WOMENS-HEALTH Messages for April, 2000: Re: Adhesions

Re: Adhesions

From: anonymous@obgyn.net
Tue, 25 Apr 2000 09:19:34 -0500 (CDT)

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In reply to: Helen: "Adhesions"

At Mon, 24 Apr 2000, Helen wrote: >
>I have adhesions from a direct result of a Total Abdominal Hysterectomy
>which I had 12/6/99. My adhesions are attached to my bowel, intestines
>and diaphram. My question is my ob/gyn told me I could not have a
>vaginal hysterectomy because my uterus had not dropped, and therefore,
>would have to have an abdominal hysterectomy, which I definitely did not
>want because I had been cut there three previous times for endometriosis
>and two c-sections. Is all this suffering I am going thru, only because
>she lacked experience in doing vaginal hysterectomies? If a person has a
>history of endometriosis and/or 3 prior laparotomies, should laparotic
>surgery be performed without advising a patient of their risk of
>adhesions?
>
>--
>Helen Chalmers
>

I consider myself to be a better than average vaginal surgeon, and I perform the great majority (>70%) of my hysterectomies vaginally, either alone or with laproscopic assistance if needed. I believe very strongly that the vaginal route is to be preferred. However, even I would not have considered attempting a vaginal hysterectomy on someone with your described surgical history. It would be absurdly risky, even if it could have been accomplished at all. I strongly doubt that your adhesions are just from the hyst for that matter. Endometriosis and C/S are 2 of the 3 biggest causes of pelvic and abdominal adhesions with pelvic infections being the third. It sounds to me as if your doctor chose the prudent and appropriate approach.

--
William D. McIntosh, MD, FACOG
Clarksville, TN

This is for educational purposes only, and is not intended to be replacement
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Next message: Harvey S. Marchbein, M.D.: "Re: pain on left side"
Previous message: anonymous@obgyn.net: "Re: Drs. A question about ORS"
In reply to: Helen: "Adhesions"

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