hysterectomy anatomy

The Long Term Repercussions of an Unneeded Total Hysterectomy

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I have always preferred natural processes. I had four natural births using Lamaze technique. I breastfed. I was a registered nurse. I knew my ob-gyn doctors for years. I never expected my life to take a sharp and unnecessary turn for the worse, but it did, after I had, what was an essentially unneeded hysterectomy with oophorectomy.

A Total Hysterectomy for a Benign Ovarian Cyst

In 1990, I was 39 years old. I was physically active, I worked out daily. My blood pressure always in the 110/70 range. I scheduled my annual exam for mid March. My cycles were regular. I never had a suspicious pap smear. A couple years previously, however, I noticed some pain on ovulation. I asked the doctor if I might have endometriosis. She said she couldn’t find any evidence on exam.

My appointment was a shock. She found a mass near my right ovary. I was scheduled for an ultrasound. The ultrasound showed a 4cm mass.

I returned to the doctor with my husband. She said the mass was likely benign, but it should be removed. She asked if we planned any more children, we said no. She then recommended that I should have a total hysterectomy and my ovaries would also be removed (TAH-BSO). Her reason was that I might have future masses. She said I was in great shape, that I shouldn’t have any weight problems. She would do a Pfannenstiel incision (bikini cut) and it would fade to a small light scar. I was shocked, my mother was going through chemotherapy for cancer. What if I had another mass later that would be cancerous!

We scheduled surgery in two weeks. She gave us the ACOG hysterectomy brochure. I talked to a couple of friends that had the surgery. Not much to it, just rest a lot after surgery. They seemed fine, and hoped I would too. I called my doctor with a few questions, how will I feel after surgery and how might it effect sex. She said the Premarin would keep me feeling just as my natural estrogen has done.

Now the date was closing in, and my doubts were rising. I was busy with my four children, age 9 to 17. I read the ACOG brochure, it seemed too simple. The day before surgery, I asked my husband if we could go to the bookstore to see if we are missing something. He felt we had ample information from the doctor and friends, and yes, the ACOG brochure. We were both nervous. My husband didn’t want to lose me should I not have surgery. I was nervous about my future. My gut feeling was not to do it, but my brain told me that I don’t want a worse situation, if I don’t have the surgery. It haunts me to this day, I had that last chance to learn the truth and I did not take it.

A Total Abdominal Hysterectomy and Bilateral Salpingo Oophorectomy

The surgery was scheduled for April 5, 1990 at 1pm. I was terrified. My husband was so scared, he barely spoke to me. When I woke up in the recovery room, I felt a large dressing on my abdomen. I told the nurse “I just want to go home.” The doctor came in Saturday morning. She told me she found a lot of endometriosis. She detailed how much of it she cleared out. She said I would never have to deal with it again.

I went home Monday, I felt pretty good. I had a lot of abdominal swelling, nut that night I got up to go to the bathroom. It was then when I broke down and cried. Two weeks later, I took a good look at my abdomen and saw the horrible swelling over the incision. I showed it to my husband and he reminded me that it should take about six weeks to heal. He was very quiet and distant since the surgery.

I went to the doctor and she was startled when she saw my abdomen. She said it should be better in the coming months.

Learning the Truth

I was frustrated, I went to a bookstore to search what happened. I thought it was a hysterectomy issue. I found Hysterectomy: Before and After by Winnifred Cutler. As I glanced through the pages, it was a sharp contrast to the ACOG (sales) brochure. This was the information I needed BEFORE surgery! I began to tear up, I bought the book and went home. I could not understand why the doctor and ACOG would not inform women of these after effects. Now my abdomen problem was the least of my problems.

I asked my husband to read the book. He did but maintained the doctor gave us all the information we needed. I felt betrayed by everyone I had believed and trusted. No one had been honest with me. At that point, I was prescribed Prozac.

My post-op appointment was tense. I told the doctor that I had numbness in my right thigh, no response. I had insomnia, breast pain from the high dose of Premarin. There was no improvement with my abdomen. She told me “Just don’t look in the mirror”. By that time, my husband knew just how these doctors work. He had no doubt that the surgery was not necessary.

Hysterectomy Consequences

In March 1991, I went to another state and had a mini-abdominoplasty for scar revision. When the cosmetic surgeon saw the scar he said “That incision was closed unevenly!”.  The three cosmetic surgeons in my area never hinted that my gynecologist was at fault. So, after my surgery I submitted my records from him with before and after photos. Anthem reimbursed me for the abdominoplasty.

I felt better about my appearance, but the after effects of hysterectomy and ovary loss were beginning to pile up. I could not have the internal orgasms I had before. Still had insomnia, thigh numbness, and problems with Premarin. I wasn’t myself, I had anger and rage. I was tired, physically exhausted.

I was on Zoloft for a year and gained nearly 60 pounds. I finally ‘quit’ doctors. In 2001, I became a vegetarian. I lost most of my weight, but I still am 30 pounds over my ‘intact’ weight. I eventually could not wear contact lenses due to eye dryness. I still have episodes of rage and anger, panic attacks and on going depression. I have low libido, and few slight orgasms, along with bad back pain, knee pain, sciatica, and hip and joint pain.

I was 5’4 and now measure 5’2. I can only get one finger (normal is 2 to 3 fingers) between my ribs and pelvic bones due to post hysterectomy skeletal changes. In February 2017, I was diagnosed with bladder cancer. Fortunately, it was low grade and manageable. It bothers me to ‘need a doctor’.  There are studies linking hysterectomy and ovary removal to both bladder cancer and renal cell carcinoma.

Where I Am Now

I am now 67. I still grieve my organ loss and the negative impact on my life. I am trapped in a body that is not mine. I recently looked at a picture of me at one year old. I wondered if that little girl would have known her life and happiness would end in 38 years.

  • I could have gone to a bookstore to research the surgery the same day I scheduled it.
  • I would have had a second, third or fourth opinion.
  • I should have listened to my gut instinct.

Research, research and research. You can’t undo the damage! Don’t let the opinions of others cost you your well-being. You are the one that has to live with the consequences! They do not!

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Image by 412designs from Pixabay.

This story was published originally on May 16, 2018. 

Post Hysterectomy Skeletal and Anatomical Changes

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I wonder if so many women would “choose” hysterectomy if they knew how it would affect their figure and internal anatomy. I know I would have told my once respected gynecologist “no way” and left never to return if I’d known just a smidgen of what I now know. Here are some of the anatomical and skeletal changes that occur post hysterectomy.

Ligament and Skeletal Changes Post Hysterectomy

An intact woman’s figure has space between the rib cage and the hip bones commonly known as the waist. The waist gives her the curve in her lower back, the natural sway in her hips, her “elongated” torso that’s proportionate to her extremities. This all changes after hysterectomy.

Four sets of ligaments hold the uterus in place. These ligaments are the “scaffolding” or support structures for the core (midsection). When the ligaments are severed to remove the uterus, the spine compresses causing the rib cage to gradually fall toward the hip bones and the hip bones to widen. This causes a shortened, thickened midsection, protruding belly, and loss of the curve in the lower back, giving the appearance of a flat derriere. In some women, these changes cause those hated rolls of fat (weight gain or not). In others, it looks more like a pregnant belly. This can be particularly distressing for women whose hysterectomies denied them the chance to have (more) children.

As if an unattractive figure isn’t devastating enough, these skeletal changes lead to chronic back, hip, and rib cage pain as well as tingling and loss of sensation in legs and feet. It also explains why, even absent osteoporosis, hysterectomized women lose height. With all these changes to the skeletal structure, I wonder if hysterectomy can also cause spinal stenosis. It would certainly seem plausible.

Evidence of my spine compressing started 12 to 18 months post-op. A crease started forming about two inches above my navel. It gradually lengthened over the next 6 months to a year until it became visible all across my midsection. I’ve always been thin (underweight) with flat, toned abs and prominent hip bones. And contrary to what most women experience after hysterectomy, I lost weight. As my spine compressed, my flat abs became “fat” and flabby. My hip bones became less prominent in the front (as my belly pooched out) and more prominent in the back since my rib cage had fallen onto my hip bones. And I now have intermittent back, hip, and rib cage pain as well as tingling in feet. My sacrum / tailbone has also looked bruised since not long after my hysterectomy.

Internal Organs Post Hysterectomy

And how does the body change on the inside? Well for one, it affects the bladder and bowel. The uterus separates the bladder and bowel and holds them in their rightful positions. Removal of the uterus causes these organs to fall impeding function. When the bladder or bowel is full, there can be a feeling of discomfort or even outright pain (exactly what I’m feeling at this moment – constant pain that increases by just walking). Complete emptying can be problematic as can incontinence. Bowels may alternate between constipation and diarrhea. Adhesions can further hamper bowel function even to the point of a life threatening obstruction. I’ve had serious bowel problems ever since my surgery 7 years ago. Chances of bladder, bowel, and vaginal prolapse and fistula also increase leading to more loss of quality of life and future risky surgeries. Hysterectomy has even been shown to increase risk of renal cell (kidney) cancer likely caused by damage to ureters. I have to wonder if functions of other organs may also be affected as our organs don’t work in isolation and may be further affected by the anatomical changes.

Nerves and Sex Post Hysterectomy

And what about sensation after all those nerves and blood vessels are severed? What’s it like having a shortened vagina that’s not connected to anything? Well, it’s no wonder sex isn’t the same! How can it be? And if you enjoyed uterine orgasms, those are obviously a pleasure of the past. Even nipple sensation can be lost because nerve endings are found all along the spine. The severing of nerves as well as scar tissue formation can cause a problem worse than loss of sensation – nerve entrapment which can be quite painful.

I’m not sure which is worse – the hormonal adverse effects or the anatomical and skeletal adverse effects. There’s no doubt though that my body has been drastically altered since the unwarranted removal of my vital female organs.

The adverse effects to a woman’s figure, as well as the many other adverse effects of female organ removal, are detailed in the video “Female Anatomy: the Functions of the Female Organs.” Priceless!

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