Aa
Deciding on whether to have hysterectomy...
I would love some experienced advice! I am 46 and have battled fibroid problems most of my life, with history of previous laparoscopy and hysteroscopy about 9 years ago to clean out some of the fibroids and endometriosis. Now that I am perimenopausal, my fibroids are out of control, growing fast & multiplying in number. I've had flooding periods for 22 days duration with huge clots, severe cramps, anemia, fatigue, etc., and I have been diagnosed with at least 2 new submucosal fibroids, several intramural fibroids, and a large subserosal fibroid the size of an orange hanging off the posterior uterus as seen on ultrasound (that one was there 9 years ago but less than half the current size).
My MD is fantastic, and has offered many options but it seems my best ones are either a) hysteroscopic myomectomy with HTA endometrial ablation, or b) laparoscopic DaVinci hysterectomy. Of course, I can't decide!
On the one hand, with multiple fibroids, some of which are actively bleeding, the recurrence rate is high once they are cut out, and I am likely still many years away from menopause hysterectomy seems like an appealing final solution to my problems. On the other hand, I hate to part with pieces of my anatomy and so perhaps it's worth doing the hysteroscopy + endo ablation, although I may end up with the hysterectomy in a few years anyway?
What are your thoughts? Thank you.
My MD is fantastic, and has offered many options but it seems my best ones are either a) hysteroscopic myomectomy with HTA endometrial ablation, or b) laparoscopic DaVinci hysterectomy. Of course, I can't decide!
On the one hand, with multiple fibroids, some of which are actively bleeding, the recurrence rate is high once they are cut out, and I am likely still many years away from menopause hysterectomy seems like an appealing final solution to my problems. On the other hand, I hate to part with pieces of my anatomy and so perhaps it's worth doing the hysteroscopy + endo ablation, although I may end up with the hysterectomy in a few years anyway?
What are your thoughts? Thank you.
It is just my opinion but I feel that a hysterectomy should be a last resort. It will forever change your life. Most, if not all problems, go away after menopause and you are 46. I started menopause at 47 and I was having no problems with it. I was glad to be going through ' the change ' . Mine is a different kind of story and I am an angry person so I do not want my experience to influence you one way or the other. I just want to say that there is a ton of information out there both pro and con. Take your time and research. You cannot undo a hysterectomy. There are a lot of posts on this web site from women who have gone through a hyster. Check them out. Good luck
This is one of the toughest decisions we women have to make! It appears that to resolve the abnormal uterine bleeding AND the pain from enometriosis and fibroids (I have all three types: submucosal, subserosal, and intramural), a hysterectomy is really the only way to go.
But I still hesitate -- I ask myself, is my case really severe enough to take this very final step of having a total hysterectomy? I know only I can make this decision for myself ... but how? What are the criteria some of you have used to "know" that you were making the right decision to have this surgery, in your heart and soul? I feel so conflicted.
But I still hesitate -- I ask myself, is my case really severe enough to take this very final step of having a total hysterectomy? I know only I can make this decision for myself ... but how? What are the criteria some of you have used to "know" that you were making the right decision to have this surgery, in your heart and soul? I feel so conflicted.
Hi there,
I had the DaVinci hysterectomy/bso/appy 6 months ago. It is the best as far as surgery goes. I had 12+ fibroids, severe endometriosis, multiple lesions on my ovaries.... You name it and I had it. I recovered pretty quickly. I took 6 weeks off because I am a nurse and the physical part of the job would have been too much if I went back in 4 wks.
Good Luck with your decision. Its a very personal choice.
Laney
I had the DaVinci hysterectomy/bso/appy 6 months ago. It is the best as far as surgery goes. I had 12+ fibroids, severe endometriosis, multiple lesions on my ovaries.... You name it and I had it. I recovered pretty quickly. I took 6 weeks off because I am a nurse and the physical part of the job would have been too much if I went back in 4 wks.
Good Luck with your decision. Its a very personal choice.
Laney
Yes, the DaVinci hysterectomy is definitely the way to go, where it is offered. The system does take longer to set up, but as Cherie points out, the benefit is significantly less soft tissue trauma, less bleeding, and a shorter recovery time...if I end up deciding on doing the hysterectomy, the DaVinci system is at the top of my list.
There's always so much to think about!
There's always so much to think about!
Most women can't handle leupron, in theory its a good choice, but for most the emotional side-effects are too much.
It is true what you say about the DaVinci taking longer, to be under anestesia longer. but it does allow the tinest incisions ans sutures or cauterising available thus much healthy tissue is left untouched,.
It does sound like a very tough decision with your specifics.Since you had such good luck with prior lap, perhaps that would be best choice for you...the verry worst thing that could happen is it may give you short term relieve and you may still need the hyster...or maybe it will buy you the time you need until menopause..Yes a crystal ball would be nice, C
It is true what you say about the DaVinci taking longer, to be under anestesia longer. but it does allow the tinest incisions ans sutures or cauterising available thus much healthy tissue is left untouched,.
It does sound like a very tough decision with your specifics.Since you had such good luck with prior lap, perhaps that would be best choice for you...the verry worst thing that could happen is it may give you short term relieve and you may still need the hyster...or maybe it will buy you the time you need until menopause..Yes a crystal ball would be nice, C
Thanks for this information! I just had a long talk with my MD (on a Sunday! She is a gem) to discuss the pros and cons of each procedure for my case, and I am still on the fence. If I could have my uterus removed magically, I would do it, but even with the DaVinci laparoscopic system she estimates I would be in the hospital 2 nights, and require a 4-6 week recovery period. Also a downside of the DaVinci is that it takes about 1.5 hours to set up, making the operative time longer thus a longer period of time to be under general anesthesia, which, like most people, scares me.
She thinks I did get "good mileage" out of my previous hysteroscopic myomectomy (with laparoscopy to clean up some of the endometriosis adhesions -- she recommends I add a laparoscopy this time to, to do the same), but agrees there is some risk of not having symptom resolution of the cramps, since those intramural fibroids can't be removed, and that the bleeding submucosal fibroids may return. I need that crystal ball to see when I might anticipate menopause! Arghh. But I have to do something...I have already failed birth control pills, and cannot do the Lupron, which she feels will only be temporarily helpful for my case, anyway.
Any other input is appreciated! I'll let you know what I decide.
She thinks I did get "good mileage" out of my previous hysteroscopic myomectomy (with laparoscopy to clean up some of the endometriosis adhesions -- she recommends I add a laparoscopy this time to, to do the same), but agrees there is some risk of not having symptom resolution of the cramps, since those intramural fibroids can't be removed, and that the bleeding submucosal fibroids may return. I need that crystal ball to see when I might anticipate menopause! Arghh. But I have to do something...I have already failed birth control pills, and cannot do the Lupron, which she feels will only be temporarily helpful for my case, anyway.
Any other input is appreciated! I'll let you know what I decide.
Effectiveness of Hysterectomy in Relieving Symptoms
Most women benefit from hysterectomy for nonmalignant uterine conditions; however, a small number report no improvement in symptoms some report additional problems.
general health. Operative and postoperative complications were assessed from patient records.
I did something I dont normally do and found a really informative cut and paste with stats,,its from the University of Maryland found it quite informative,,a good study.
The study initially enrolled 1,299 women, assessments.
The principal diagnoses leading to hysterectomy were uterine leiomyomas (48 percent), menstrual disorders (16.5 percent), uterine prolapse (13.2 percent) and endometriosis (8.6 percent).
Only 21.4 percent of the patients reported no complications during hospitalization, and more than two thirds reported one or more mild complications during the same period. Nine women (0.7 percent) had serious complications, and 48 (4 percent) were readmitted to a hospital within the year following surgery because of conditions related to hysterectomy. The most common serious complications were related to the incision or urinary tract problems.
TABLE 1
Problem Relief with Hysterectomy
Symptoms Improved 12 months post op
back pain 72%
Vaginal bleeding 99.3
Pelvic pain 88
Activity limitation 94.6
Sleep disturbance 63.1
Fatigue 67.7
Abdominal bloating 78.1
Urinary incontinence 74.2
Psychologic function 75.4
Depression 74.8
Anxiety 59.8
Quality of life 64
Limited physical function 64.1
Limited social function 85.4
Poor health perception 62.0
--------------------------------------------------------------------------------
NOTE: Data are presented as percentages (n/N). Problem relieved = no longer having the problem at a problematic-severe level, among those who did report having the problem at a problematic-severe level before hysterectomy. Total numbers of respondents for the different symptom categories vary somewhat because of missing data.
Braveheart I hope these statistics help you some..to have this surgery is one of the most difficlut decisions any woman can make. Its very seriosu surgery, the recovery for the majority is hard, but it does get easier with each and every passing day. Most women are glad they had it done. Some have regretted it tremendously. I always say this surgery is last option only.
the Da Vinci robotic assisted is state of the art,,its the method I used,,,on my home page I have a journal that i wrote titled My hysterectomy story ...your more than welcome to read it ...the Davinci allows very percise incisions and decreases healing time and you have smaller incisions all good things.
It sounds like you have tried many other options and it sounds like your condition is progressing in a negative manner. Please read as much as you can find on DaVinci...if your a person who can watch such things there is a video of the whole davinci procedure on u-tube..not really gorey, informative.
If you where 10-15 years older Id advise you to for sure wait as you would be in menopause soon,.,,in your case only you can decide..do you want to suffer like this until your fully menopausal,,symptoms should al dissapear by then ( cept the fun new ones we get with menopause) you may not be fully menopausal till 60 one never knows.I can tell you in all honesty if I was you and had all your symptoms,,,knowing all that I do about the Robotic Method I would get the hysterectomy, If you can retain your ovaries it would be to your benifit.
Most women benefit from hysterectomy for nonmalignant uterine conditions; however, a small number report no improvement in symptoms some report additional problems.
general health. Operative and postoperative complications were assessed from patient records.
I did something I dont normally do and found a really informative cut and paste with stats,,its from the University of Maryland found it quite informative,,a good study.
The study initially enrolled 1,299 women, assessments.
The principal diagnoses leading to hysterectomy were uterine leiomyomas (48 percent), menstrual disorders (16.5 percent), uterine prolapse (13.2 percent) and endometriosis (8.6 percent).
Only 21.4 percent of the patients reported no complications during hospitalization, and more than two thirds reported one or more mild complications during the same period. Nine women (0.7 percent) had serious complications, and 48 (4 percent) were readmitted to a hospital within the year following surgery because of conditions related to hysterectomy. The most common serious complications were related to the incision or urinary tract problems.
TABLE 1
Problem Relief with Hysterectomy
Symptoms Improved 12 months post op
back pain 72%
Vaginal bleeding 99.3
Pelvic pain 88
Activity limitation 94.6
Sleep disturbance 63.1
Fatigue 67.7
Abdominal bloating 78.1
Urinary incontinence 74.2
Psychologic function 75.4
Depression 74.8
Anxiety 59.8
Quality of life 64
Limited physical function 64.1
Limited social function 85.4
Poor health perception 62.0
--------------------------------------------------------------------------------
NOTE: Data are presented as percentages (n/N). Problem relieved = no longer having the problem at a problematic-severe level, among those who did report having the problem at a problematic-severe level before hysterectomy. Total numbers of respondents for the different symptom categories vary somewhat because of missing data.
Braveheart I hope these statistics help you some..to have this surgery is one of the most difficlut decisions any woman can make. Its very seriosu surgery, the recovery for the majority is hard, but it does get easier with each and every passing day. Most women are glad they had it done. Some have regretted it tremendously. I always say this surgery is last option only.
the Da Vinci robotic assisted is state of the art,,its the method I used,,,on my home page I have a journal that i wrote titled My hysterectomy story ...your more than welcome to read it ...the Davinci allows very percise incisions and decreases healing time and you have smaller incisions all good things.
It sounds like you have tried many other options and it sounds like your condition is progressing in a negative manner. Please read as much as you can find on DaVinci...if your a person who can watch such things there is a video of the whole davinci procedure on u-tube..not really gorey, informative.
If you where 10-15 years older Id advise you to for sure wait as you would be in menopause soon,.,,in your case only you can decide..do you want to suffer like this until your fully menopausal,,symptoms should al dissapear by then ( cept the fun new ones we get with menopause) you may not be fully menopausal till 60 one never knows.I can tell you in all honesty if I was you and had all your symptoms,,,knowing all that I do about the Robotic Method I would get the hysterectomy, If you can retain your ovaries it would be to your benifit.
Have an Answer?
You are reading content posted in the Hysterectomy Community
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
Normal vaginal discharge varies in color, smell, texture and amount.
Bumps in the genital area might be STDs, but are usually not serious.
Chlamydia, an STI, often has no symptoms, but must be treated.
From skin changes to weight loss to unusual bleeding, here are 15 cancer warning signs that women tend to ignore.
