Sally’s Lap-Assisted Vaginal Hysterectomy

Type of Hysterectomy: Laparoscopic-Assisted Vaginal (Total) Hysterectomy

Age at surgery: 66

Location: West Chester, PA

I really did not “suffer” like so many of my Hyster Sisters. I knew I had several fibroids, but was told they would shrink with menopause. I was 13 years post menopause, but in September 2015 started to bleed. I had a transvaginal ultra sound which showed several large fibroids as well as a mass on my left ovary. Prior to another appointment, I started having pelvic pain and was running a fever of 102 degrees and was told to go to the ER. I was admitted and stayed 3 nights due to a pelvic infection. After more testing I was told I would need to have a total hysterectomy. At the age of 66 I was not too worried as, a woman hospital doctor about my age, who also had a total hysterectomy said re: our girl parts, “Who needs ’em?” A biopsy of the cervix prior to surgery showed no cancer. My ObGyn surgeon was young, and had practiced at The Mayo Clinic and Johns Hopkins, so I did not get a second opinion.

I came in the morning for out-patient surgery and went home the afternoon of the next day. I had general anesthesia and a catheter in over night. The only real problem I had in the hospital was during the night after the surgery, I had sharp pain in my right ribs and shoulder due to the gas that is injected to inflate your abdomen during laparoscopic surgery. I could hardly breathe and rang for the nurse who came immediately and gave me a shot of morphine.

Except for a painful bladder infection from the catheter, recovery was more or less uneventful. Yes, “rolling” out of bed the first week to ten days was challenging as was getting up off a sofa etc. In addition, in those first few weeks of soreness and fatigue, where I wondered if I would ever be myself again (YES you will!), my main worry about life after a hysterectomy probably seems shallow or silly. But I really worried if I would still like lavenders, bright pinks, blues and long skirts. (YES I do!) I was afraid I would take a liking to front-end loaders and plaid shirts. My surgeon released me to regular activities after my 8 week exam.

However my biggest “complaint” has not been physical, but the lack of communication or transparency by my doctor. He had initially told me if the fibroids were too large to take out laparoscopically he would make the traditional bikini line incision. When I woke up I just had 5 little “holes” so I assumed all was well. He visited for all of two minutes and said, “Everything went well and all pathology was clear – any questions?.” In hindsight I should have asked, “Tell me all about my surgery”. The mass on the left ovary was scar tissue pulling the ovary over from a myomectomy I had in 1986. As I only had five holes, I assumed all was well.

In the next weeks my main complaint was a very sore and tight vaginal area. I spent my days leaning against the end of the couch reading and watching videos. At my two week check I asked his nurse, and she said, “Oh, your fibroids were too large and were pulled out through your vagina.” He added it was like I had a five pound baby.

At my eight week internal exam, which was painful, he said, “Well, you tore during surgery so we had to do a repair.” (OK – Thanks for telling me two months later!) When I asked him about the chance of bladder prolapse, as the bladder leans against the bottom of the cervix (which was no longer there) he said, “No chance, if anything I pulled you too tight!”. Because I respect authority and tend to keep my mouth shut, I just replied ‘thank you”, but wanted to ask why he hadn’t told me this in the hospital.

The only things I would say is that since I’m thirteen years post-menopause, I had assumed my ovaries were no longer producing estrogen. But after my surgery I had three nights where I woke up with night sweats that soaked through my nightie so much that I had to change twice on those nights! I guess I was producing more estrogen than I thought. In addition, I am still concerned with my voice, as I am a cantor at Mass. I have noticed my middle register is not as clear. However that may be because I was on “Hiatus” for two months and did not do a lot of vocalizing.

We’re flying out to Arizona next week for a vacation. To be very truthful, I basically feel like myself again. But almost three months after surgery, my vaginal area is still a bit tender and my husband and I still have not attempted sex. (He is a SAINT!) That will be a question for the gynecologist.

Everyone’s circumstances and experiences are different. But I would say at least:

1) Have good communication with your surgeon.
2) Have a good support system while you are home. Stock up on non-perishable foods before your surgery.
3) Listen to your body!!! If your surgeon says you can return to work at six weeks and you’re exhausted- stay home.