Hysterectomy in 2 weeks - help!

[White Falcon]

My PN has reached the point where I am bed or couch-bound. Constant pain, 24/7.

GYN thinks endo may be aggravating the nerve. Also have much worse PN with periods, pelvic pain, and abnormal uterine growths. Supposed to have laparoscopy assisted vaginal hysterectomy and excision of endo.

I have terrible PN flare with pelvic exams, and am super worried that vaginal trauma during the surgery will make my PN really bad. As the GYN who is doing the surgery is also the doc who confirmed the PN diagnosis, I am not worried that she will do anything stupid to the nerve. I think that the simple act of having a speculum stretching the opening is enough to cause me trouble.

Has anyone had a laparoscopic hysterectomy that didn't involve going in through the vagina? Any tips or advice? Thanks, ladies. I have one last appt on July 2. Surgery is scheduled for July 14.

[acw]

Hi WF,

I had my hysterectomy almost 2 years ago. It was a laparoscopic supracervical hyst (although the doctor does total lap hyst, too). While the uterus wasn't removed through the vagina, I think that he still used a speculum and some tools (for example, a uterine manipulator) that went in the vagina during surgery. However, I believe that caused much less trauma than actually having a vaginal hysterectomy.

Keep in mind that many gyns aren't trained to do laparoscopic hysterectomies. Talk to your doctor about your concerns. See if she could offer you the LSH or TLH. If she can't, and you think it would be beneficial, see if she can refer you to a doctor who can.

Best of luck to you.

Take care,
Anita

[Violet M]

WF,

I have been told by one of the top gyns in my state that there is a steep learning curve when it comes to using the laparoscopic approach with a hysterectomy and you should only go to someone who is very experienced and talented.

Even with the laparoscopic approach there can be extra tension put on the PN due to the suturing and possible tightening of the pelvic floor musculature. This may be a temporary or a permanent problem afterward and may be helped by myofascial release of the pelvic floor post-operatively. I was told this by several gyns and not one of them would even consider a hysterectomy of any type due to my PN pain -- they said it would make it worse.

Some of the women on this forum are here as the result of a hysterectomy that left them with more problems than they started with so please be careful, get a 2nd opinion, and go into it with your eyes wide opened. My intent is not to scare you but to give you information that I have learned over the years.

Best wishes -- I hope all goes well for you!

[nyt]

White Falcon,

As recommended by Violet, get a 2nd opinion. Like many women on this forum my problems started at a LAVH. However, I also had a bladder sling done at the same time which has added to my problems. Just be careful.

[White Falcon]

Anita, Violet, nyt, Thanks for your replies.

I saw my surgeon today, and changed the surgery to a laparascopic supracervical hysterectomy (LSH). She agreed vaginal hysterectomy (LAVH) was too much pressure on the PN. She is the best GYN surgeon in the province, and also the doc who confirmed the PN and sent me for the nerve block. She is very knowledgeable and experienced, about age 50, trained originally in Barcelona, Spain. She specializes in treating chronic pelvic pain. She will also be excising any endometriosis. She did say that even the LSH requires an instrument to be inserted into the vagina and into the cervix, but it is far less trauma than the LAVH.

Whether this will help the PN pain, she couldn't say for sure. She hopes that removing other sources of pelvic pain, such as endo and adenomyomas (uterine growths), that the brain and nerves might calm and have less overall pain. She is referring me to a rehab doc who is working closely with her to help patients post-operatively with physio, pain mgmt, etc. I know that my PN is much worse pre- and during my period, so having no more periods should stop those really miserable two weeks. Hopefully, if it's not aggravated every cycle, it can start to settle down and heal.

Violet, thanks for the info. My cervix will be left in place, so no suturing and hopefully less of the trouble you mentioned. nyt, sorry you had such a poor outcome after your LAVH. I watched a video of the vaginal part of the surgery, and I was cringing. No way could I tolerate that much digging around down there!

Anita, did you have PN pain before your LSH? Any difference in pain afterwards?

[Violet M]

I hope this approach works well for you. Please let us know how it goes.

[Amanda]

Good luck with your surgery, it sounds like your gyn is very knowledeable with the PN which is great. i had a vaginal hysterectomy and pelvic floor repair which was the cause of my PN problems however I wonder if i have a Lap hysterectomy would the result be the same?
I wish you every best wish and look forward to hearing from you after your surgery.