Total hysterectomy or salpingo-ooph? Can’t decide…help!

I had my visit about a week ago.  When she asked about my desires for removing the uterus I told her that I didn't want to do it unless there was medical reasoning for it.  With BRCA2 there is no concern about the uterus or cervix.  And since I went through chemopause I'll won't be taking taxmoxifen.  There are issues with taxmoxifen causing uterine problems but that was off the table for me.  So last week I had a trans-uterine ultrasound.  If that comes back clear then we're just taking the ovaries and fallopian tubes.

BTW - my aunt died of cervical cancer when she was in her mid-fifties.  But getting a pap smear is no big deal and I don't see any problem staying on top of anything that might develop.

I understand your desire to do this sooner rather than later.  But I know they have concerns with taking away the estrogen too soon because it has other benefits including heart health.  Did the doc go over those with you?  Are there any options for high risk scans until you're forty?

Hi, I had the whole enchilada out.  I had had 5 years of tamoxifen also, but when they took the uterus, they said it was fine.

Since you are BRAC, if it were me, I'd do the whole thing.  It's also a bit easier to do both at once.  Would you continue to worry re: uterine cancer?  If so, it makes this decision a bit easier.

I have never regretted it once and it was a very easy surgery and recovery, altho a bit boring.

If your mom had it, and you are BRAC+, well I'd go for it, but in the end, it is what you are feeling.

As it was explained to me, they generally take everything at once, as it is easier that way and can be done laparoscopically. Itty bitty incisions, no scars. I did, however, keep the cervix (ask re: a "supra cervical" ooph and hyst.) as that is sort of the plug that holds it all intact.  Haven't had any issues, some sexual stuff (dryness, easily fixed).

I reccomend a site "hyster sisters" to you that was a wonderful source of info and support to me on all of these issues.  Try to go there and they will help!

Good luck and PM me if I can help you further.  I saw it as a  pre emptive strike in this war, not only that, but hey, I never met my ovaries, they were trying to knock me off (ER+++) and I regarded my uterus as a holiday inn that my daughter stayed in for awhile, and that's all.

It's sure nice to be done with the periods, too .  And no, I didn't suddenly age, like the horror stories you hear.  I look the same as I did pre surgery, two years ago.

Good luck in your decision making.  This surgery is not hard, it was a walk in the park compared to mastectomy.  I only ever took extra strength tylenol.

xoxo

annie

I had the whole kit and kaboodle taken in 2000.  Not because of cancer, but early menopause and continuing abnormal paps.  I have not had any problems. No problems with prolapse or orgasms.

If you just take the ovaries, and end up on tamoxifen, it has side effects of possible tumors of the uterus.  I would take it all.  If the cervix is gone, too, talk to your dr. about prolapse and what will be done to prevent it. But with continued and proactive gyn visits, cervical cancer would be easier to detect.

The equipment might be gone, but the playground is still there!

Will be praying for your decision.  Knowledge is power.

BRCA1, I had salpingo-ooph yesterday. Here's the weird thing..I almost want to whisper this in writing (ha!) but i've not had a hot flash since Monday. Surgery was Tuesday and today nothing! Wonder if the surgery has anything to do with it. My luck they'll start right up again after I finish typing this

I've been on tamoxifen for about a month, so my gyn recommended a vaginal ultrasound to be sure there were no unexpected uterine issues. It turned out all was fine so I was able to keep uterus/cervix. I know this is a hard decision. I'm also Brca1 positive, we have limited choices. Go with what you feel is right for you and get "double routine" checked. Our ovaries have to go, no choice there, but I would delay removing the cervix and uterus if it doesn't feel right, now unless the ultrasound uncovers issues otherwise, then that will point you in the direction you have to take. Take care of yourself!

I had a TAH/BSO about 5 years ago (due to large ruptured ovarian cysts). I let him take the uterus as well as I was done having kids long ago (48).  Since they suspected ovarian cancer, I wanted the cervix gone as well. Fortunately, everything turned out benign, but I had to go thru immediate surgical menopause while recovering from major abdominal surgery--it was rough. Even with the ovaries removed, you can still get ovarian cancer due to microscopic cells left behind in the peritoneum (always make sure they do  peritoneal washings during the surgery). Some studies say the cervix gives support to the pelvic floor, others say that isn't true. Actually, my gyn said the support comes from lots of different muscles and ligaments, not the cervix (being a PT, I agree with him), so if those remain strong, (kegels exercises!!!!!) you shouldn't have problems with prolapses. (no problems here in the bedroon!)

aNNE

I too am trying to make the same decisions on whether to do the total hyst or the ovaries and tubes only.  I am also trying to decide about the tamoxifen.  Does any one know the difference in side affects between the two and how have people that have taken the tamoxifen done in terms of side affects.  Thanks for any help

my onc, plus my "2nd opinion onc", both want me to do 5 yrs tamoxifen even after I have my ooph, and only then switch to an AI. They both told me that tamox works for post-menopause as well, and the most impt thing is to have as many years as possible with either medication, and since they are both only prescribed for 5 yrs at this point, they prefer I have 10 yrs protection by using both. I am going to do the tamox metabolism enzyme test, because if I don;t have the enzyme then i'll skip tamox and go straight to an AI, but otherwise I will do both. I'm still doing neo-adj chemo, then surgery and rads, so I have approx 4-5 months to do more research on this.they only want me to start tamox after i finish rads.