Hello, @joannepayne – I just did a quick Google search. According to the National Institutes of Health (.org) 'spontaneous expulsion' does indeed happen.
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Hi All, an UPDATE here…
I had surgery on the 9th to remove my very large uterine fibroid, uterus, fallopian tubes and cervix. Cervix had to go, unfortunately, due to the very large size of the tumor – it was either remove the cervix in order to make room for the tumor to come out vaginally or have a large abdominal incision, according to my surgeon — which is a riskier surgery and much harder recovery. (And, for those who aren't familiar, when a tumor is as big as mine, attached as it was to my uterus, a hysterectomy is the safest option.)
My big concern going in was losing my ovaries, as well. And the very good news is that I found a surgeon who agreed with the research I'd found online that the ovaries continue to serve a purpose in your body, even after menopause. (I'm 52 and not yet menopausal, so I was concerned about being plunged into menopause prematurely. Also, recent studies show that ovaries play a role in heart and lung functioning – at least I think that's what it was…)
So I'm exactly a week post-surgery today and beginning to feel the healing kick in. What's amazing: my waistline. That tumor was so big and here I just thought I'd been overdoing it on the pasta all these years. Incredible. Even with the four laparoscopy incisions in my belly, residual abdominal pain and all the repercussions of pain meds (digestively – oof) I feel back to myself again. It feels like I just aged backward by about 5 years – my body actually feels younger. I could cry.
And this is my message to medical personnel: first, don't tell a woman to go home and relax when uterine fibroids are detected. Tell her to monitor them closely for growth and/or signs of malignancy. I could have avoided 5 years of discomfort, debilitating periods and urinary problems – not to mention two very stressful months scrambling to find a new GYN, arrange this major surgery, get all the imaging to make sure there was no cancer or spread of cancer in my pelvic area – if my original GYN had taken 3 minutes to talk to me about this condition.
Second, when you ask a woman what her symptoms are, understand that fibroids may have been growing in her pelvis for years. The effects have been so slow to manifest that she can't identify, for sure, how her body feels different. Urinary troubles? I guess I have to pee more… Lower back pressure? Doesn't everyone who sits at a desk have that? Bloating, discomfort, heavy periods? Um, yeah, but what woman past 45 doesn't… This list goes on.
For any of you facing a possible hysterectomy for fibroids, know that if you've got a 2nd – maybe even 3rd – opinion, and the consensus is that this is the best option, it's a good thing. It's scary, and you need to take off at least two weeks of work after, but it's a godsend. I was completely unaware of all of this two months ago. It felt like a part-time job just educating myself. But I'm grateful beyond measure that I found a doctor (a man, ironically) who, unlike my original GYN, was sympathetic to all the ways in which this major surgery might affect my life. He took the time to talk to me about the options, and reassure me that, for instance, losing my cervix would not diminish my sex life. He expressed concern for my wellbeing as a whole person in a way that my last two female GYNs never had.
And just to be clear, just because you have to have a hysterectomy for fibroids doesn't mean you have to lose your cervix – mine was a special case. A good friend just had to have the same procedure but got to keep her cervix bc her tumor wasn't as large as mine. There's a lot of misinformation online about the impact of this type of surgery on your life, especially on your sexual wellbeing. It's a little early for me to report on that, but I'm optimistic, based on the conversations I had with my surgeon — who, by the way, was the one to raise the topic, I was too mortified. I'll be grateful to him forever for anticipating that concern of mine and for normalizing this as a talking point in our first meeting. (When I'd worked up the courage to broach the topic with my original – female – GYN, she stammered and literally waved her hand to dismiss me.)
I hope this provides some good news for someone. I so wished I'd had a girlfriend who'd been through this.
Oh, and word to the wise, if you come through a surgery like this one and especially if you need pain meds after, stay on a liquid diet for the first couple days. Medical personnel kept telling me to eat, so I did. Big regret. I ended up with impacted bowels. Nothing a laxative didn't solve, but it made for a very distressing couple days, as I'd never experienced that before. Or maybe begin a laxative pre-emptively. I was taking stool softeners, but it didn't prevent the situation.
Over the last year I've noticed that – as, unbeknownst to me, my fibroid was enlarging dramatically – I experienced cramping after orgasm. I also noticed slight urinary incontinence in the hours after. I don't have any guesses as to the reason, it's just interesting to hear someone else describe discomfort after orgasm – I wonder if it's fibroid-related.
Best of luck with following up on your situation and getting good care. I for one am grateful for your candor. That any of us are made to feel embarrassed about writing frankly about sexual/reproductive problems is a terrible shame.
Just wanted to post an update: I've since gotten a second opinion – invaluable! – and also spoken to several friends who happen to be going through this same thing – all of whom have recently had a hysterectomy bc of fibroids, all of whom had it done laparoscopically. (Turns out I had friends suffering from the same pain and frustration this summer and I didn't know. Which raises the question – again – of why many OBGYNs dismiss uterine fibroids as easily as they do.)
In my situation, it turns out my GYN – who's also an oncologist and surgeon – just has a particular mindset when it comes to fibroid removal in women over, say, 50yrs: she is of the opinion that any risk of ovarian cancer is too big a risk, so why not just eliminate the chance of that happening, since "you're not using your ovaries anyway". Also, it turns out my GYN doesn't have access to the equipment needed to perform the surgery laparoscopically at the hospital she's affiliated with, which is why she was recommending a full-on abdominal incision-type procedure.
The doc I went to for a second opinion has a different take on the situation and he's affiliated with a better-equipped hospital. He believes the documentation that's been out for a little over a decade demonstrating potential health risks associated with the premature removal of ovaries because – as I'd read online – the ovaries continue to play a beneficial role in the body for several years past menopause. (I think it's maybe connected to heart and lung functioning? Can't remember.)
Now, obviously, if you have a personal or family history of reproductive cancers (cervix, ovarian, breast, etc.) it may be wise to prophylactically take out some or all of those body parts. But for me – no family history, all clear PAPs – the potentially damaging health consequences to removing my ovaries (not to mention I'd like to experience menopause naturally (gradually) instead of being plunged into it overnight) are enough to make me want to keep them as long as I reasonably can.
Next steps for me: have an MRI to get a clearer image of the tumor than ultrasound can provide – that way, this 2nd surgeon can make a better-informed decision about my risks for getting ovarian cancer. If the MRI reveals any signs my tumor is malignant, we'll re-assess. But for now, the plan is to remove – laparoscopically – only my uterus, the fibroid/s attached to it, and fallopian tubes.
Either way, women should know that when hysterectomies for fibroids are done laparoscopically, they now 'bag' whatever they're removing (uterus, fibroids, etc) to prevent any potential 'spill' or 'spread' of abnormal (cancerous) cells into the abdominal cavity. (Please correct me if I've got any of this wrong, this is my best recollection of what the doc – and friends who've had the procedure – described.)
For now, I'm grateful to have found a surgeon who is confident that we can get the offending uterine fibroid (and uterus) out without doing a full-on abdominal incision — it means a shorter hospital stay, less pain-management afterward, less chance of complications, easier recovery, etc.
If I can possibly swing it, I'll get a third opinion as well. I've never been more convinced in the wisdom of getting more than one evaluation of any medical issue – the disparity in what one doc said over another was an eye-opener. Hope this helps anyone facing these choices…
Hi @hopeful33250 and thanks for your reply. To be clear, I actually agree with the reasoning for a hysterectomy. My fibroid measures almost 10cm and, from what I gather, removing the uterus is best practice at this point. (Fibroids almost always re-grow, and removing just the fibroid is a riskier surgery, typically only recommended – from what I read – for women who still want to conceive. I'm 52 and happily childless, so that's not me. 🙂 )
My main concern is my doc's recommendation to remove ovaries and cervix, as well as the uterus. I'm still struggling to understand why the rush to remove additional organs when I've not had an abnormal PAP smear and I have not started menopause yet. I wonder if screening for ovarian or cervical cancer is somehow more difficult after removal of the uterus? My primary care doc said that in perimenopause, there is sometimes a greater risk of cancers growing/spreading faster, and maybe that's why my GYN wants to be so aggressive with treatment?
Thanks again for your very good questions – it's all helpful at this point. : )
@contentandwell, the whole question of a biopsy is one that I have, too. (I always think of these questions about an hour AFTER I've left the appointment.) A friend, who is not a medical professional, wondered how much can be assessed during surgery – like, while they're in there, can they determine the presence of abnormal cells, and then remove the ovaries or not, depending?
I think my overwhelming feeling here is, why isn't there more conversation in medical offices, and why do we (well, me) let ourselves be rushed out of appointments with our doctors before we've gotten a satisfactory overview of something as significant as the removal of three (four?) organs?