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Endometrial Ablation vs TAH & BSO Endometrial Ablation vs TAH & BSO

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Unread 04-17-2003, 08:44 PM
Endometrial Ablation vs TAH & BSO

Hello! I'm new here & this looks like a great place to answer some questions from folks who've been there!
I'm 44 & have been diagnosed with heavy bleeding, uterine fibroids & high risk HPV. My doctor says we've tried everything & now its time to consider 2 options to deal with these issues.
She says it would be a TAH for me because of the size & placement of my uterus, remove the cervix to take care of the risk for cervical cancer & says I should consider removing the ovaries as well. That part threw me for a loop, but she says there is a good chance my ovaries wouldn't start working again due to my age.
I have to admit that part worries me the most. At 44, I hadn't even thought about menopause & can't say I understand all the HRT issues & how long I'd be on that. She says she'd put me on a "patch".
I'm also already borderline osteoporosis & am taking Fosamax for that.
The other option is Endometrial Ablation which has a quicker recovery time, but she says only about 40% of women will not have periods afterwards. I'm tired of the heavy bleeding, hiding in the house, worrying about accidents & think I'd like to be completely rid of periods plus this wouldn't take care of the HPV or the fibroids.
My mom had a hysterectomy more than 20 years ago for endometriosis & has been on a low dose of HRT since the beginning. My younger sister has also been diagnosed with endometriosis & her dr wants to do a hysterectomy on her as well.
Reading your posts, it sounds like my journey has just begun!
I'd like to hear your thoughts.
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Unread 04-17-2003, 09:11 PM
Endometrial Ablation vs TAH & BSO

Hi Sunny!

I had the ablation done at age 39 because of heavy and excessive bleeding and pain caused by many fibroids. After the ablation I had no bleeding for about a year and a half. Then the bleeding gradually resumed and became heavy again because the fibroids had grown so deeply into the uterine wall. At age 41 I had a LAVH hysterectomy - my uterus and cervix were removed, I kept both ovaries. I am now 14 months post-op - I am finally living pain free with no bleeding. I have no regrets about trying the ablation first...in my case I needed the hysterectomy eventually.

HysterSisters is an awesome site to do research and ask questions. Keep us posted on what you decide to do. Take care.

Unread 04-17-2003, 09:42 PM
Endometrial Ablation vs TAH & BSO

Hey Sunny, for a second I was getting worried about your post... that maybe I had a twin somewhere or that maybe I was posting my story in my sleep. lol I realized you were not me when I read the part about your sister. I don't have a sister so now I know I am not sleep typing........

I decided to go ahead with the hysterectomy. My Dr. wanted to perform an ablation with "Novasure" which is a brand new type of ablation. She also offered the balloon type which has been around for about 4 years, I think. She suggested the other new one because the results with the balloon ablation have not been very promising statistically. The new Novasure is done with radio waves that basically cauterize the inside of your uterus. They have their own website, I think it's Novasure.com. Anyway, you know, that sounded so gross to me, I just was really hesitant about the procedure. That, coupled with the fact that Novasure just got FDA approval mid January this year had me running. Not to mention that my Dr. had (because it is so new)never actually done the procedure. I am sorry, I don't want to be anyone's guinnea pig! Although she did offer to have the other Dr. in the office "supervise" while she actually performed the procedure. It being April, I can't imagine he's done too many of these procedures since mid January.........

The other reason I opted for the hysterectomy was, because I too have HPV and cervical dysplasia that has to be treated frequently. I read (I think on the Novasure site) that there is a risk that if the ablation does make it so that you don't have your period anymore you won't be able to detect the early signs of uterine cancer. Well, I am all about early detection, and with this cervical issue I feel, well, kinda like a walking time bomb anyway. What if, what if, what if....... I didn't like those odds. I felt like I was darned if it worked and darned if it didn't.

I am sick to death of all this bleeding and I really would like some relief. I read that some women end up having the ablation procedure done 2 and 3 times and then some end up having the hysterectomy anyway.

I guess wanting relief so bad from the bleeding and always worring about by cervix did it for me. I am having a TAH. Since I had a c-section, I also have quite a bit of adhesions so they can't do my hyst. any other way Dr. says. I felt a huge wave of relief when I finally made the decision for myself. What ever you decide, I bet you will to. Now, my date is set for May 12 and the waiting part........ well everyone will tell you....... it's the pits.

Hey, if you do end up having a hyst. and have your cervix removed, keep going in to have smears done. I've heard it is unlikely, but you can still get vaginal cancer from the HPV. Guess I can't remove that too. My husband might have a small cow! lol
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Unread 04-17-2003, 10:13 PM

I talked to a good friend of mine who is an OB/GYN about an ablation. She told me that I should not pick that as a procedure, that it would be a waste because the eventuality would be a hysterectomy anyway.
Unread 04-17-2003, 10:30 PM
Endometrial Ablation vs TAH & BSO

I know ladies who have had the ablation done and it has worked great for them. Whether or not it will work depends on the cause of the bleeding and pain. Each case needs to be looked at individually...what works for one may or may not work for someone else. Consult with your own doctor about your own medical needs to make a decision.

Unread 04-17-2003, 10:58 PM
Endometrial Ablation vs TAH & BSO

Dear Sunny:

This thread contains links to more info on ablation and fibroids: https://www.hystersisters.com/vb2/ann...p?s=&forumid=4

I was able to keep my healthy ovaries when I had a TVH 4 years ago (at age almost 43).... and so far, they seem to be puttering along fine

As for post-op pap smears, my surgeon (a uro-gynecologist specializing in pelvic reconstruction) told me that the uterus, cervix & vagina are all embryonically the same. There is no dotted line in there for the surgeon to use when removing your uterus and/or cervix. Therefore, cells from the uterus & cervix could be left behind after a hyst.

Once I had my post-surgery check-ups behind me, my regular doc suggested that a healthy pap test result means I could have the pap smear every 2-3 years.

Since I am past 40 (ack!!), I have decided to continue *annual* (more or less) visits to my doc. My car goes for regular check-ups, my dog needs shots every year to get a license... and gosh darn it, I think *I* am worth some regular check-ups too. And as long as I'm in there (& naked ), I may as well get the works.

I think my good health is an asset worth maintaining.
Unread 04-18-2003, 06:50 AM
Endometrial Ablation vs TAH & BSO

Thanks for all the info! So much to think about.
I've had problems on & off for so many years. Several doctors--usually men! Would practically pat me on the head & tell me the pain was normal.
The periods have just gotten heavier over the years. They aren't all horrible, but I never know when the next bad flood will be. They all start out normal & then about day 4, I get this ripping pain & then just totally flood running back & forth to the bathroom every 10-15 minutes. Sometimes just as I pull my pants back up I can tell I need to pull them right back down & change again. There have been many instances of flooding down to my knees before I knew what was happening. It hasn't happened at work, but do I need to tell you I live in fear of that?
The whole surgery/treamtment thing is optional. The gyn is leaving the decision totally up to me. My decision is just how much & how long am I willing to live with this? One minute I think, ok, I'm doing the hysterectomy. The next minute I think, maybe the endo ablation--Novasure is also what my dr is talking about. You're right, sounds gruesome!
I guess everyone else goes through the same thing. I never knew my periods weren't normal since I never experienced anybody's but mine.
Thanks again! I'm sure I'll think of plenty more questions!
Unread 04-18-2003, 07:22 AM
Endometrial Ablation vs TAH & BSO

Originally posted by sunny03
The gyn is leaving the decision totally up to me. My decision is just how much & how long am I willing to live with this?
Statistics show that 85% of hysterectomies are elective, done for quality of life issues, not to SAVE a life. Get 2 or 3 medical opinions to help you see all sides of this. Get smart about your symptoms and your options, and make the best choice for YOU.

Sending huge cyberhugs
Unread 04-20-2003, 06:46 AM
Making a Choice


I am 46 and had a thermal ablation 3 years ago because of heavy bleeding. (I did have the horrible experience of having to leave work with a sweater wrapped around my waist.) My doctor recommended a hyst at the time, but I choose the ablation because I was scared to have the hyst. I am now scheduled for a hyst on June 24.

I do not think it was a waste to have the ablation, because it bought me 3 years. On the other hand, I am having the hyst anyway so it would have been nice to have it done and over with!

It was a tough decision because no one could find a reason for the heavy bleeding, no fibroids, no endo. I think if they found something concrete, I probably would have had the hyst.

The bleeding has not returned to the horrible clotting and heaviness that it was before the ablation, but I have terrible cramping for at least 3 to 4 days and sometimes I bleed for 10 days. Each month is different, but when a bad month comes, I can't get to the operating room fast enough, and when a not so bad month comes, I wonder if I have made the right choice. It truely is a difficult decision.

I have had an MRI which showed a slightly enlarged utereus, some thickening of the walls, and two small fibroids. The doc said it is "indicitive" of adeno.

I am sure that I will stick to my guns this time and finally end this monthly horror! I am leaving the ovaries and my cervix and I have decided to have a TT while I am in there!! I have always wanted one!!

Sorry for the long story, I hope it helps to hear from others who have been on the fence about surgery

Best of luck to you in making your decision!

Unread 04-20-2003, 08:18 AM
Endometrial Ablation vs TAH & BSO

Wow! There are other women out there like me! I never knew!
I've been to the edometrial ablation website/forum, too. My doctor says about 40% of women won't have periods afterwards. From what I've read on that website there are a lot of disatisfied women on there. It looks like many of them--at least yesterday were considering a second procedure or a hysterectomy.
Not everyone of my periods is horrible, but the ones that are sure make me want to do something right then! And it would be nice to do it only once.
Thank you for all the info. This is very helpful.

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