Hysterectomy necessary?

I am 19 days from having my scheduled Hysterectomy.
It is supposed to be Lap surgery with one surgeon & also with my GYN Oncologist to make the incision if he finds it needs to be done.
I am having my uterus, tubes, & ovaries removed.  The cervix will remain.
The reason for this operation:  
I had irregular bleeding & after several trans vag ultrasounds & 10 days of Provera, my Uterus lining  was still around 18mm. & also I had fluid filled cysts on the ovaries which would go from one side to the other & reduce or clear up in size.
I had a D&C Hysteroscopy on Oct. 7th. by my regular GYN.
The results were he removed a polyp & also "abnormal cells" (I guess this is on the pathology report?????)
I then went to a GYN Oncologist who after the exam told me I am a good canidate for the  Laparoscopy Hysterectomy.  He consulted with his partner and they agreed that both doctors would be in the operating room if the incision type hysterectomy had to be performed.
My FREAK OUT is this:
1.  Is this surgery necessary???
2.  Do the ovaries HAVE to come out to avoid the progress of any more "abnormal cells" steming from the uterus?
3.  Is having everything in there removed going to cause me to be more prone to other cancers?
4.  What about all the hormones produced by these the woman parts, which are being removed, and how do they contribute to hormonal changes in the body post surgery?
I have been reading and reading all over the internet (legit sites) and also a few books on the whole menopause thing and frankly I am FREAKING OUT!
I am only 47 and never had ANY pain or issues, except for being overweight and irregular periods.
Never had a fibroid.
I had a cervial polyp removed in an office procedure in Oct '07.  Never heard anything more about that from the office so I am sure it was fine.
What should I be doing at this point?
Thank you so much....I feel SOOOOOOOOOOO lost & alone!
~Vicki
ps:  If you want or need more info, please ask!  

[Elaine Brown, MD]

Hi!
Number one, I see absolutely NO reason to remove ovaries, unless you want the 99% guarantee this gives of no ovarian cancer.  Almost all of the current literature is getting more and more conservative about leaving them in, as we are getting less and less aggressive about giving hormone replacement therapy.  I wouldn't go for the OLD "oh we'll just take them out and give you hormones" line any more.
Number two, I don't think you even need your uterus out.  If you were my patient and you expressed any reservations about surgery (some people want it out YESTERDAY!)
I would discuss the option of three months of provera therapy and a repeat office biopsy or D&C.  Nowadays our surveillance for endometrial cancer is excellent, and we can almost always cure it at an early stage if it does come up--in your case we have the advantage of knowing that we need to watch closely.

If you don't want any more bleeding problems, then a hysterectomy is a great option.
If you want a guarantee that there are no cancer cells in there right now, then hysterectomy is a great option.
You can have your uterus out with your ovaries left in!  This is a simple Vaginal hysterectomy.
I chose to keep all my parts when I had an abnormal polyp--3 kids and 5 years later, I am doing well.

Hope this helps!

Dr B

[whiteorchid]

A friend of my just had a myomectomy.  She had a huge cyst (size of canteloupe) growing and it was causing severe anemia, pushing on organs, etc.  Not sure how it went but it she was looking at having a full hysterectomy as well and was freaked out.  

Please look into finding a "reproductive endocrinologist" - they specialize in these types of issues.  You need someone who really knows their stuff (because these polyps, etc can grow back), someone who is willing to listen to your concerns.  Good luck...

Here's a link to search for a doctor near you: http://www.socrei.org/SREImap.html

[SooooooStressed]

I hope you get this message...

Thank you so much for your detailed response!  It is so much appreciated!!!

One thing I forgot to put in my original message and want you to know about is what is on the Pathology report:

Endrometrial curetting:

-Multiple fragments of endometrium admix with blood demonstrating "complex endometrial hyperplasia with focal atypia"

- Some of the endometrial glandular proliferation is associated with squamous morules.


Endometrial polyp:

-negative for adenocarcinoma
-Multiple polypoid fragments of endometrium demonstrating "complex endometrial hyperplasia with focal atypia"
- some of the polypoid fragments have spindled stroma with prominent thick walled vessels and may represent hyperplasia arising in endometrial polyp.
-Some of the glandular proliferation is associated with squamous morules.


Thanks so much..... after your response here, I am going to talk to my GYN/oncologist

~Vicki