be a lot quicker, meaning there is less trauma for the body during surgery. The other reason is the nerve supply in and to the cervix which enhances pleasure during sex, something I am fairly attached to myself. Your vagina will also stay in place a lot better (yes it can collapse) and is suspended by keeping the cervix, there is also less chance of infection post op. Hope this helps. I' m having my subtotal hysterctomy next Wednesday, definitely keeping my cervix...
Unread 05-31-2002, 05:02 AM
Keeping Cervix? Your Decision or Dr's?

Golly - some very interesting comments!

Having a somewhat medical background (pharmaceuticals), I too have my opinions on whether to keep your cervix-with-a-smile, or not. Although it's generally accepted that "if it's not broken, leave it in", I've read more than a couple of clinical trial transcripts (I can list who and where if needed, later) where for many women, keeping the cervix for the sake of keeping it is simply not beneficial, in both the long and short term.
There simply isn't an easy answer to this question - every woman is different, and will have different reasons for keeping, or removing, her cervix. One thing IS very clear though - we should never, ever, try to influence her decision due to our own preferences. That serves only our interest, and not hers. It's one thing to inform, quite another thing entirely, to persuade.

As for me, my Mum had both cervical and breast cancers (she's a survivor), and my maternal grandmother and aunt both died of cervical cancer that metastasized to the bladder.

That made my decision fairly simple - even though I'm relatively young (28), my cervix will be leaving it's little haven inside of me, as of July 30.

Kiki made some very good points, as did all of you. It really IS down to personal choice - as long as we women educate ourselves on the pros and cons, and make an informed decision on this basis, that should be the end of it.

Whilst it's true that many of us are easily swayed by our physicians, I'm of the belief that generally speaking, the doctors are NOT there to harm us, endanger us, or make rash decisions about our healthcare. Call me trusting, but if I can't trust my doctor to keep MY priorities at the forefront of his decisions, then I can't trust him to perform *any* surgery upon me.

It takes a strong woman to decide, participate in, and recover from, such a major surgical procedure. Congratulate yourselves, ladies, for being so strong, and so empowered.

We're not sheep, and we won't be led *grin*.

Warm hugs to all,


Unread 05-31-2002, 05:11 AM
Keeping Cervix? Your Decision or Dr's?

One thing I forgot - regarding Kiki's question about doctors maybe not being interested in the latest education/developments.

Generally, both surgeons and physicians are required - by law - to complete CME courses (Continuing Medical Education), throughout their careers, precisely for this reason. Of course, that doesn't imply that certain doctors will welcome new advances with open arms...however...

There's really not much chance of your physician being *that* archaic in his knowledge


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