Hi, I am new to this board. I am 44 and have been experiencing some problems that started the beginning of this year but otherwise am very healthy. A little history about myself. I had a C-section done in October of 1986 and LEEP surgery done in September of 2003 due to Pre-cancerous cells on my cervix. All of my pap smears since have been normal but in January of this year I had a really bad period and experienced major abdominal pains and lower pelvic pains. Went to my regular doctor and she sent me for a Transvaginal Ultrasound which showed that I have an enlarged endometrium of 1.3 cm and one small uterine fibroid. My left ovary was normal but my right ovary would not move with manipulation of the probe but otherwise was normal, they think due to possible pelvic adhensions maybe caused from my C-Section? I was referred to a specialist who recommended that I have a D & C/hyperscopy done so that they could test the tissue, etc. My D & C was scheduled this past Friday, July 16 and my doctor said that they tried but were not able to the D & C because my cervix was to narrow/small and that the next step now is to have a hysterectomy. My question is, is this my only option or should I try to get a second opioion from someone. I know deep down inside that I should go ahead with the surgery because I have a horrible family history of ovarian cancer, ovarian cysts, etc. and my mother and grandmother both had full hysterectomies done by the time they were 50. Any advice would greatly be appreciated. Thanks and God Bless.
You may wish to get a second opinion and see what this other doctor says before going ahead. In light of your family history, you definitely need to proceed with more vigilance than you would otherwise.
Did your doctor perform an endometrial biopsy ? This can be done in the doctor's office and it does not take long (it is uncomfortable but extremely quick). This is a sampling of the tissue from your endometrium to ensure that it is normal. A thickened lining is usually a cause for concern because it MAY turn into endometrial hyperplasia which may in turn transform into uterine cancer. Women who are overweight have a much higher risk for this type of cancer. I have never had children and my cervix was extremely tight but my doctor was still able to take a sample by clamping the cervix open (not a pleasant experience but as I said, it is very quick).
Has your doctor said if you would have a complete hysterectomy or not ? There are different types of hysterectomies and a surgeon could remove only your uterus and leave your ovaries and cervix in tact, or take out everything. Taking out the ovaries will kick you into instant surgical menopause and you need to be prepared for this. If you have an extensive history of ovarian cancer in your family, you need to discuss the possibility of removing your ovaries with your doctor. You may also see about getting genetic testing to see if you carry the BRCA 1 and or BRCA 2 gene. If you carry these genes, ovary removal after you have had your children is usually recommended. However, I do not know what they would recommend if you do not carry these genes. Keep in mind that you don't have to carry these genes in order to acquire ovarian cancer but if you do carry them, your risks are substantially higher.
Normally I am vehemently against the removal of either the ovaries or the uterus. I think that there are way too many needless hysterectomies being performed today and the side effects for some can make their situations worse than before. However, if there is gynecological cancer in the family, you have to be vigilant and see things a bit differently than if there is no cancer in your family. A thickened uterus can sometimes be thinned out with drugs. Another surgeon may also be able to perform the D & C while the one you have now cannot. There are options.
If you really trust your current doctor, you may want to seriously consider the hyst, in which case, you need to discuss what kind of hysterectomy is being recommended and what to expect with this procedure. Otherwise, you can try to get a second opinion before making this decision. Another gyne may be able to present you with other less invasive but just as reliable options. You also need to consider the symptoms you are experiencing. Are they going away or are they getting worse ? This is also extremely important.
I wish you the best and I hope I have managed to give you some information that you perhaps may not have had before so that you can make a sound medical decision.