laparoscopic vs. laparotomy

[jodasven]

I am 37 with no history of cysts, abnormal paps or fibroids.  I had a laparatomy done in Feb. 2010 to remove 2 cysts,  largest  measuring 13cm and 1 fibroid 8cm. My CA125 was 730.  Therefore, they proceeded with the laparotomy so they could do the frozen sections. During the surgery, they discovered that I had extensive endometriosis. After recovering at home, two months later, I had an MRI because I was experiencing severe abdominal pains.  I developed another cyst 13cm on my left ovary.  My doctor suggests that I get a hysterectomy.  I do not want to try any medications because I feel that they will only mask the problem and eventually I will have to deal with it.  I have two children, and don't plan on having additional children.  My doctor suggested performing the hysterectomy laparoscopically to avoid opening me up again.  She will remove the endometriosis through coagulation.  Do you think that these two methods are the appropriate treatment?  I read about excision surgery using scissors but the three doctors I found who do it do not accept my insurance.  Do you think that the coagulation technique will be effective in conjunction with the hysterectomy?  Also, should I try and preserve one ovary to avoid menopause?  My CA125 is still elevated, do you think it is safe to proceed with the hysterectomy laparoscopically?   Thank you sooo much!!!

[jodasven]

I am going for a 3rd opinion on Wednesday, with a oncology/gynocologist so hopefully i will get more answers.  The other two doctors said they could get everything out laparoscopically.  Thanks sooo much for your support. Will keep you updated!!

[fungirl1011]

Hi and welcome.  I am so sorry that you have to go through all of this again.  I can't answer your question about coagulation because I do not know anything about it.  If your doctor can do the hysterectomy laprascopically, then that is the way to go.  As you know, laparotomy in no walk in the park.  Does he think that he is going to be able to get the cyst our that way too?  If you able to preserve your ovary, that is what I would do so you do not have to go on hormones.  I have always been told that a CA125 is not always accurate in women who are pre-menopausal, and that endometriosis can also rise the levels.  If you are not comfortable, is it possible to get a second opinion form a gynecologist that will take your insurance?  It never hurts to have a second opinion.  Good luck and keep us updated on how you are doing.  

Oh yeah, I forgot to ask if you have a surgery date?