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Vag. hysterectomy w/Burch Vag. hysterectomy w/Burch

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Unread 01-25-2003, 06:38 PM
Vag. hysterectomy w/Burch

One doctor I went to this week prefers to do a vaginal hysterectomy....he says because my uterus and bladder are so severely prolapsed and that is why I am a good candidate for this. Also, he says he can more easily accomplish the bladder suspension vaginally also. He says he wants to do a laparoscopy also to see what the cause of my pelvic pain is. He did find two fibroid tumors in my uterus during vaginal ultrasound and he also an area of something that could either be adenomyosis or a bunch early fibroids he said. I have had a lot of in-between bleeding (between periods) and heavier bleeding during periods and I am anemic now he says.

I am really worried about having a vaginal hysterectomy. The thoughts of going in vaginally really disturb me and I wish it could be done abdominally. I also read the Burch repair has better success rate when done abdominally rather than vaginally.

What to do....what to do....what to do????
Has anyone else on this site had a vaginal hysterectomy? How have you been since?

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Unread 01-25-2003, 08:08 PM
Vag. hysterectomy w/Burch

Hi Amaryllis,

Lots of us have had vaginal hysterectomies. The TVH initials in my signature stand for total vaginal hyst. My bladder, bowel and uterus were all prolapsed and my doctor did everything vaginally. Is there anything in particular that disturbs you about having it done vaginally?

If you do a search on the site for the word vaginal you'll find lots of threads talking about the procedure.

If you are not comfortable with what your doctor suggested, then you might want to get a second opinion, to see if you receive the same advice.

The recovery time period is pretty much the same as abdominally, except that we don't have an external incision. I also needed repairs done for a cystocele (bladder prolapse) and a rectocele (bowel prolapse) so going in vaginally made it possible for all three procedures to be done at one time.

Please let us know what you decide to do.


Unread 01-26-2003, 05:34 PM
TVH vs. TAH?...

Thanks for your reply, Karen. Actually, that was my second opinion I should have said. I should have mentioned that in my post. The first opinion was from my regular OB/GYN doctor who says I need an abdominal hysterectomy because he says I have an extremely enlarged uterus. The second opinon doctor says I have only a slightly enlarged uterus and that he prefers the vaginal hysterectomy especially for someone like me. He says everything is so prolapsed...the bladder and uterus....that he can get to everything much easier. He would do the laparoscopy first of all and then follow with the TVH and Burch repair after he sees what is causing the pain. He suspects there is more than the fibroids, such as endometriosis and the laparoscopy is how he can see that. This second opinion doctor is supposed to be one of the best and he comes from a teaching hospital. Anyway, it is because I have two totally different opinions that I am very confused on what to do. Guess I need a third opinion. My fear of having it done vaginally is worrying that it will interfere with intimacy between my husband and I.

In regards to the bladder suspension, did you have a Burch repair? I understand it is one of the best. The second opinion doctor actually wants to try a new sling rather than the Burch. But, I told him I had researched about the Burch and it has been a lot longer and the success rate is best for the Burch. He agreed yet said he feels the sling is just as good as the Burch. His practice has been doing the sling repair for one year and he has done 50 of them. Anyway, he did agree to at least do the Burch.

Second and third questions for you, if I may, how long did you have to wear a catheter and how long were you in the hospital?

I will probably go with the second opinion doctor, but it makes it particularly confusing after he said my uterus is only slightly enlarged and the first doctor said it's extremely enlarged and the size of 12-week preg. size. I asked the second opinion doctor about this and he said he has no idea why the first doctor thought that but he read the operative report from the D&C and hysteroscopy that the first doctor did and verified that is what he found. However, the first doctor did report he had poor visibility during the hysteroscopy. (the D&C and hysteroscopy was 1 year ago, by the way) Sorry, to ramble on so. I will try to hush now. Anything you can share helps. Thanks so much and I will try to figure out how to put those cute HUGS icons on here later. ---Amaryllis
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Unread 01-26-2003, 06:38 PM
Vag. hysterectomy w/Burch

Hi Amaryllis,

First, before I forget - to put a smilie into your posts - when you are typing your post or your reply, there is a box titled Smilies at the left-hand side of the reply box. You can enlarge that box to a full page, and you will see the possible smilies and how to type them. For example - to insert a You would type : hug : (but without the spaces before and after the word). (We are allowed 4 per post.)

Now, to answer your questions. I didn't have a bladder suspension - my bladder was prolapsing, but not badly enough to require a suspension, so our situation was a little bit different in that respect.

I think it's pretty common to have a catheter during your surgery. Since I was hooked up to a morphine pump, I was gld to have the catheter and not have to try to walk to the bathroom right away. It was taken out the following morning, and I went home that afternoon.

Regardless of whether you have an abdominal or a vaginal, you will not be permitted to resume relations with your DH for at least 6 weeks - maybe longer, depending on how well you have healed. In our case, we waited a little bit longer, because the stitches from the repairs were still uncomfortable, but once they had finished healing, everything was OK.

Since the two doctors you have seen do disagree quite a bit, and you do have time, I agree with you that it might be a good idea to get a third opinion, if you aren't totally comfortable with the second opinion.

Please let us know what you decide to do.



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