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Old 11-13-2011, 10:17 AM
 
Location: Up above the world so high!
45,270 posts, read 86,039,386 times
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Quote:
Originally Posted by zoso1979 View Post
What? In my experience hysterectomy includes the decison if the ovaries should be left or not. It's oophrectomy. What you do depends partly on your age.

According to my Dr the average age for the onset of menopause is 52.4 years. By the time you hit your 50s they begin to stop working. His comment to me is that they actually become a liability as the rate of ovarian cancer increases. He would have left them in, but the disadvantages outweighed the benefits.

One thing I've come to believe for certain is that EVERY woman is different and the more we share on this can be very helpful to others!
Many hysterectomies do not include the removal of he ovaries. Averages are just that, an average of women, meaning a lot will be younger than 52.4 and many will be older

Since I was not completely thru menopause it was in my best interest to leave the ovaries. For older women who have long since finished menopause it is considered wise to take the ovaries. Our OP is not thru menopause yet, there would be no reason from anything she has written to believe her doctor would take the ovaries out.
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Old 11-13-2011, 11:14 AM
 
Location: Mostly in my head
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I had the ovary with the fibroid tumor removed and the other one left; uterus was taken. My ovarian fibroid was the size of a grapefruit, I was told. The theory was that the one ovary would provide hormones but it didn't. At the age of 36 I went on HRT and stayed on it for many years.
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Old 11-13-2011, 11:54 AM
 
Location: Tigard, Oregon
851 posts, read 2,475,859 times
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Quote:
Originally Posted by lovesMountains View Post
Many hysterectomies do not include the removal of he ovaries. Averages are just that, an average of women, meaning a lot will be younger than 52.4 and many will be older

Since I was not completely thru menopause it was in my best interest to leave the ovaries. For older women who have long since finished menopause it is considered wise to take the ovaries. Our OP is not thru menopause yet, there would be no reason from anything she has written to believe her doctor would take the ovaries out.
Thanks, and I agree!

I'm saying that hysterectomy and oophrectomy are not entirely separate issues. Age is one critieria and the average age is helpful as there's no way for anyone to know just WHEN menopause will begin; it's a process, not a single point in time.

I haven't started menopause (yet) but it was eminent and my dr actually said it could be considered "malpractice" if he were to leave them, however he would have if I'd asked him to. (I'd not had ANY issues with them.) OP does not mention her age and and it is a significant consideration. My Dr and I agreed that due to my age, it no longer made sense to leave them. It's the position of my Dr that HRT is quite safe today. I'd probably have decided differently if I'd been much younger.

There certainly is a lot to condsider everyone is different. If I'd been younger I'd likely have decided differently. I'm just saying that AGE alone CAN be a reason to remove the ovaries IF a hysterectomy is already being done. !
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Old 11-13-2011, 12:01 PM
 
Location: Up above the world so high!
45,270 posts, read 86,039,386 times
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Quote:
Originally Posted by zoso1979 View Post
Thanks, and I agree!

I'm saying that hysterectomy and oophrectomy are not entirely separate issues. Age is one critieria and the average age is helpful as there's no way for anyone to know just WHEN menopause will begin; it's a process, not a single point in time.

I haven't started menopause (yet) but it was eminent and my dr actually said it could be considered "malpractice" if he were to leave them, however he would have if I'd asked him to. (I'd not had ANY issues with them.) OP does not mention her age and and it is a significant consideration. My Dr and I agreed that due to my age, it no longer made sense to leave them. It's the position of my Dr that HRT is quite safe today. I'd probably have decided differently if I'd been much younger.

There certainly is a lot to condsider everyone is different. If I'd been younger I'd likely have decided differently. I'm just saying that AGE alone CAN be a reason to remove the ovaries IF a hysterectomy is already being done. !
Do you mind if I ask your approximate age at the time of surgery?

Just can't believe your doctor took your ovaries prior to menopause when you weren't having any problems! That can throw you into a forced surgical menopause and can be really rough to live with.

And the latest research on HRT is that is should be used short-term, not for decades and decades the way it's been prescribed in the past.
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Old 11-13-2011, 12:05 PM
 
Location: Up above the world so high!
45,270 posts, read 86,039,386 times
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oops, just saw you said you were 51 at time of surgery

So glad you are enjoyed renewed energy and just general overall feeling better!

I know I sure haven't felt better in my life. My hysterectomy was just the ticket to that
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Old 11-13-2011, 12:56 PM
 
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My doctor advised me to have ovaries removed at the time of my hystertomy for fibroids, so I did. I was 47. So no I don't think my situation was that different just a different doctor's advice.
I still believe it is a good idea (wish I had) completely investigate every alternative before doing the surgery.
The laser thing would not have worked for me because I had lots of fibroids, inside and outside the uterus.
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Old 11-13-2011, 04:24 PM
 
575 posts, read 848,955 times
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Quote:
Originally Posted by zoso1979 View Post
Thanks, and I agree!

I'm saying that hysterectomy and oophrectomy are not entirely separate issues. Age is one critieria and the average age is helpful as there's no way for anyone to know just WHEN menopause will begin; it's a process, not a single point in time.

I haven't started menopause (yet) but it was eminent and my dr actually said it could be considered "malpractice" if he were to leave them, however he would have if I'd asked him to. (I'd not had ANY issues with them.) OP does not mention her age and and it is a significant consideration. My Dr and I agreed that due to my age, it no longer made sense to leave them. It's the position of my Dr that HRT is quite safe today. I'd probably have decided differently if I'd been much younger.

There certainly is a lot to condsider everyone is different. If I'd been younger I'd likely have decided differently. I'm just saying that AGE alone CAN be a reason to remove the ovaries IF a hysterectomy is already being done. !
I am 55 and haven't had a period since this February. I have no pain and obviously no bleeding. I am overweight so I can't tell if the puffiness above my C Section scar is all fat or from fibroids. I was getting ultrasounds for the last three years and the size had not changed since first noticed in 2006. Yes my uterious is enlarged which is pressing against my bladder as if I was pregnant so I pee constantly but I have had that urgency before the fibroids. This year my Gyno didn't feel the need to do the ultrasound and she does say fibroids shrink in the absence of estrogen. I am going to get a second opinion since it has been a year since the last ultrasound. It's funny that I had hot flashes all summer and when it cooled down, they completely stopped. My Dr. thinks I may still be producing estrogen for the hot flashes to completely stop and predicted I would get my period last week. I didn't. She said my uterus is the size of a 3-4 month pregnancy.
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Old 11-13-2011, 04:54 PM
 
Location: Up above the world so high!
45,270 posts, read 86,039,386 times
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Quote:
Originally Posted by oldraider View Post
My doctor advised me to have ovaries removed at the time of my hystertomy for fibroids, so I did. I was 47. So no I don't think my situation was that different just a different doctor's advice.
I still believe it is a good idea (wish I had) completely investigate every alternative before doing the surgery.
The laser thing would not have worked for me because I had lots of fibroids, inside and outside the uterus.
Wow, some doctors recommending women get their ovaries removed so young when they aren't having any problems with them really surprises me!
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Old 11-13-2011, 05:23 PM
 
Location: Up above the world so high!
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New study questions benefits of elective removal of ovaries during hysterectomy

""Presently, observational studies suggest that bilateral oophorectomy may do more harm than good."
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Old 11-13-2011, 11:44 PM
 
Location: Georgia, USA
21,485 posts, read 26,089,700 times
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First of all ladies, to clarify the definitions:

  • Hysterectomy: removal of the uterus.
  • Oophorectomy: removal of an ovary. It may be unilateral (one ovary) or both (bilateral).
  • Salpingectomy: removal of a Fallopian tube. It also may be unilateral or bilateral.
A gynecologist does not use the term "complete" hysterectomy. That is a lay term for removal of the uterus and both tubes and ovaries. A doctor would call it a "total hysterectomy and bilateral salpingo-oophorectomy. The "total" means the entire uterus was removed. A"subtotal" hysterectomy means the body of the uterus was removed but the cervix was not. Most hysterectomies are "total" in that regard. Sometimes one tube and ovary is left. It is possible to remove the tube and leave the ovary, but commonly the tube is left with the ovary if both are normal.

The issue in this thread is the best treatment of fibroids, and that really depends on the age, menopausal status of the patient, and whether the ability to get pregnant is a concern.

  • For the patient who wants to get pregnant, the fibroid(s) can be removed, often laparoscopically, using a telescope inserted through a small incision near the navel and several additional small incisions. This leaves the uterus intact, but scarring may predispose to rupture of the uterus during pregnancy, especially in labor. Therefore a Cesarean before labor may be recommended. Some fibroids can be removed from inside the uterus via hysteroscopy, in which a telescope is inserted through the cervix into the uterus, if they are under the uterine lining and accessible from that route.
  • If pregnancy is not desired, there are alternatives to surgery. In a patient who is likely to enter menopause fairly soon, there are medications that can shrink fibroids. However, they are expensive and have side effects, including menopause like symptoms. So they are not suitable for long term use. After menopause, fibroids do tend to shrink because of lack of estrogen, though the amount of shrinkage varies a great deal. Another alternative, if the main symptom is bleeding, is to destroy, or ablate, the uterine lining via hysteroscopy. There are several techniques to do this. And the newest approach involves threading a catheter into the main arteries of the uterus and embolizing the fibroids. Microscopic spheres are injected into the arteries to block the blood supply to the fibroids and cause them to shrink. The embolization is done by a radiologist, usually as an outpatient. The disadvantage of any procedure that leaves the uterus in place is that new fibroids may develop. Uterine ablation and fibroid embolization do have potential complications, and some women end up having hysterectomies anyway.
  • Some women may want to consider hysterectomy if their fibroids are large, menopause is not imminent, and they want definitive treatment. Large fibroids may or may not be associated with heavy bleeding, but they commonly cause the bladder pressure several of you have reported. They can also be uncomfortable due to sheer weight and can cause bowel pressure. A uterus larger than about that of a three months pregnancy size may not shrink after menopause enough to relieve pressure symptoms. Shrinkage after embolization also varies. These days, most hysterectomies that in the past would have required an incision similar to a Cesarean incision can be done with the laparoscope. The reduces the recovery time afterwards. The uterus can also be removed vaginally, with no abdominal incisions at all, if it is not too large, especially in women who have had vaginal births. The vast majority of women who have hysterectomies for fibroids are pleased with the results.
  • The decision to remove normal ovaries or not must be individualized. Obviously, an abnormal ovary would most likely need to be removed. For young women who have many years before natural menopause, keeping normal ovaries would be the most common option. This prevents "surgical menopause" and the need to possibly take hormone replacement for an extended period. Women who do not wish to take hormones or who have contraindications to taking them will want to keep their ovaries. The risk of breast or ovarian cancer can be evaluated on a case by case basis. As the age of the patient approaches menopause, some women may want to opt for removing the ovaries. If a hysterectomy is done in a patient who is already through menopause, it becomes easier to decide that there is little to be gained by leaving the ovaries. One consequence of not removing the ovaries, however, is the possibility of developing painful scar tissue which may result in additional surgery later on.

Any woman with fibroids needs to have a thorough discussion with her gynecologist about her options, nonsurgical and surgical, and if surgery is selected, make an individualized plan for what is done with normal ovaries. This maximizes the chance that she will be completely satisfied with her treatment.
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