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Gynecology (Expert Forum)
Need opinion on hysterectomy please.
Answered by
Elaine Brown, MD - Pregnancy, Gynecology
Elaine Brown, MD - BLOG
Billings - MT
Need opinion on hysterectomy please.
by Patti1965, Oct 27, 2009 11:47AM
Hi, I have had 2 CA-125 tests this year, the 1st one was done in June during my period and was at 52 (showed slight anemia also) the 2nd was done at the end of my period a month later and was at 47.My doc also order an abdominal and transvaginal ultrasound which showed 2 6-7cm(tennis ball sized)uterine fibroids and normal ovaries.Doc asked ME if I knew I had fibroids when she has been my gynecologist for 20 yrs so I would think SHE would be the one to tell me.Anyway, now I have scheduled surgery in 10 days for a hysterectomy per her advice and I am worried.I have been researching online and it seems that women w/ovarian cancer and other severe conditions have CA-125 levels over 100...I am not really bothered by these fibroids-I do get heavy bleeding the1st day or 2 of my period, and a bad odor the last day or so, PMS-bloating, fullness, headaches, lower backache(sometimes), moodiness and a feeling that I will get my period any second for about 2 wks before my period actually arrives, and I get numbness in my upper thighs if I'm standing for awhile.I feel that my doc wants to cure my high CA-125 by giving me a hysterectomy.She said that the fibroids or endometriosis (which I have never been diagnosed with) could be causing the high CA-125 or something with my ovaries that cannot be seen on the ultrasounds. She says that she would biopsy my ovaries while she's in there for the hysterectomy...Does my condition sound severe enough to require hysterectomy with no other treatment options? It seems that I should have other options, can you please tell me about them?Hysterectomy seems quite extreme to me, am I taking the high CA-125 too lightly?I'm confused, please help. Thank you! :) (Oh, btw, I'm 44, never had kids, have had abortions and a uterine infection 15-30 yrs ago.) Thanks!!!
Doctor's Answer
by Elaine Brown, MD, Oct 30, 2009 11:39AM
, Oct 30, 2009 11:39AMTo: Patti1965
Hi!
It does not sound to me as though you have an absolute indication for a hysterectomy.
The only absolute indication is cancer. Ca 125 is a very poor test and can be elevated for many reasons, including fibroids. It can also be within normal range when a woman has cancer. I would not operate based on a lab value, ESPECIALLY when there is a condition that explains the value. Hysterectomy is ONE option for treatment of fibroids, but you should definitely research the other options and decide if that is the right option for you. Fibroids tend to regress after menopause and are rarely symptomatic in later life. They can be watched with ultrasound or MRI (which could also see your ovaries by the way). I can't tell you that you don't have cancer though, and neither can your doctor without doing surgery. Bottom line--IT IS YOUR BODY--don't get talked out of your parts if you still want them!
Good luck!
Dr B
It does not sound to me as though you have an absolute indication for a hysterectomy.
The only absolute indication is cancer. Ca 125 is a very poor test and can be elevated for many reasons, including fibroids. It can also be within normal range when a woman has cancer. I would not operate based on a lab value, ESPECIALLY when there is a condition that explains the value. Hysterectomy is ONE option for treatment of fibroids, but you should definitely research the other options and decide if that is the right option for you. Fibroids tend to regress after menopause and are rarely symptomatic in later life. They can be watched with ultrasound or MRI (which could also see your ovaries by the way). I can't tell you that you don't have cancer though, and neither can your doctor without doing surgery. Bottom line--IT IS YOUR BODY--don't get talked out of your parts if you still want them!
Good luck!
Dr B
Member Comments (3)
by louise20, Oct 27, 2009 05:31PM
To: Patti1965
Please dont just have a hysterectomy,go on the hysterectomy site and see the alternatves.I had a hysterectomy and have since found out,there was other treatment available,please check it out.My doctor total me there was no treatment for fibroids but there is,if i had known this I would have never had my hysterectomy,take care.
by helpmypain999, Nov 08, 2009 11:08AM
To: Patti1965
i agree with louise 20 dont just assume you need to have a hysterectomy! My gyno told me this was best for me but turned out probably could of had just lysis of adhesions that could have caused all of my problems because colon was adhesed to uterus which probably was causing my heavy bleeding and heaviness feeling with cramping,and constant constipation, but didnt have a preop laparascopy which would have shown that. Had to have 2nd surgeon called in during hyst to take care of this situation before gyno could procede with hyst. which was risky cause of anemia and not healthy prior to surgery. You should always get 2nd opinion before, or get laparacopy prior so docs know what to expect and be prepared for whatever the situation may be. I am 9 months post hysterctomy, and still having worse pain, swelling, bowel problems,etc than i had before hyst. I hope this helps you, and I will be praying for you to get better no matter what your situation will be Good luck.
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