Total Laparoscopic Hysterectomy & Uterine Prolapse ?'s - Hysterectomy Message Board

jeff's girl · 02-26-2005, 05:03 PM

I have been scheduled for a partial hysterectomy in April due to uterine prolapse. My first question is about the procedure itself. I am having a TLH (Total Laparoscopic Hysterectomy) in which no portion of the surgery is done through the vagina, unlike the laparoscopic assisted vaginal hysterectomy where the uterus is removed through the vagina. I will have 3 small incisions and go home the same day. Has anyone had this done? How was it?

My second question is regarding my uterine prolapse, the reason for my surgery. I'm only 33, not that it matters, and I just don't want to rush into this. I've been told for several years that I had prolapse of the uterus, but in the last 2 to 3 years it's gotten worse. I don't have any debilitating symptoms, just slightly annoying things like mild, nagging pelvic pain and low back pain and sometimes urinary incontinence (a couple of drops, really) and urgency. None of these are constant. They come and go. My doctor that I really loved and trusted (who also delivered both of my children) died 3 years ago at a very young age, unfortunately. I have a new doctor that I've seen a couple of times from the same group so he has my chart records from my last doc and he says it has gotten significantly worse since the last time I saw him. I really like this new doc, but I don't have that trust that I had with the old one. I'm just concerned that I'm rushing into this. He told me that I need to have this done, preferably in the next 6-12 months because he said that right now my vagina and bladder have not been affected by the prolapse and the surgery would be fairly simple since there would be no repair done to them. He said I can wait, but the surgery will eventually be more complicated if I do. I've had a tubal ligation, so having more children doesn't weigh into this decision at all and he's leaving my ovaries so there are no concerns about hormone issues. He said that doing Kegel's won't help me now because it's beyond that. Does what he's telling me sound familiar to anyone else? It's not that I don't believe him, I just want to make sure I'm doing the right thing.

Zerberbaby · 02-27-2005, 10:26 PM

I had a lap assisted hysterectomy for prolapse when I was 32. My tubes had also been tied and my periods were killer...plus I had the year before had a uterine suspension. You do not say if this option was offered to you, but it is also a possibility in most cases.

From my personal experience however, the suspension was a much more painful surgery than the hysterectomy. The recovery time for the hysterectomy is considered longer (because of lifting restrictions) but I felt much better much more quickly after the hysterectomy. I had more pain and it lasted much longer with the suspension.

I was also one of the 1/3 of women who prolapse again after hysterectomy. I had an additional surgery that required an abdominal incision to lift my vagina and secure it into my backbone with a screw and have my bladder re-suspended in a mesh cradle to put it back into place.

Your doctor is correct about kegel excersices...once you have prolapsed they will not help. He/she is also correct in telling you that the prolapse will only get worse and that the pain/discomfort and problems with things like your bladder such as cystocyle and your intestinal tract (rectocyle) resulting in problems with constipation and such will become more problematic as the prolapse drops further. This can happen quickly, or very slowly...there is no way to know for sure. You could be fine till you are 60 or it could "slip" tomorrow and you could be in terrible pain (btw, if the slip does happen it does hurt like hell, but they can "push everything back up in place" literally at which point all you can really do is take it easy and have surgery to fix it).

Unless you are attached to the idea of keeping your uterus (but I can tell you, never having to think about a period again is awfully nice), the hysterectomy is not a bad option.

I would suggest however, that if you are not comfortable with this doctor that you find another one. Your relationship with your ob/gyn in the area of trust is very important. Unless you have a job that required heavy lifting, and your symptoms are manageable to you, there is no great rush to have the surgery. Take your time and find someone who you trust and are comfortable with.

No matter what you decide to do...Good Luck!