Thread: vertical or horizontal: the rest of the story see post #

Hi ladies -

I have a giant fibroid in my uterus and will have surgery on Jan 7. I meet with my surgeon on Dec. 24 to discuss what she will do.

Here's my question, if it doesn't matter to my surgeon, should I be cut vertically or horizontally? Does one or the other involve cutting the muscles? I can hide the horizontal cut under my belt, but I am just so clueless as to what would be best in the long run.

Help this ignorant person out please with advice.

ezma

I have a 4 1/2" horizontal scar from 23 years ago. Many muscles were cut and I have had trouble feeling my lower ab muscles to this day. I believe my surgeon was sloppy and probably a better surgeon and 23 years of advances may improve things for today's surgeries. I also have a pouch that hangs over the incision that won't go away - luckily belts hide and contain it for me much better than the lycra skirt costumes.

Don't know if vertical would cut fewer muscles but it seems like it might?

Sorry to hear you have to go through this - will be thinking of you.

I had a friend who had a hysterectomy this past fall, she has one very SMALL scar just above the, um, hairline ;-) I believe its horizonal, but its not big at all. Depending on the conditions, I believe they can also do a hysterectomy from inside as well, and that leaves no scar at all.

well actually from what I've learned, a vertical line is somewhat 'outdated' and a horizontal line (or Pfannenstiel incision) is more commonly used, it leaves less scarring (usually a smaller scar) and heals quicker...

Sometimes the decision between horizontal or vertical incision depends as well on the location of the fibriod in the uterus...

I will try to look up some more information for you at work tomorrow...

I had 11 uterine fibroid tumors that I had to have surgery on in 2001(the largest the size of a large grapefruit/small cantaloupe:)), so I now sport a horizontal 6" scar [I guess it would be] around/above the pubic bone(?). And yes, they did cut through muscle w/definitely visible result although at the time I didn't realize the effect; Surida's post just gave me an "A-Ha" moment as to why I always have a bit of a pouch above the scar no matter how thin/fit/exercised I am! I am very interested in your thread, Ezma, and shall be watching/reading w/personal interest to see what gets posted and/or what your doctor has to say about this, since I know that I shall probably be having a hysterectomy soon (fibroid tumors coming back). I'm wondering if a newer, vertical inciscion would make any difference (besides me having an "X" marks the spot..l;,:)) in terms of muscle cutting. I can tell you that right after surgery I was in pain but I got right into physical therapy as soon as I could and martial arts (at the time), but ever since it's kind of numb/no feeling on the scar itself and it's very hard for me to "feel" when I do an ab roll or anything even though I can "see" it happening in the mirror... dunno if that makes sense. Anyhoo, I'm sure it had something to do with when my muscle was cut into...

I have had large fibroids too, but--in spite of my gyn's, shall we say, *encouragement*, I resisted a hysterectomy. They were not interfering with my life in a significant way (at least, not enough to justify surgery), so I opted for the "wait and see" approach. Now, about 3 years post-menopause, I just had my first pelvic exam in years in which my gyn didn't mention the "H" word or recommend an ultrasound. She could feel that they gotten smaller.

I mention this because, if you're near menopause and the fibroids are not causing you discomfort, you might want to just wait them out. They tend to shrink after menopause.

Originally Posted by Taj

I have had large fibroids too, but--in spite of my gyn's, shall we say, *encouragement*, I resisted a hysterectomy. They were not interfering with my life in a significant way (at least, not enough to justify surgery), so I opted for the "wait and see" approach. Now, about 3 years post-menopause, I just had my first pelvic exam in years in which my gyn didn't mention the "H" word or recommend an ultrasound. She could feel that they gotten smaller.

I mention this because, if you're near menopause and the fibroids are not causing you discomfort, you might want to just wait them out. They tend to shrink after menopause.

I am pre-menopausel, can hardly eat anything because I feel so full all the time. My mass is large and it is crowding out my organs.

good stuff here ladies. oh, I will take a picture this weekend of my beautiful perfect tummy so I can cherish it.

Originally Posted by EzmaSiddiqah

I am pre-menopausel, can hardly eat anything because I feel so full all the time. My mass is large and it is crowding out my organs.

good stuff here ladies. oh, I will take a picture this weekend of my beautiful perfect tummy so I can cherish it.

Sounds like you are making the right decision for you, then. My best wishes for a speedy recovery!

I had one done 10 years ago also due to cysts on my ovaries and large fibroid tumors. My incision was done vertically, and I didn't have any choice in the matter, but it never bothered me to have it done that way. After having twice a year ultrasounds for several years an surgery to keep removing the cysts that kept returning, I was told told to stop putting a hysterectomy off.

I had no pain afterwards,and was up and around the next day. I was just a little sore and took Tylenol for it.

Hi girls, have to run to rehearsal... but will be back.

(I'm also an histersister - had a subtotal histerectomy last March 20)

Later! Got to go! .w.:

Qamar

most ladies i know have had the horizontal "bikini cut" and have been fine with it. hope you feel better soon

I wouldn't "wait it out". I'd at least go for a laparoscopic peek to see if there's anything else going on in there.


Fionna

My incision was horizontal. To be subtle I had to be shaved, incision was in the that area. It's difficult to locate the scar and until I gained weight (due to steroids - another health issue), no overlap. It seems the lower incision made the impact less obvious the impact. My surgeon encouraged me to be involved in the decision-making process, she said it was empowering. I agree.

Are you going to undergo a hysterectomy, removal of the uterus, or a myomectomy, removal of the fibroids only?

Fibroids are benign growths of muscle and connective tissue that grow
until you reach menopause. Then they slowly and gradually shrink to a
negligible size, at which time they become small and calcified.
The average size of the uterus (including fibroids) in the late 30s to
early 40s is a 10-12 week pregnancy (about 13cm in the largest
dimension); in the middle 40’s, the average size of the uterus with
fibroids is the size of a 14-16 week pregnancy (about 17cm in the
largest dimension); and in the late 40s to early 50s, the average size of
the uterus with fibroids is the size of a 18-20 week pregnancy (about
21cm in the largest dimension).

Fibroids are not a disease, they are your genetic blueprint. A woman
never needs a hysterectomy for fibroids unless she has the wrong
doctor.

The only fibroids that cause bleeding are those that are submucosal, or
in the inside layer of the uterus—in the endometrium. Small fibroids
(under 4cm) that are causing heavy bleeding and large blood clots can
by shelled out in a procedure called a resection, using a hysteroscope.
Larger fibroids, if they cause symptoms you cannot live with until
menopause, can be removed with a myomectomy, which is still a
major operation, but the uterus remains intact. Hysterectomy, removal
of the uterus, causes many well documented, permanent, irreversible,
and life-altering problems which you can find listed at
Hysterectomy Alternatives and Aftereffects, hysterectomy consequences, support, HERS Foundation, hersfoundation.org.
Watch the free video "Female Anatomy: the Functions of the Female Organs", and learn about the lifelong functions of the female organs, and what changes take place in a woman's body when the organs are removed.

wow that's awesome info, I will learn…Less removed is better, but the surgeon will see what's inside. We will have a plan together~

Great site, Nora, thank you for posting it!

ETA: Gosh, I didn't realize it was your site, or that you were the author of "The H Word."

Hello Ezma,

It's been 10 month now since my surgery: two fibroid tumors the size of grapefruit were remove (they were outside the uterus) and my uterus which was covered by numerous smaller fibroids like grapes. I still have my ovaries.

The incision was horizontal, about 6 or 7 inches. I still have a little numness around the scar and sometime, at the end of the day, I feel some pain after dance class, training or simply after being in a sitting position for to long.

I usually rest for a while on the cough with my "Magic Bag". on my belly, I also take it with me to bed once in a while.

There is been some ups and downs during the healling time, which is normal: it is a major surgery. And in my case since the tumors were so big the post-pain I'm dealing with is caused by the adhesions (fibrous scar tissue): The tumors were "stiking" not only to my uterus but also on other organs and the abdominal wall.

But then, it is nothing compare to what I was dealing before for almost a year. Severe abdominal pain, bladder problem, constipation, back pain, fatique, etc.

I also found this website very informative and useful.

Hysterectomy Support Discussions, Before Hysterectomy, After Hysterectomy, Recovery - HysterSisters

Hang in there honey, I also will be thinking of you and sending you good vibes! Give us some news and do not hesitate to PM me if you want.

Qamar

My sister had surgery for her 8 fibroids last year. She was measuring at about an 8 month pregnancy size....One fibroid was so big, we actually named it (yes we're share a dark sense of humor). She had embolization done, and has had no real problems since. It stops the blood flow to the fibroids, thus causing them to shrink and eventually disappear. She had a bit of pain afterwards, but took care of it with Tylenol.

I hope you can avoid a hysterectomy, but I also understand the pain that can be caused by these buggers. Good luck!

I had a horizontal incision for my hysterectomy in Nov 2007 for a grapefruit sized fibroid with severe bleeding.

no complications. minimal scar (love BioOil for that.) kept my ovaries.

was back to dance & yoga at 6-8 weeks.

best decision ever.

I'm checking and reading all these posts like a psycho, thanks ~

Some important things to remember in making this decision.

The uterus has important functions all of your life. When the uterus is removed a woman has a 3X greater incidence of heart disease, and when the ovaries are removed it's 7X greater than an intact woman. Women are sexual into old age, but when the highly pleasurable contractions of the uterus that occur with orgasm no longer occur when the uterus is removed. During a hysterectomy the vagina is cut into at the top, around the circumference of the cervix, then the vagina is sutured shut at the top, shortened and made into a closed pocket.

If you watch the free video "Female Anatomy: the Functions of the Female Organs" you will have an understanding of how your pelvic structure, lower back and skeleton are affected by severing the broad band of ligaments, blood supply and nerve supply that attach to the uterus.

You can read what a thousand women reported about what they have experienced after hysterectomy in the Adverse Effects Data.

It's great that you're gathering the information you need to make this important decision. Hysterectomy can only be done, it cannot be undone.

I've had three abdominal surgeries:
Age 23: Oopherectomy, right side. Laprascopic (sp?) turned into a 3 inch incision to remove a badly cystic/necrotic ovary.

Age 32: Emergency C section, was fortunately a horizontal incision at the bikini line.

Age 36: Tubal ligation of left ovary and cautery of endometriosis.

So, now I'm 38 and in looking back I'm grateful my outcome has been good overall. I do have adhesions that affect my bowels (sorry, graphic) and occasionally I'll get sharp pains where the scarring is. I hardly regret my horizontal incision because my surgeon is awesome. It's a fine white line just above my bikini line and it's only 4" long: he pulled an almost full term baby through that so I imagine the scar you will have could be about the same as mine (or less, grin). It has taken a long time for control of my lower abs to come back and there is minimal numbness at my incision site.

I believe that there is a technique for hysterectomy that preserves the cervix so you're not left with a 'pocket.' Might be worth asking your doctor about it.

Good luck, make an informed decision, and you will heal more quickly if you take it slow and rest. Please stay in contact with us because major surgery is emotionally tough to handle and it can be depressing. If you have anyone that can come over and keep you company every day it would give you something to look forward to, and if she is really nice, maybe she'll give you a nice shoulder/arm/hand massage. Good luck!!!!

Hi Doozer, well you've really had a doozy of surgeries! Glad to hear your uterus was not removed, and that you're doing well.

It sounds like Ezma is taking her time to make a fully informed decision, which is an excellent approach.

With regard to "preserving" the cervix, there is a supracervical hysterectomy in which the body of the uterus is removed, and the cervical stump remains. Because the stump of the cervix is not removed the vagina is not shortened. However, all of the nerves and blood supply to the cervix is severed so that the body of the uterus can be removed, so no feeling remains in the cervical stump. Because the body of the uterus is removed, women who experience orgasm will no longer experience it without a uterus.

Because a hysterectomy is never needed for fibroids unless you have the wrong doctor, myomectomy (surgical removal of fibroids leaving the uterus intact) can be performed if fibroids are causing a medical problem, I encourage you to take your time in making this important decision. Hysterectomy can only be done, it can't be undone.

Originally Posted by Taj

Great site, Nora, thank you for posting it!

ETA: Gosh, I didn't realize it was your site, or that you were the author of "The H Word."

huh?? .w.: Thank you for bringing this up Taj... :policeblinker:

Norawcoffey, it’s kind of a “strange coincidence” that you have registered to this belly dance forum the next day following Ezma’s post!!!! I doubt that you are in anyway related to belly dance, and are probably using this thread to promote your website.

I’m not saying that this site is totally wrong, by I just dislike this opportunist way of doing it.,m:: It’s just that Bhuz is for people of the belly dance community.

And as for what you have mentioned in you last post: “Because the body of the uterus is removed, women who experience orgasm will no longer experience it without a uterus.” ,f:: Excuse me but that is total bull! Since the surgery, my sex life is better than it never was compare to the last year of pain, discomfort, and extreme fatigue that I was going through.

And assuming that women who add an hysterectomy had it because they had “the wrong doctor” is very condescending.

That’s just my 2 cents!

Ezma, your not an ingnorant person, and we Bhuzzers (the realones!) are sending you good vibes for you next appointement with you doc. Keep us posted.

Qamar

I did look at that site briefly, and what has come out of it is (pending doctor feedback), I will just have the fibroid(s) and cysts removed and will keep everything that I can. Will update this post after my surgeon appointment on the 24th. love to my bhuzzers!!!

Originally Posted by EzmaSiddiqah

I did look at that site briefly, and what has come out of it is (pending doctor feedback), I will just have the fibroid(s) and cysts removed and will keep everything that I can. Will update this post after my surgeon appointment on the 24th. love to my bhuzzers!!!

I had ultrasounds every six months, (for three years), and also kept having my ovarian cysts removed because I didn't want to have a hysterectomy. After the cysts were removed each time, they wasted no time in growing back, so my doctor finally said that it had to be done, so I did. I had no problems with the surgery, and no problems afterwards, and I'm glad that I had it done.

If your doctor recommends taking everything out, and you trust your doctor, I would recommend having it done so you won't have any more problems.

good to know gypsydanse, thank you and all the rest who posted here!

Hi Ezma - I've had two life saving surgeries for ectopic pregnancies over the years, and both were bikini cuts (told my doctor - next time, velcro!). Like some of the others who have posted here, I too had the little numb bulge above my scar for years and a pooch that would not go away. About five years a go I had lipo and my tummy is better than ever now, cosmetically speaking. All this was towards the end of my "other" dance career, but pre-belly dance. Nowadays I barely notice the scar or any sensation of numbness, which has improved/decreased tremendously as I've become more involved with BD. My scar is like a 4" horizontal dent at the pubic bone and is easily hidden by my bedlah. Bear in mind that these surgeries were done maybe 20 years ago, and I'm guessing that the techniques are much improved by now and far less invasive. Hope that helps you make the decision that's right for you. Best of luck to you.

I just did a google search for NoraWCoffey. She's registered here and is using Bhuz soley to promote her foundation and website. Hysterectomy Alternatives and Aftereffects, hysterectomy consequences, support, HERS Foundation, hersfoundation.org.

She has nothing to do with belly dance at all.

Honestly, so what? She's weighing in with an opinion based on experience and research. It's not as if she's plugging a product in multiple fora, then running away. I doubt we'll be seeing much of her--she just seems to want Ezma to taker her time and get all the info she can before making a huge decision. I really can't argue with that.