Laproscopic surgeries to deal with fibroids
January 24, 2023 2:48 AM   Subscribe

I am hoping to hear from women who have had a laproscopic hysterectomy or myomectomy to deal with fibroids. I am especially interested in knowing about recovery experiences and any longer term outcomes for pelvic pain and bladder/urinary issues. Recommendations for surgeons in New York City would be very appreciated.

Early 40s female with fibroids causing pelvic pain and urinary frequency due to pressure on bladder. I hoped to wait it out until menopause but symptoms are becoming difficult to deal with. Heavy bleeding is less of an issue.

I have had consultations with two surgeons who have suggested laproscopic myomectomy or hysterectomy. I have no plans for children and lean towards hysterectomy as one surgeon said recovery is about the same as for myomectomy when done laproscpically and that risks for complication are lower. I also like knowing that the fibroids can't return.

I am interested in hearing from women who have had either surgery, especially about recovery experiences and any longer term impacts on pelvic pain and bladder/urinary issues.

Recommendations for surgeons in New York City would be very appreciated. I am not 100% on board with either surgeon and still looking for recommendations. Thank you for any thoughts.
posted by anonymous to Health & Fitness (16 answers total) 7 users marked this as a favorite
I've been through something similar. You should look into some of the not so talked about issues with hysterectomy, there's a lot with sexual health that may surprise you. I hate to be cagey, but please memail me for more details, I'm not big on broadcasting my health on the internet.
posted by kellyblah at 3:18 AM on January 24 [1 favorite]

I just had a laparoscopic hysterectomy in November, although it wasn’t for fibroids. I only wish I had done it years ago. The recovery time for me was fairly minimal — two weeks off work and then another two working from home, but to be honest I could have gone back to the office after one week at home. I took oxycodone for the pain for about about two days after the surgery, but after that only Advil for a few days. I’ve had no long-term effects at all, other than not getting my period anymore.

My surgeon was Monica Prasad-Hayes at Mount Sinai and I would highly recommend her.
posted by holborne at 6:05 AM on January 24 [1 favorite]

I had large fibroids and experienced the same symptoms as you. I opted for a hysterectomy and my surgeon used a Davinci robot to perform the procedure. I didn’t have my ovaries removed but I did decide to keep my cervix.

Due to the nature of the largest fibroid (baseball sized, pedunculated outside of my uterus) I had some fairly major bleeding. Despite this I had the same experience as holborne above. I took two weeks off of work but could have gone in after a week. I was fairly tired for about a month though because of the blood loss (my surgeon decided against a transfusion despite the blood loss).

I have not experienced any sexual dysfunction and it’s been 12 years since the surgery. I love not having a period!

My surgery was in Florida so i can’t help with a recommendation.

Good luck!
posted by onebyone at 6:18 AM on January 24

I had a total hysterectomy with ovary removal (my mother had ovarian cancer. Removal was prophylactic) because of fibroids that bled, making me anemic and exhausted. My surgeon used the Da Vinci robot. Unlike the two posters above I had quite a bit of post-op pain and was mostly in bed/on the couch for a week, though after that I was mobile and had minimal pain. Absolutely no problems since.

I would suggest you seek out a gyn/onc surgeon if you truly have no surgical connections in New York. This subspecialty focuses on gynecological surgery, and though it is often for gyn cancer, they do plenty of non-cancer procedures and tend to have additional staff like Nurse Practitioners who are available for phone calls and can be a simpler conduit to the doc if you have questions. They are full-time surgeons, as opposed to the typical OB/gyn. I had Dr. Thomas Randall when he was in Philly, but he relocated to Boston and is now at Mass General. There are plenty of excellent gyn/onc surgeons in NYC, probably most practicing at academic institutions. You might ask your gynocologist for a recommendation. Best of luck to you!
posted by citygirl at 6:38 AM on January 24

I was supposed to have a laparoscopic myomectomy. Once surgery began, they found that the type of fibroid I had (fatty tissue) could not be cut into pieces and removed like they had hoped and they had to switch to open myomectomy instead.

Open recovery sucked (worse than my later c-section, because my fibroid was on the back of my uterus and they had to stretch my abs quite a bit to get to it) and I was not prepared for the possibility of open surgery. I would make sure you are aware that this can happen and that the recovery for open can be very long and uncomfortable (I was out of work for 3 weeks and didn't feel like myself for at least six months).

ETA - Long term, I feel great not having a fibroid and would do the surgery again. If I could go back in time, I would have gone to a different hospital (I'm in Maryland so that doesn't help you) because I felt like a lower priority patient since I "just" had a myomectomy and did not receive very good care. I also would have learned a bit about open recovery and learned how to get up from lying down before the surgery because that sucked so badly and no one taught me the easy way to do it.
posted by jessica fletcher did it at 6:51 AM on January 24

I just had this literally 12 days ago, AMA (they took everything except my ovaries). I'm doing pretty great over here. Pain levels are manageable (I haven't taken opioids since I left the hospital). Surgery was largely with complications (though my fibroids were, as surgeon described them, "shockingly large". It took longer than expected and required a tiny not-quite-episiotomy-like stitch at the bottom of my lady business (see "shockingly large). I ended up spending an unexpected night in the hospital, but it was truly NBD.

I'd been reticent about the surgery, not because I wanted kids (I am 46), but because I am very bad at sitting still and wasn't relishing the recovery. But the recovery has (so far) been just fine. My mom came down the first week to help me (mostly it's the ban on lifting things that requires assistance) and my best friend (and fellow MeFite) is here now for the next few. I can't lift anything over ten pounds for eight weeks and I can't swim/have sex for twelve weeks, but did some advance work to time this out so these things wouldn't be as big of a deal. I'm mostly hanging out on the sofa with the laptop . I'm working because I'm in a non-physical job and it's a family business, but theoretically I could have taken up to a month off. And honestly, I feel pretty close to fine. Like, pain level without Ibprofen (which is the only thing I am taking) is about a 2.5 and ALREADY less painful than life with fibroids.

My fibroids were awful. I had bleending, but I also had load-bearing pain. Back aches, bladder pressure, fatigue, nerve pain, indigestion. All of which caused me loads of anxiety (I'm a bit of a hypochondriac) and sent me to a variety doctors trying to solve problems that were essentially gynecological in origin.

Two years ago, in March 2021, in an effort to avoid major surgery, I had a fibroid embolization. It was expensive and excruciatingly painful (like worst pain I've ever had in my life painful) and took far longer to recover from than was originally billed. It rid me of the two smallest fibroids (out of five), but it did nothing to the big ones, which, in fact, only got bigger. I spent a lot of time rage crying last year when I realized that the embolization had done effectively nothing.

I am not fully recovered so, knock on wood, but I'm pretty confident in telling you that this hysterectomy is the best thing I've done for myself in decades.
posted by thivaia at 7:25 AM on January 24 [4 favorites]

So, this was me about two years ago. I have constant allergies barely held in check by a lot of meds (and, uh, won't get rid of my cats) so I had a chronic cough. Every so often, that cough would worsen if I got a cold/bronchitis/whatever. At that point, I would cough to the point of urinary incontinence, sometimes a small amount, occasionally (and upsettingly) a large amount. I started wearing panty-liner style pads daily. Eventually, due to this and also to a few other things, I went to the gyno (my previous pap smears had been done by my family doctor) and asked for a workup. They discovered multiple fibroids, one of them definitely causing pressure on my bladder, and some of them on one ovary. The suggestion made was a total hysterectomy and they would play it by ear about the ovaries - if they could save them, great, if not, they would remove them as needed. I was at the time in my middle 40s with no kids and no plans for them, so it was an easy decision. They scheduled me for laproscopic surgery with the DaVinci robot.

They ended up leaving me with one ovary, and removing everything else. In a surprise turn, they discovered I had endometriosis very badly (my mother had it very badly as well). I hadn't had any real issues from it most of my life, although I wonder if it started accelerating later in life as I was starting to have some issues that may have been related. Still, all guesswork. My doctor had to call in a bowel surgeon to help stitch a few things back together. However, it was all still laproscopic.

Because of my years of coughing, I had weakened the neck of my bladder, and the doctor offered me a bladder sling. I asked about it here and based on responses plus other research, opted not to have it. I would rather wear a pad if necessary than go that route. I recently had the worst cold I've had in years and had the kind of coughing where you have to brace yourself against a wall - I definitely wore pads through that. Most days I get by without one.

I found my recovery pretty pain-free. I was in the hospital for two days, and then had recovery time at home. I really didn't need much pain medication at all. I was able to take the dog to the dogpark and walk slowly around (picture me in a caftan at the height of summer, sitting decorously on a park bench) and on the whole found it a very easy experience. I feel pretty great now. My one ovary is still functioning, so I haven't had to worry about hormone replacement choices just yet. On the whole it's been a very positive experience.
posted by PussKillian at 7:33 AM on January 24

Like jessica fletcher did it, I was also scheduled to have a laparoscopic myomectomy but ended up having an open myomectomy. This was 12 months ago. I lost a lot of blood and had a transfusion in hospital. I was very woozy and tired for the first four weeks and was okay by week six. It took me a couple of months before I was comfortable to start hiking again. I was very active before the surgery and I think that helped with recovery. The first couple of weeks were the hardest and I needed help to get in and out of the shower (we had a bathtub/shower combo), put on my socks, etc. My partner basically took over in the house and I mostly laid on my sofa with lots of cushions trying to be comfortable. I started taking tiny walks from day 4/5. I would walk a little and get up and down the one flight of stairs we had, extremely slowly. Walking really helped with the pain as often the more intense pain I experienced was trapped gas and moving around helped with that a lot. I'd also say that it's easy to overdo it and there were a couple of occasions where I ended up in a lot of pain because I pushed myself to do more before I was ready. So it's okay to take it extremely slowly. Oh and do look into scar massaging to help with the healing. A year later, I have fully recovered and have no lingering issues.

The reason I didn't have a hysterectomy instead is that all the doctors I saw (in the UK) were extremely reluctant to recommend it because they thought I might want to have children in the future (age 38 at the time). I don't but I didn't dispute this because I wasn't sure if I wanted a hysterectomy. I would seriously consider a hysterectomy if I need to have surgery again because the open myomectomy kinda sucked recovery-wise.

Having said that, my quality of life has improved so so much and I'm so happy I had the surgery. I hadn't fully appreciated how uncomfortable I had been for years beforehand. I had discounted/ignored a bunch of symptoms over time and put up with a lot of pain and discomfort and it was amazing to have that gone. Feel free to get in touch with any questions and good luck with it!
posted by mkdirusername at 9:50 AM on January 24

I had heavy bleeding, pain, and frequent urination. They put me under to do a myomectomy but I didn't have one that day. We learned then it was not just fibroids, but also suspected endometriosis or adenomyosis. I ended up having a laparoscopic hysterectomy, and adenomyosis was confirmed on pathology. Best thing I ever did. They removed my uterus, fallopian tubes, and cervix. I asked that a uro-gyno surgeon take extra care to, uh, tack things down in there since I had no cervix, nothing to anchor to. And I was a newlywed at age 41. I don't remember the post-op pain very well, but I do remember feeling like my weeks of FMLA might've been overkill.

Twelve years later, and I've never regretted the surgery. I do still have urinary frequency, so it obviously wasn't the pressure on my bladder that was the culprit for that. Every other symptom resolved immediately, I've had no side effects or new symptoms, and I freed myself from the tampon cartel.
posted by ImproviseOrDie at 10:23 AM on January 24

I had heavy bleeding and lot of pain because of multiple fibroids. My fibroids were big and some were attached to the uterus wall . I had abdominal hysterectomy a decade ago. I kept my ovaries and cervix. It was tough one month for me. I was in severe pain and had to be on complete rest for few weeks.

We had to move few months after my surgery. So, lot of bending and packing . It took a toll on my body. Even then, I feel it was the best thing happened to me. I was in my early 40’s too . My life got better after the surgery. Few years later, I had to start HRT because of early menopausal symptoms. But , having a good gynecologist and with the right amount of hrt, I was able to lead a normal life.

Check out hystersisters forum . You will find answers to many of your questions there.

Most important thing I learnt( very late though) from this forum is starting your PT after having hysterectomy. It will help strengthen your abdominal muscles , which will prevent further surgeries. Usually, doctors don’t recommend PT after hysterectomy. But, if you can get one and start in few months after your surgery, it may do good in a long run.

I can share my experiences from my recent surgery, if you memail me. Good luck and hope you find a good surgeon.
posted by SunPower at 10:34 AM on January 24

I had a trans-vaginal myomectomy 5 years ago in my early 30s for a fibroid that turned out to to about grapefruit size.

I would strongly recommend asking about minimally invasive options and if you would be a candidate for this type of myomectomy. It depends on the placement and size of the fibroids but it was a great option for me, although the fibroid turned out to be larger than the surgical team expected and kind of at the boundaries of size for this approach.

It was an outpatient procedure and recovery was easy. I felt really woozy and achy the same day, pretty good the following day, and fine the day after that. Your are restricted from exercise for a week or two, and penetrative sex for 6 weeks, but get to avoid the bigger surgical recovery aspects. I've had no impacts on sexual health or urination, and no pelvic pain.

I went to GW hospital center in DC, which turns out to have a focus on minimally-invasive gynecological surgery. Happy to talk over MeMail if you have any questions!
posted by foodmapper at 10:39 AM on January 24

I had a laparoscopic procedure to resolve an ectopic pregnancy. Recovery was very very easy.

I have also had an open myomectomy (one fibroid was 11cm, too large for a laparoscopic procedure and they had recently stopped recommending the robotic morcellation procedure for fibroids). My recovery from that surgery was also pretty easy (as it was from my C-section, so it's possible that I am just not prone to complications, and in fact I experienced almost zero pain after any of these three pelvic procedures and used very little pain medication - for me the hour or so after the general anesthesia was the worst part). The benefits of removing the fibroids have been excellent. 8ish years later, I do have some new fibroids that are starting to cause me occasional problems.
posted by vunder at 11:18 AM on January 24

I had a good experience with Dr. Anne Hardart of Mt. Sinai, who didn't make any BS attempts to dissuade me in the name of fertility. Very straightforward, very clear, very methodical. We were going to go laparoscopic, but had to convert to open. (I wasn't thrilled with the perioperative care, but that was an issue with the hospital, not her.) I was out of work about 2.5 weeks. The biggest irritation after the first couple days of pain is the lifting restrictions, which make it hard to clean and such. And then you're just tired for a while. Getting the weight off my bladder was a net positive, and by the time I had the surgery I was so done with all the bleeding that I was perfectly happy to give the old girl the heave-ho. Can't say I've missed her.

Separately, while I had not one, but two, failed uterine embolizations (which happens, like, never) beforehand, and did find the first in particular a very unpleasant experience (thivaia's not wrong!), it's still far less invasive than even a laparoscopic surgery, spares the uterus in case it has any sentimental value to you, and allows for a quicker recovery. If you haven't considered it, you might want to. (Not trying to second-guess you, but my (first) gynecologist was ready to go straight to surgery, and I had to raise the possibility of embolization myself.)
posted by praemunire at 5:18 PM on January 24

I had a supracervical hysterectomy in October - when my doctor told me that the recovery is comparable to a myomectomy I figured that there wasn't any point in risking having a second surgery for fibroid recurrence if I didn't want kids. I saw a doctor at the Weill Cornell fibroid clinic and had a great experience there.

The first week was HARD. The pain was significant but manageable, I found it much more difficult to deal with the short term loss of my abdominal muscles. By week two I was up and about and able to care for myself, although I had to be very careful about rationing energy and not overexerting myself. I was pretty reliant on friends and family for help with household chores, grocery shopping etc. I work in person so I took the full six week recovery time off and I'm so glad I did; even though I was feeling mostly physically okay after a month the overwhelming fatigue and brain fog persisted for another couple of weeks and I would have struggled even with WFH. You never know how your recovery will go - I had some thankfully minor issues with infections that contributed to my slower recovery.

Over three months out and I feel amazing, no regrets. It did take a while to see results in terms of abdominal pain and bladder issues as the surgery causes its own trauma to those areas but now my bladder holds twice as much as it used to and the only abdominal discomfort is some residual aches from the surgery.
posted by fox problems at 5:58 PM on January 24

I had a laproscopic hysterectomy to deal with fibroids. The gyno insisted I keep my ovaries (which I didn't want to because PMDD). I was in hospital overnight, stayed home next 6 weeks with bearable pain. I built up my walking slowly because I'd get to a point, and get sharper pain, and immediately imagined my vagina falling out. After 6 weeks, cleared for sex (which went very well). Didn't lift anything heavier than a plate, squatted instead of bending. Had occasional discomfort for next 6 month. Have enjoyed being menstruation-free but can't tell if I've move from perimenopause into menopause: at 55 (OP at 48) I occasionally get a tender breast (previous symptom of onset of menstruation).

Best of all - not leaving backpackers' sheets looking like a murder has been committed and any dampness in my pants is sweat.
posted by b33j at 3:25 AM on January 25

I had endometrial ablation that removed two fibroids and my fallopian tubes during the process, laparoscopy. Recovery was about a week - I was shocked at the pain but that was mostly because I was comparing it too gallbladder removal and an investigation laparoscopy to check for endometriosis. It was mostly just bruising at the incisions, achiness, and being very tired. I had it because I'm done having kids and don't want to need iron transfusions every month or two.

Sexual health wise, very little difference for me - I spot on occasion instead of a period but still often get symptoms since I still have my ovaries (early 40s so we wanted to maintain as much as possible). No pain during sex at all, no cervical bleeding during sex, less constipation, no cramps, fewer migraines, and I can identify what is hormonal vs blood loss/iron levels now. Which has meant treating the skeleto-muscular aspect of migraines since they were linked to my period but weren't hormonal - it's changes to my ligaments/muscles exacerbated via stress and hormones.

A friend of mine had the ablation done about a year before me. For both of us it has been transformative with only positive changes to penetrative sex.
posted by geek anachronism at 10:34 PM on January 25

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