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Old 07-22-2009, 07:21 AM   #1
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Questions to ask Dr. regarding hysterectomy

I'm seeing my gynocologist in a few weeks regarding having a partial hysterectomy done where the ovaries and cervix are left in but the top part of the uterus is removed. She said a few months ago when I had an exam and ultrasound that she thinks I will be a good candidate for a laproscopic hysterectomy.

I have multiple problems and don't see any alternatives to a hysterectomy - enlarged uterus, lots of small-medium fibroids, prolapse, and thickened uterine lining.

I understand the benefit of leaving the ovaries in, but what is the benefit of leaving the cervix in? What questions should I ask the doctor when I go for the consultation?

 
Old 07-26-2009, 10:57 AM   #2
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Re: Questions to ask Dr. regarding hysterectomy

I just saw this post.

The cervix provides a little hormonal support even after menopause. The cervix also offers some support for the pelvic floor.

I don't know how old you are, but if you are over 30 I strongly suggest that you ask your doctor about the following tests.

HPV test: If you are over 30 and have not had one, then ask your doctor to run one on you, before you have your hyst. It will tell the doctor of the virus is active. [Most women who have been sexually active at some point in their life have been exposed to the virus, but it isn't active.]

If the virus is active, then ask the doctor to do a colposcopy with an ECC (endocervical curettage). The colposcopy is basically a pap smear with a microscope (called a colposcope). Usually doctors take biopsies of the outer cervix when they see problems, but the colposcope can only "see" the outer cervix. The ECC scrapes the cervical os (the hole in the cervix that leads from the vagina to the uterus), similar to how a pap scrapes the outer cervix.

The pap generally tests squamous cells from the outer cervix. The ECC scrapes glandular cells that are in the cervical canal. The pap generally cannot detect glandular cells, therefore there can be problems in the canal, even when paps have always come back fine. They test for different types of cells.

If your doctor has not already run these tests, I strongly suggest that they be run before the doctor leaves in your cervix.

The reason I say all of this is because of my history. I know my case is quite rare, but there are some lessons women can learn from my experience.

I've had good paps every year from age 19-44. When I was 44 my doctor asked if I wanted the HPV test with the pap. I said sure. It came back positive for high risk HPV, and a clean pap. Long story short, I went to a gyn for a colpo and ECC. The colpo was fine, the ECC found the highest level of precancerous cells (adencarcinoma in situ). I later had a cone biopsy which showed cancer (adenocarcinoma Ia1). I then had a hyst (cervix and uterus only). I am now 1 year postop and have been released from my gyn/onc. I know, deep in my heart, that if my regular doctor hadn't done the HPV test and the gyn hadn't done the ECC then my cancer would still be growing in my body. And . . . my paps are still good. I had cervical cancer (glandular cells) and have NEVER had a bad pap.

So, before your doctor takes out the uterus and leaves the cervix, I'd think you and the doctor would want to ensure that the cervix is healthy. And not just the outer cervix, but the upper/inner cervix, too.

I take it you have not scheduled your hyst yet. I strongly suggest that you take a wirtten list of questions to your next appointment (or make an appointment just to ask questions). Leave room to write answers.

I hope that helps.

 
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