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Single or bilat oovarectomy? elective hysto?
55, no children, no history of difficult periods, symptoms etc. Went on est/pro HRT at age 50 after finding out I had gone from being nowhere near menopause to completely through it in about 18 months -- correlating to the time I was getting married for the first time. Just didn't want the hassle of symptoms during newlywed period; difficult enough getting married at 50. Now -- sonar found ovarian cyst 6 cm. Endometrial lining is 6, down from 7 three years ago but still too high for my age. CA 125 has ranged from 4 to 7 in last 10 months, so that's good. Will get endometrial lining biopsy results tomorrow. Have already been told that if it shows atypical changes, I should go ahead and have a hysterectomy. Doc wants to remove the ovary with the cyst, and says it's up to me to go for elective hysto if the endometrial biopsy is negative. I can't find anything on the internet that would make me NOT opt for the hysto, but I'm undecided about preserving the one ovary. One friend said the hormonal production of that ovary was going to go way down over the next few years anyway, so why not get it all taken care of? But then I also found one report on the internet that said the reduced risk from ovarian cancer by a total oovarectomoy at my age is not worth the increased risk for other issues, including cardiovascular disease. 4% difference in mortality by age 82 between people who had overgone a bilateral oovaarectomy and those that had preserved their ovaries. But nothing to indicate the value of preserving ONE ovary when the other one is going. Any thoughts? And anyone have experience with laprascopic gyn. surgery using the Da Vinci robotic system?
I wanted to conserve my bad ovary and just have the cyst removed. My doctor recommended removing the whole ovary because of several reasons: I won't be trying for children, and if by the very small chance that the cyst was malignant (I am close to 50, so my chances a little bit higher than someone in their 20's and 30's), it is safer to remove the whole ovary. I really wanted to preserve the ovary, so my doctor said he would try to remove just the cyst if everything looked okay once he got in there. Turns out, he noticed changes on the ovary itself, and decided the safest thing would be to remove the ovary. I did go for a second opinion, and the second doctor agreed with my doctor - recommended removal of ovary. I think when you get a little older, they tend to recommend this. With one ovary, I haven't noticed anything different. I still get my periods and I don't feel any different - no symptoms of menopause. I wish I could have kept my ovary, but I guess the situation warranted removal.
One thing I've read on here is that sometimes, when the ovary is preserved, women will go on and get more cysts in that same ovary. I don't know if this happens in postmenopausal women. You may want to bring up the option with your doctor and see what he/she says.
BTW, everyone on my father's side has died from strokes. I am already on blood pressure medication and a special diet for high cholesterol. I am in good shape, and I am trying everything to get the odds in my favor. My mother did pass away from ovarian cancer, but her oncologist and my ob/gyn both said that it was a kind that is not genetic and I am not at higher risk for developing it. So I decided on the basis of my heart disease risk.
One thing I've read on here is that sometimes, when the ovary is preserved, women will go on and get more cysts in that same ovary. I don't know if this happens in postmenopausal women. You may want to bring up the option with your doctor and see what he/she says.
BTW, everyone on my father's side has died from strokes. I am already on blood pressure medication and a special diet for high cholesterol. I am in good shape, and I am trying everything to get the odds in my favor. My mother did pass away from ovarian cancer, but her oncologist and my ob/gyn both said that it was a kind that is not genetic and I am not at higher risk for developing it. So I decided on the basis of my heart disease risk.
Thank you both (MarieMichele, outdoorsgirl) so much for such quick, insightful responses. I have a family history of cardiovascular disease (father died at 44) and dementia (mother), but no cancer among parents or grandparents. So I'm leaning towards keeping one ovary just to be conservative regarding the risks I know I already have. Now I'm wondering if the cyst can be removed safely without removing the one "bad" ovary. Interesting that MarieMichele mentioned conservation of the cervix; one internet entry said that cervical removal could affect sexual enjoyment. I had a LONG celibate period in my 30s and 40s, and feel like I have some catching up I want to do, although a late-in-life marriage has its own challenges in that regard.
My doctor is an ob/gyn, not an oncologist, but very very intelligent, and has a slightly different opinion from MarieMichelle's doctor. He is always rattling off statistics when I go see him, and he did mention the difference in mortality rates that you cited.
I am premenopausal and have had one ovary removed due to a cyst. It made sense to me to keep my other ovary so I wouldn't have to go into surgical menopause. I also am at high risk for cardiovascular disease and osteoporosis, so even if I were menopausal, I would still elect to keep the remaining ovary. I will take my chances on having to undergo another surgery.
Here's a link for keeping your ovary. There's no one right answer. For some women, it makes sense to remove both ovaries due to cancer risk or other ovarian problems. For others, like myself, it made sense to keep one ovary. Just another point of view.
http://www.menopauselifestyle.com/blog/having-a-hysterecomy-5-reasons-to-hang-on-to-your-ovaries
I am premenopausal and have had one ovary removed due to a cyst. It made sense to me to keep my other ovary so I wouldn't have to go into surgical menopause. I also am at high risk for cardiovascular disease and osteoporosis, so even if I were menopausal, I would still elect to keep the remaining ovary. I will take my chances on having to undergo another surgery.
Here's a link for keeping your ovary. There's no one right answer. For some women, it makes sense to remove both ovaries due to cancer risk or other ovarian problems. For others, like myself, it made sense to keep one ovary. Just another point of view.
http://www.menopauselifestyle.com/blog/having-a-hysterecomy-5-reasons-to-hang-on-to-your-ovaries
There are so many conflicting opinions in the medical world, who knows if a single correct answer will ever exist.
I opted for bilateral silpingo oophorectomy (BSO) (both ovaries/tubes) at age 48 because of the high likelihood the remaining ovary could go cystic or worse. Also never had children and I completed menopause at age 46. My gyn/onc didn't think hormone output of a post-menopausal ovary to be that worthwhile compared to the risk of ovarian cancer, and based on his experience with previous patients, saw that remaining ovaries rarely behaved themselves (needing monitoring or removal at a later date). There are plenty of women that get cardiovascular problems, osteoporosis, etc. without having any ovaries removed. So what do we blame: ovaries, genetics, lifestyle, diet? Will we ever know in our lifetimes? HRT increases the risk of heart attack, stroke and breast cancer. There's NO great answer for women right now. It is truly unfair.
I didn't want to undergo another surgery at a later date when I'd be older and possibly less tolerant of another major abdominal surgery. As it was, my own cyst was so large, I was past the point of being a candidate for laparoscopic surgery and my surgeon was a Da Vinci specialist. I needed a 4.5 inch incision instead. Sorry, I don't have first hand experience of that less invasive procedure (which can be an outpatient or overnight hospital stay), but you can take my surgery story and cut the hospital stay and recovery period down to about 1/3 or less of what it takes for full open surgery (laparotomy) like I had. It is in the "about me" section of my profile.
Recovery from gyn laparoscopic surgery takes about the same amount of time no matter how much is removed. Internal healing takes longer but estimate about 2 weeks for good external healing and ability to return to work, but try to avoid heavy lifting for about a month or two. If for any reason your surgery goes to open surgery with the type of incision I had, recovery is more like 6-8 weeks.
I lost the cyst and both ovaries/tubes, but kept the uterus/cervix. With your endo problem, the uterus certainly should go and I'd make a case for retaining the cervix if you can, but much depends on what the doctor recommends in your situation.
Best wishes to you on whatever you decide. Sometimes you have to trust your instincts when making this difficult decision.
I opted for bilateral silpingo oophorectomy (BSO) (both ovaries/tubes) at age 48 because of the high likelihood the remaining ovary could go cystic or worse. Also never had children and I completed menopause at age 46. My gyn/onc didn't think hormone output of a post-menopausal ovary to be that worthwhile compared to the risk of ovarian cancer, and based on his experience with previous patients, saw that remaining ovaries rarely behaved themselves (needing monitoring or removal at a later date). There are plenty of women that get cardiovascular problems, osteoporosis, etc. without having any ovaries removed. So what do we blame: ovaries, genetics, lifestyle, diet? Will we ever know in our lifetimes? HRT increases the risk of heart attack, stroke and breast cancer. There's NO great answer for women right now. It is truly unfair.
I didn't want to undergo another surgery at a later date when I'd be older and possibly less tolerant of another major abdominal surgery. As it was, my own cyst was so large, I was past the point of being a candidate for laparoscopic surgery and my surgeon was a Da Vinci specialist. I needed a 4.5 inch incision instead. Sorry, I don't have first hand experience of that less invasive procedure (which can be an outpatient or overnight hospital stay), but you can take my surgery story and cut the hospital stay and recovery period down to about 1/3 or less of what it takes for full open surgery (laparotomy) like I had. It is in the "about me" section of my profile.
Recovery from gyn laparoscopic surgery takes about the same amount of time no matter how much is removed. Internal healing takes longer but estimate about 2 weeks for good external healing and ability to return to work, but try to avoid heavy lifting for about a month or two. If for any reason your surgery goes to open surgery with the type of incision I had, recovery is more like 6-8 weeks.
I lost the cyst and both ovaries/tubes, but kept the uterus/cervix. With your endo problem, the uterus certainly should go and I'd make a case for retaining the cervix if you can, but much depends on what the doctor recommends in your situation.
Best wishes to you on whatever you decide. Sometimes you have to trust your instincts when making this difficult decision.
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