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Making the decision - fibroids Making the decision - fibroids

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Unread 01-02-2003, 06:09 AM
Making the decision - fibroids

How do you decide whether to get a hysterectomy or just have the fibroids removed? I have been posting on the other board, here's my story:

When I had the sonogram, the dr said the fibroids may not even be whats causing the bleeding. I have been bleeding constant for the last two months except for a few days break here and there.
I read about the fibroid embolization, and the thought of having something rot away and pain for a week and possible death from sepsis does not sound like a good option to me. I dont want any more kids, and I dont want to take the chance of this coming back again or the surgery not helping.
What are the pro's and cons of hysterectomy vs removing the fibroids only?
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Unread 01-02-2003, 06:56 AM
Making the decision - fibroids

Fibroids often grow back, or new ones can form- this is the major reason against simply removing fibroids. The UAE option, (which you don't want), only shrinks fibroids; doesn't get rid of them, so you could still bleed, if fibroids are the source of your problem. Also, this has been around for just a few years- no real long term studies of how effective the treatment is exists.

What else does the doc think could be causing the bleeding? You mention you've never been tested for endo; for a definitive diagnosis you need a laporoscopy.

You might want to try posting your question on (the Women's Health Forum). There are volunteer OB/GYN's who answer medical questions for free. Usually you get an answer the same day. If they don't answer, you can re-post your question after 48 hours.

It sounds like you've been going through a lot. I hope you get to the bottom of it soon.
Unread 01-02-2003, 07:01 AM

I also had fibroids, three of them, in fact. I had researched my options before choosing to have my hysterectomy in May. I was also having excessive bleeding to the point of being hospitalized several times.

According to my research - removal of just the fibroids is done to preserve reproductive functions or in cases where a hysterectomy is contraindicated. If you are not planning to have more children, then you may not want to go this route. A lot of times, the fibroids and the problems return.

There is also a procedure known as thermal ablation which would destroy the lining of the uterus, reducing or eliminating the excessive bleeding. However, when fibroids are involved, especially on the interior lining of the uterus, this is not usually an option.

A hysterectomy would be a permanent solution to the problem, but also has it's own set of risks and complications. You would need to determine whether to keep your ovaries or not, if you'll need HRT, what risks are involved with HRT if you do need it, and if you do decide on a Hyst, the length of recovery time may be a consideration (4 to 8 weeks, depending on the procedure.)

I can't tell you what choice to make, that is a decision you will have to live with and need to research carefully. However, I can tell you that if I had to choose again to have just the fibroids removed or have a hyst, I would definitely have the hyst. I had no complications, a very uneventful recovery, and now, seven months later, I feel like a new woman. No more hugh tummy from the fibroids, no more excessive bleeding, no more pain. It was worth it all!

Good luck in making your decision and lots of s,

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Unread 01-02-2003, 08:06 AM
Making the decision

I have also gone through the same decision making process and have a TAH scheduled for 2/4/03. It took me 3 years to decide that a hysterectomy was the best option for me. A book that I found very helpful to start the decision making process is "Sex, Lies and the Truth about Uterine Fibroids" by Carla Dionne. There is no right answer and you have to get to the point that you are comfortable that the decision you make is the right one for you. Believe me, everyone will have their opinion and be willing to give you advice!

This web site is also one of the best sources of information I've seen. Part of my decision was based on talking to women who had hysterectomies and listening to what the women have written about their decision here. I see very few postings from women who have not suffered for a long while before their surgery. I believe the most successful results happen when the patient has made the choice herself.
Unread 01-02-2003, 08:28 AM
Making the decision - fibroids

Hi PrincessPam,
Everyone is different, but here's my input:
I have put off having this done for 5 years, partly because of bad advice from doctors who didn't check things out thoroughly, but for the last 2 years just out of fear and denial. I have several golf ball size firoids, and one that has now grown to the size of a small cantaloup. Also, I have been having periods that last up to 5 weeks for 4 years now.
According to my current doctor (whom I trust) they grow back more often than not. Also, all the ladies I've spoken with who have had them removed have all had to have a hysterectomy in the long run anyway. My thought is, why go through more suffering than necessary?
This is an important decision and a difficult one to make. However, I know that it's the right decision and that my life and health will be better afterward.
Coming in here, you will find a lot of support and help. I have met so many sisters who are so happy afterward because they feel so much better, and that is really encouraging. I hope this is your experience also.
Unread 01-02-2003, 09:19 AM
Making the decision - fibroids

Thanks everyone. So it seems the opinion is that removing the utuerus is a better solution than just removing the fibroids. Does anyone know, are there more chances of adhesions with hysterectomy than with surgery to remove the fibroids? I really see no reson to keep the utuerus, since I dont want more kids. I certainly cant go on like this much longer or I will be on disability. So I have to do something.
I dont see any reason to remove the cervix, fallopian tubes, or ovaries. Is this just a cancer precaution? Or are there other benefits to this?
I have never had a lap so I dont know if I have endo, my dr suspects it because I have bowel and bladder problems with no known cause. The sono just showed fibroids and ovarian cysts, didnt show endo. The uterine lining was small, but I havent had one in 1 1/2 years. I will probably have to have a sono first to see what has changed.
Unread 01-02-2003, 09:30 AM
Making the decision - fibroids

I'd discuss this with your doctor. Mine told me that I run chance of future problems if I keep anything. Since I am 53 and not planning more kids, it seems best for me to just do it. I also have the bladder and constipation symptoms and really want them to go away. But - it's your body, your decision, so talk to your doctor and even get a second opinion if you feel the need.

Unread 01-02-2003, 09:55 AM

Hey there!!! Just saw your post and wanted to add my I had my TVH 11/4 and have not for one day regretted it....I too had fibroids..three of them matter of fact....was plagued with flooding, clotting periods coming every 14 days and which lasted 10 days!! Went thru super maxi pads and super plus tampons at the same DR put me on BC pills which took months to work and I still bled thru them at times....I am 45 and done with babies...maybe some grandchildren someday??...After finding the fibroids on ultrasound, my DR gave me my options.....hysterectomy or live with the bleeding...Okay no real choice there so we scheduled for a vaginal hyst...kept the ovaries.... Why go thru having the fibroids removed?? That is a major operation in don't need the uterus to go thru menapause.....I was done with it so.....lets get rid of the trouble causing organ.....
The waiting for surgery was the hardest thing to endure...the surgery itself was easier and less paiinful than having my boys...I was back to work within 4 weeks...I feel awesome!! Yes I get tired at times...Your body tells you when to slow down. It was a true pleasure to pack up the stockpiile of fem products in a large gift bag and give them to the girls in our billing linen closet in my bath has so much room now....and I am just waiting for Victoria Secrets Semi Annual Sale to buy more new the high cut cotton ones.....
Don't be afraid of surgery....ask lots of questions and you can email me anytime....Good luck and take care....

Unread 01-02-2003, 10:04 AM
Making the decision - fibroids

Thanks for the post lilly. You're an angel. I'm a 1/13 lady in waiting and your happy attitude and sunny remarks are a tonic.

Unread 01-02-2003, 12:25 PM
Making the decision - fibroids

Hi roro,

having a hyst or trying to just deal with the fibroids in other ways is a really difficult decision. I feel that I got bad advice for a number of years from my previous gyn and did the "watchful waiting" routine so long that I ultimately didn't have any other options besides the surgery, because my uterus was so large and my fibroids so numerous.

I was having awful symptoms and my quality of life has improved immensely now.

However, I was totally clueless about surgical menopause and all it can entail, so I would really recommend you read up on hormone therapy, so you know what you might be getting into! I have done fine on estrogen, but some women have a really hard time finding a hormonal balance.

As for removing the cervix, ovaries, and tubes, you need to also read up on this and discuss with your doctor. I ended up deciding to have my ovaries removed--I'm 48. It turns out they were pretty cyst-filled anyway, but I hemmed and hawed about it up until the bitter end. My doc also removed my cervix, and i'm not sure that I would have had a choice in the matter, because I had a lot of fibroids down in that part of my uterus. I forgot to ask him about it. Some people feel that retaining the cervix can help in maintaining sexual pleasure and pelvic support; however, there is some contradictory evidence about these claims.

I'm alittle worried in your case that your doc isn't sure about the cause of the bleeding. Hopefully your further tests will give some more answers!

good luck!

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