Elective hysterectomy and Ultrasound questions

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I Have had bad lower back pain for over 3 years. My periods are only 2 days sometimes 3 days. I am 38 yrs old with 3 kids and tubes tide for 11yrs now. Doctor offered a hysterectomy but he said it was elective surgery?

Ultrasound differences

last years ultrasound is not available but the Endometrial stripe:  14 mmTranscription Date: 03 Dec 2013 @ 1608 Reason for Order: 34 Y/O WITH SEVERE DYSMENORRHEA OVER THE LAST YR PLEASE  DO US AND CHECK FOR ANY ABNORMALITIES.Findings:

The uterus measures 7.3 x 2.7 x 3.9  cm. The insonated portions of the  myometrium are homogeneous in echotexture and morphology. There is no  sonographic evidence of a focal area of abnormal echogenicity.

The endometrial stripe complex is normal in its sonographic appearance and  measures 4 mm.

The ovaries are identified bilaterally and are symmetric in size, shape and  echotexture without evidence for a discrete and clinically significant  cystic or solid mass.

The right ovary measures 2.6 x 1.8 x 1.7  cm.

The  left  ovary measures 2.9 x 2.5 x 2.3  cm. A dominant follicle is noted  in the left ovary.

Blood flow is documented to both ovaries on Color  Doppler imaging.

There is no free fluid in the cul-de-sac.Transcription Date: 27 Jul 2017 @ 1455

FINDINGS: The uterus is normal in size and shape for age and parity. There is abnormal hyperechoic echogenicity the anterior wall of the uterus which appears contiguous with the thickened endometrial lining. There is mild Doppler flow within the hyperechoic area.  The adnexal regions, including the ovaries, are visualized and appear normal. There is no free cul-de-sac fluid.

MEASUREMENTS: LMP:  21 June 2017 Uterus:  7.9 cm in length x 4.0cm in AP x 5.0cm in transverse Endometrial stripe:  18 mm Right ovary:  1.8 x 1.3 x 1.7 cm Left ovary:  2.9 x 1.5 x 2.4 cm

IMPRESSION:  Unremarkable pelvic ultrasound.

 

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  • Posted

    I'm sorry not to be able to offer much here. One question, is your doctor suggesting a hysterectomy may ease your lower back ache?

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  • Posted

    I would ask for a second opinion Sule.  I had a hystrectomy and it didn't ease my back pain.  I am not a medic but there doesn't seem to be a lot wrong with your uterus and I have never heard of suggesting a hysterectomy for back pain, if I have read your post correctly.  This is a major operation which could have consequences some time in the future so seems drastic a procedure for back pain.  Take care..

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  • Posted

    Dr. calling it elective surgery cause you are requesting it, not Dr. advising it. Your ultrasound is normal so there is no indications there for it to be removed. It's major surgery. You will immediately have to deal with early menopause & its consequences can be not pretty. Plus there are many many documented cases, on here as well, of problems worse than the reason for hysterectomy, post-op, and some stuck with those consequences for rest of their lives. Periods are finite, post-op problems can be for life. I disagree with removing normal functioning body parts in the hope of that solving a problem that probably actually isn't even being caused by that anyway. Have they fully investigated your back ache? My opinion is elective hysterectomies are just wrong. Menopause can sometimes not be much fun & not when body forced into it rather than letting it naturally occur when it's time. You won't know till too late if you can sail through this, & there's no turning back if you end up with worse stuff to deal with. 

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    • Posted

      I want to say that it varies from person to person. It's not sposed to be as severe if ovaries left, but still can be for some. Definately still straight into menopause as of course no more periods, but you can't predict what your hormones are going to do in reaction to no uterus. 

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    • Posted

      If the menopause happens naturally then of course the first indication is unpredictable periods, plus all the other unpleasant perimenopause symptoms. However if your periods cease because of a hysterectomy, and your healthy ovaries remain, then your body still has a monthly cycle, you still have oestrogen, and the benefits of that. If you have a hysterectomy at 35, for example, you may have 20 more years before hitting the menopause. 

      Once again, correct me if this doesn't ring true. It's certainly the case with those women I know who had a hysterectomy at a young age! 

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    • Posted

      IIn the December 2011 issue of Obstetrics & Gynecology, Duke University researchers corroborated what many physicians have felt for many years, namely younger women who underwent hysterectomy had an approximate 2x increased incidence of early menopause. This early menopause increases a woman's risk for heart disease, osteoporosis, and other medical ailments. While the exact mechanism is not known, it is felt to occur from disrupting the ovarian blood flow during surgery (which allows the uterus to be removed surgically). This disruption causes early ovarian failure and therefore early menopause. This should give woman pause before pursuing hysterectomy for benign conditions like fibroids when there are excellent non-surgical approaches available to treat fibroids (ex. Uterine Fibroid Embolization).

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    • Posted

      I was 42 with my hysterectomy (they left one ovary) other had a lot of cysts and went right into menopause within a few months after surgery. My Dr. didn't expect that and thought Id be fine with one ovary! I agree mine was basically elective (a lot of pain and mostly low back/tail bone pain) no-one could tell me the problem had a hysterectomy since it was recommended to me by several OB/GYN. I had an ablation and a small amount of endometriosis but my hysterectomy was unnecessary procedure. I regret everyday of my life having this surgery and it turns out that I was having Pelvic Floor Dysfunction and thats why the back pain/tailbone pain was happening. I would absolutely never recommend this surgery unless absolutely sure its needed. Now, I am dealing with HRT at 44 and not finding the right balance and sexual dysfunction! I wished I'd never done this surgery.

       

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    • Posted

      Hi Mel, so sorry you are feeling just the same as me!  Regret every single day as well,, My sexual disfunction remains and has never returned back to normal.  But there may be hope for you with the right hormone balance and it could be that a bit of testosterone may help you but you would have to get this via a private consultation and prescription.  Hope things get better soon.
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    • Posted

      Hi there, I am currently on Estrogen patches, been prescribed testosterone cream just recently (a few weeks) to apply vaginally (clitoris) and I use progesterone bio identical cream on my inner arms, etc. I'm in the USA and my Dr. will easily prescribe the bio identical hormones, but I just don't believe they are quite balanced. He doesn't really monitor blood levels just goes by your symptoms! He says the blood work really isn't reliable, so I just don't know. I was hoping the HRT would help with the sexual dysfunction but I have been trying it for over a year now and still having problems, although the testosterone cream is a new addition so maybe it will help in some way, I hope. Did you find the testosterone helped you sexually?  It's so frustrating! I had this surgery 2 years ago and I feel like it may never get better :-( , but glad to know that I am not the only one with this problem, I felt like a freak! I really feel that it has a lot to do with lack of blood flow to the area and caused a huge decrease in sensations in the clitoris and vagina (maybe the cut nerves/ blood flow loss, etc). I realize that I was probably having uterine contractions with orgasims and now that it's missing that makes sense but I don't understand why the clitoris seems affected by the surgery as well. I am perplexed! I also had a Laproscopic Vaginal hysterectomy with one ovary removed, but although they left my right ovary it stopped working after surgery as well! 

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    • Posted

      Everything you are saying Mel applies to me, I am perplexed as well and why some women are not affected sexually and then some are makes me feel that it is down to the skill of the surgeon or care (or don't care) in that they cut vital nerves/muscles and do the damage.  I had the testo patches when I had a uterus for low sex drive.  I had a great medical professor who believed in monitoring blood levels for all the hormones, my testo levels were 0.07 when an average women before monopause is 2, 3, 4 or even more.  I had blood tests for hormones every 6 months.  Also my estrogen levels were declining.  As said, I felt great.  Then in the UK they stopped the teso patches, then some time after that I had a hysterectomy for prolapse after the mesh that was holding the uterus up failed.  Big mistake for me.  I was advised to do pelvic floor exercises to try and get my sexual function back, it's not worked.  It's like the medics are saying the fault is with me not the surgeon.  I have searched many articles online which have explained what has happened to the lack of function but it doesn't explan why some women are OK.  The HERS Foundation are so anti hysterectomy that it's depressing if you've had to have one but they also do some explanations.  I can only send all my best wishes that you will be OK one day.

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  • Posted

    Should I not be worried about the last ultrasound?

    Transcription Date: 27 Jul 2017 @ 1455

    FINDINGS: The uterus is normal in size and shape for age and parity. There is abnormal hyperechoic echogenicity the anterior wall of the uterus which appears contiguous with the thickened endometrial lining. There is mild Doppler flow within the hyperechoic area. The adnexal regions, including the ovaries, are visualized and appear normal. There is no free cul-de-sac fluid.

    MEASUREMENTS: LMP: 21 June 2017 Uterus: 7.9 cm in length x 4.0cm in AP x 5.0cm in transverse Endometrial stripe: 18 mm Right ovary: 1.8 x 1.3 x 1.7 cm Left ovary: 2.9 x 1.5 x 2.4 cm

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    • Posted

      I'm really sorry, but this is far too technical for a non medic. I would want all the findings explained to me in language I could understand. 

      I hope you get the advice you need, before making a decision. 

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  • Posted

    The final comment in your ultrasound report is that it's normal. The Dr. has read it but didn't advise any further investigations needed going by the report. Dr. didn't advise hysterectomy required cause of result, but rather that being sort by you hoping it might end your problems. If ultrasound was suspect then Dr. would firstly recommend a D&C for lab investigations from the scrapings, plus a hysteroscopy which is popping a camera up inside uterus via vagina to inspect insides. I believe all that would and should be done first before hysterectomy is advised. Have your smear results being entirely normal? 

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