hysterectomy questioning

Hi,

To be as brief as possible had a previous myomectomy 13 yrs ago for fibroid removal in hopes of getting pregnant.  13 yrs later I have multiple fibroids, some large about 6cm some small about 1cm.  My dr. has been pushing for a hysterectomy for months and months and since I have no major discomfort or pain, no heavy bleeding I keep ignoring what she is saying.  But now  I recenlty had another sonogram, fibroids increased slightly but I have also had problems with biaxel complex hemorrgic cysts which we have been keeping an eye on.  Due to the fact that the right ovary shows a mulitoccular hemorragic cysts with wall thickening with what they believe to  have excrescense on the right ovary.  my doctor now says that right ovary needs to come out (I fully understand that) but that the uterus and left ovary should also come out with it.  I am not only worried but something in my gut tells me this is too drastic.  I have told my doctor if not for the questioning of the right ovary I would not be talking any surgery at all.  I fully understand the need for the right ovary to come out but not all of my organs with it.  Please advise.

[Elaine Brown, MD]

Hi!
Reasons to do a hysterectomy for fibroids include: pain, bleeding. obstruction of the ureters or pressure on other nearby organs, rapid growth suggesting malignancy.
If you don't have any of these problems, then it is probably not necessary to have the uterus removed.  Certainly there is no indication to take the other ovary. UNLESS there is cancer in the right ovary. If there is a focus of cancer in that ovary, and unless you are very young (less than 30) the majority of doctors would recommend removal of everything.

A hysterectomy is a bigger surgery than an oophorectomy (removal of ovary) which could theoretically be done laparoscopically, although if there is significant concern about malignancy, it should probably be done through an incision.  There are more potential  complications and a longer healing time associated with hysterectomy.
If the uterus does begin to cause problems though, the risk is that you end up having two surgeries.

Remember that ultimately the decision is yours to make--it is your body.  Your doctor should cover all of the pros and cons, especially including hormone replacement therapy if both ovaries are taken.

I hope this helps you in making the right decision for YOU!
Good luck!
Dr B