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HYSTERECTOMY: Endo Hyperplasia in Morbidly Obese Woman, Non-childbearing, with history of cancer Questions...From: anonymous@obgyn.netSun, 18 Nov 2007 13:54:03 -0600 (CST)
For the last ten years I have been dealing with excessive bleeding and clotting and irregular bleeding (4-6 months at a time. My bleeding is so excessive at some points that I bleed through overnight maxipads (tampons are not an option as my clotting is so heavy when I pass them that they "slip through") and has exceeded more then 2 tablespoons of lining/clot at one time. At different times it's caused me to become anemic. I am 38, have never had children, do not want to have children--ever, have a personal history of cancer and a family history of uterine cancer. I am also morbidly obese (350 lbs.). I understand the science involved with the excessive estrogen and am working on weight loss presently. I have just been diagnosed with endo hyperplasia with no atypia after an endo biopsy was performed last week. My GYN is VERY new (just finished her residencies). In the past I have been treated for the irregular bleeding with birth control pills (had to stop due to high blood pressure that was not controlled and blood clots that formed in the legs--HBP now controlled with medication), synthetic progesterone (did not work), and natural progesterone creams (obviously didn't work with the hyperplasia). I want a total laproscopic hysterctomy. My GYN suggests the following: 1. IUD insertion with progesterone to help facilitate lining shred to save the uterus, leading me to bleed even more for 3-4 months with no promise that is will resolve the issue. She says that I cannot have a laproscopic hysterectomy because I have not had children and a) my uterus is too high and b)my cervix is too small to pull the uterus through if they do a partial lapro and partial vaginal. She says that an abdominal hysterectomy is the only option for hysterectomy for me and that I am a poor candidate due to my health conditions (obesity, HBP, allergy induced asthma) for an abdominal (which I don't want an abdominal hysterectomy anyway). I carry my weight in the lower abdomin and healing at the incision would be very difficult. With my personal history of cancer (melanoma) and my family history of uterine cancer, and the fact that I am at very high risk for developing uterine cancer, especially with the hyperplasia,my history of attempted treatments and irregular bleeding, is it reasonable that a total laproscopic hysterectomy be considered to resolve this issue? Why can't my cervix be removed as well? Is it true that my uterus would be too high because I haven't had children? Can't they diolate my cervix to pull whatever they need to out if they have to do a vaginal hysterectomy? I just don't understand why my option is yet again, another, "just deal with it" treatment and why an abdominal hysterectomy is being seen as the only hysterectomy option. For the record I am seeking a second opinion. Any advise, answers, etc. would be greatly appreciated.
-- "Take it out!" Overland Park, Kansas
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