Hysterectomy info
August 6, 2008 9:23 AM   Subscribe

What are personal results and effects of a laparoscopic hysterectomy? I have read everything from placid endorsement to rabid opposition, each with footnotes and links to prove their point. Most of all, I'd like to hear from people with real experiences. The other choice is a simple tubal ligation, but the fibroids could make a full hysterectomy appealing at this point.
posted by anonymous to Health & Fitness (6 answers total)
I've not had a hysterectomy, but rather a unilateral salipngo-oophrectomy. But I think they also graduated from a laproscopy up to a more conventional incision halfway through (but I was a bit of a weird case -- I had turned up in the ER with excrutiating abdominal pain, and after 9 hours of testing had ruled out appendicitis, tubal pregnancy, and other mundane sources, the laproscopy they gave me revealed that I was experiencing a rather serious case of ovarian torsion and they had to remove it in rather a hurry).

What exactly did you need to know? I can tell you the size of the incision I had and how quick I recovered from that...
posted by EmpressCallipygos at 9:37 AM on August 6, 2008

My view is this: Don't have a hysterectomy unless medically necessary.

Is you doctor advising? Are the fibroids bothersome? Are you having increased bleeding? Are they causing pain? Have you explored other avenues like endometrial ablation (sometimes this technique can remove fibroids, it depends on how the fibroid is growing in the uterus).

I don't know what you mean by "full hysterectomy", if you're talking total hysterectomy and oophorectomy, I would never consider oophorectomy unless medically necessary. You will go into menopause immediately.

I had a vaginal hysterectomy (no lap). It was medically necessary. I still have my ovaries. Sure, there are "advantages" I suppose. Less organs to become cancerous and all that, but hysterectomy isn't something to consider lightly (many people have in the past and doing hysterectomies willy-nilly has become old-fashioned) and I wish I hadn't needed one. I wish I still had my organs even though I did have a tubal with my second C-section. Either you need surgery or not. There are disadvantages to hysterectomy. Even if you keep your ovaries it is likely you will go into menopause earlier, because even though the ovaries are alive and well they are still compromised of the blood supply they once had because the uterus is gone.

The other choice is a simple tubal ligation, but the fibroids could make a full hysterectomy appealing at this point.

I'm not sure what you mean by this statement. Hysterectomy shouldn't be used as a form of birth control.
posted by LoriFLA at 9:58 AM on August 6, 2008

It's hard to know what to say without knowing why you're considering a hysterectomy.

I had a laparoscopic bilateral oophorectomy at 45 and am very happy I did. I did it because I had endometriosis, huge and painful ovarian cysts, and a high (genetic) risk of breast cancer (research suggests that removing the ovaries can cut risk in half for women in my genetic class; others' mileage may vary). Recovery from the surgery was less painful than my typical period. I think I took one dose of pain meds and walked a little hunched over for a couple of days. I was dancing in a week.

However, this was just an oophorectomy, not a hysterectomy. One doctor recommended that I also have my uterus removed because the gene I have also increases my risk of endometrial cancer. However, that risk is relatively low and a yearly ultrasound can keep an eye on the endometrium. I didn't want to remove an entire organ that was really just a victim and not the cause of my trouble.

The instant menopause meant hot flashes but also vast relief. In addition to ending my severe pain, the surgery improved my mood, and my immune system started working a lot better, probably because it was no longer distracted by almost-constant inflammation from the endometriosis. The remaining endometriosis tissue and scarring have not caused much trouble, probably because they aren't being stimulated by estrogen (I'm not taking estrogen "replacement").

I have increased risk for osteoporosis because of the surgery but otherwise like menopause a lot.

However, endometriosis is not fibroids. An oophorectomy is a major decision. So is a hysterectomy. While in my experience laparoscopic surgery was a piece of outpatient cake, organ removal of any kind has all sorts of repercussions. If your goal is birth control, I'd say tie your tubes and leave everything in place.
posted by PatoPata at 11:14 AM on August 6, 2008

I have had a vaginal hysterectomy about 10 years ago. (cue jokes about the gynecologist who became a mechanic and did all his work on the car through the tailpipe.)

I'm pretty happy with it. Even discounting the "I stopped having cancer"[*] part of the surgery, the cessation of weird menstrual-related issues was pretty awesome.

Recovery was pretty quick, considering I had an organ removed. I was up and walking around (albiet slowly) the day after the surgery. I went home the day after that. Once home, there were the usual anaesthesia-related issues of my digestive system rebooting after an opiate-induced shutdown. But that and a bit of leg/groin ache from the stretching they presumably did during the procedure were my main physical complaints. I was pretty slow-moving for most of a week after that, but rapidly regained my previous physical levels.

Once things were healed, penetrative sex was still good -- I'd heard that some women have problems reaching orgasm after a hysterectomy, but I had no problem. During sex, the lack of a cervix (since a vaginal hysterectomy involves excising around the cervix and pulling the uterus and cervix out of the body that way) was ... weirdly noticable at first but otherwise unremarkable. Mostly a "something is different... can't quite place what it is" experience.

I've also had my ovaries removed about five years ago, which happened decidedly un-laproscopically, as it also involved removing a tumor the size of a cantelope and some smaller friends. So I can't speak to the recovery from that procedure if done laproscopically.

I will say that I haven't had any menopause issues besides slightly more sensitive skin. No hot flashes, none of that. I gather my experience of menopause is something of an edge case compared to many of the women I know who have already gone thru menopause naturally.

[*] possibly untrue as current theory is that my ovarian and uterine cancers started around the same time, but the ovarian cancer was slow-growing enough that it took years to have unavoidably noticable symptoms.
posted by rmd1023 at 11:15 AM on August 6, 2008

my mom had a laparoscopic hysterectomy last year at 53 , after ~15 years of progressively worse pain due to uterine polyps and various attempts at remedies (ablation, etc.. i can't remember all of them now). she said she felt much better, even a day after the surgery.

this is what she wrote in an email the day after: "Just wanted to let you know that I was released from the hospital about an hour ago and am home now, feeling okay. (The drugs are very helpful!) The procedure went smoothly and I have virtually no incisions -- just three little holes near my belly button. Although I feel good, I'm following the rules, which is to stay quiet and rest for a couple of weeks."

i showed up for a visit about a week after that and she was taking it easy but walking around and in very little or no pain and saying that she felt much, much better than before the operation, even while still healing.

since then she's been very happy, no complications of any sort, and from what i understand the pain is gone, as are the cancer fears. (i haven't asked for any details on the icky stuff, it's my mom!) all in all, i think it was an overwhelmingly positive experience.
posted by sergeant sandwich at 11:13 PM on August 6, 2008

Read this book. It is extremely helpful in deciding whether or not a hysterectomy is the right way to go.

If you're able to keep the ovaries, the after-effects of hysterectomy are minimal, and the recovery time for laparascopic hysterectomy is relatively short. I had an abdominal hysterectomy, and the recovery was ~6 weeks. I was up and around for short walks the day after surgery, and pretty much back to normal activity after 5 weeks, driving after 2 weeks with a loosened seat belt and a towel on my lap. Again, that was with the more invasive abdominal hyst. With a laproscopic hysterectomy you'll probably be home from the hospital the same day, and back to work in roughly 2 weeks.

Of course the other obvious factor is your age and whether or not you want children. If you're near menopause anyway, a hysterectomy is pretty much a no-brainer, but if you're late 30s and will be losing your ovaries, you'll have to go on hormone replacement therapy (HRT). Most women have no problems with HRT.

All that said, it's better to not lose your equipment if you don't have to. There's always the option of having a hysterectomy down the road if the simpler treatment doesn't work.
posted by Koko at 12:00 PM on August 22, 2008

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