Thirteen years ago (when I was 39) I was diagnosed with having a 11 cm in diameter fibroid. I did not have any of the symptoms the rest of you have written about. All of the gynaecologists I saw at the time found it remarkable that I was not having any symptoms at the time, but still said it would be advisable to have removed, but at the time my life was quite busy and I felt I could not afford to take the time off to recover from a major surgery.
A year later I started having very bad stress and urge incontinence and all the doctors I saw said it would be because the fibroid was so large and pressing against my bladder. It was very bad because I was studying to be a teacher at the time and when you are in front of a classroom you can not just run out of the room to find a toilet. In the long run it was one of the factors that added to my decision that teaching may not be a suitable profession for me. Then after a few years I got tired of feeling bloated and wetting myself every day. At the time I had just moved and the doctors at my new practice said it was not a severe enough reason to have a hysterectomy so I did nothing at the time.
Then I moved again and about three years ago one of the doctors at my new practice agreed that my situation was affecting the quality of my life and if I wanted to she would refer me to a consultant. The gynaecologist I saw said she could perform an abdominal hysterectomy, but it was too large for her to do this laparoscopically. I discussed this with my brother, who is in the medical profession, and he asked me why she could not perform a laparoscopic hysterectomy as something like 90% of all the hysterectomies at his hospital are done laparoscopically regardless of the size of the fibroid, because if done successfully, there is much less blood loss during a laparoscopic hysterectomy and far shorter recovery times.
I did some research and came to the conclusion that with my fibroid being so large, only those gynaecologists with advanced laparoscopic training would be confident and skilled enough to attempt a laparoscopic hysterectomy as opposed to an open abdominal hysterectomy, so I wrote to the Royal College of Obstetricians & Gynaecologists and the British Society for Gynaecological Endoscopy and asked them if they may be able to advise me on who in my area may have advanced laparoscopic training and they both replied.
I discovered after some more research that I would have been able to find out the same information if I had studied private hospital’s websites, as private hospitals are trying to gain patients by selling the quality of their specialists to you and because of this they put a far more detailed mini curriculum vitae of each consultant on their websites, than the NHS does on their websites and usually each consultant at a private hospital is associated with a NHS hospital you could see the consultant at as well. Of course experience counts as well, as you want the consultant to have done a number of laparoscopic hysterectomies prior to your operation, rather than have someone who has just completed his or her training recently as it requires a higher degree of skill and complication to perform a laparoscopic hysterectomy than an open abdominal hysterectomy and as in every other profession we all get better at doing something with more experience.
I then proceeded to see a urogynaecologist at the advice of not only her, but two other gynaecologists, to see if anything could be done to relieve my incontinence without having surgery and he said “no”, except perhaps a hysterectomy and there was no guarantee that a hysterectomy would cure my incontinence either, but there was no way of telling unless I had one. I found this odd, given three gynaecologists had recommended me see a urogynaecologist thinking he could perform some tests to see if there may be another cause and thus cure for my condition, but I accepted his advice, as he is supposed to be one of the more experienced urogynacologists in the area.
The gynaecologists also suggested I have a consultation with a radiologist concerning uterine fibroid embolisation to shrink the fibroid, which is much less invasive than an operation, so I did and he said there was no way to know beforehand if and how much the procedure would shrink the fibroid. So I had one a year ago, hoping to avoid needing surgery, but the fibroid did not shrink very much from the procedure.
I feel the radiologist misinformed me on its feasibility as well, as in order to be effective, an embolisation must reduce/cut off the blood supply to the fibroid. So it’s effectiveness is also based on how much blood is being supplied to the fibroid in the first place. For someone with a relatively new fibroid with a lot of blood flowing through it an embolisation can be very effective in shrinking the fibroid, but for someone who has had a fibroid for a very long time and the fibroid has become calcified to a point where there is very little blood flowing through it any more, decreasing the blood supply to it does not have anywhere near the effect it would in the first scenario.
So finally after exhausting all my other possibilities I had a total laparoscopic hysterectomy and bilateral salphino-oophrectomy at the beginning of August. When I came too I was in quite a lot of pain for two days, but not enough pain to require any pain killers stronger than codeine tablets. I spent two days in hospital, even though they would have preferred if I had left after one day, and then went home. For the next five days I took pain killers in the morning and the evening and got plenty of rest. After that I stopped the pain killers, because I did not have any pain, except very occasional mild stabbing pains which went away quickly.
I began taking increasingly longer walks each day for exercise and after two weeks began doing my own shopping as well. Each week I got stronger and stronger and was able to do more things. The operation had turned out very well with no apparent complications. The only advice I would have to give regarding the recovery period is to remember to take it easy no matter how well you feel. I probably would have done better to take a few short walks during the day than one long walk every day. In addition, be careful what you lift. When I walked to the supermarket I only bought enough light food which would fit into my backpack, as not to pull any abdominal, pelvic or pubic muscles and the only time I got in any pain from this is when I got tempted by an apple pie which did not fit into my backpack four weeks after my operation and it took two days for the pain to go away.
Nine weeks after my laparoscopic hysterectomy everything feels fine and I no longer even feel uncomfortable when sitting for long periods of time. I perhaps would have been completely fine four weeks ago with sitting down for long periods of time, if I was not so over weight. As each time I sit down all the fat in my stomach area puts pressure on the operation site. So the last bit of advice I would give is if you are over weight and have a chance to lose a little weight before surgery I would strongly recommend doing so, but if you do not have a chance to do not fret as I am 3 stone over weight and managed to recover just fine in the long run. It just took a bit longer than it should have.