Hysto - before or during bottom surgery

[FTMax]

I've finally settled on getting bottom surgery in the future. My only question at the moment is if anyone knows of pros/cons associated with getting a full hysto (to include uterus, ovaries, and cervix) BEFORE surgery or AS PART OF the bottom surgery procedures.

I'm really interested in the medical and healing aspects if anyone knows. My insurance would potentially cover the hysto as a standalone procedure not associated with bottom surgery, which is about the only benefit I can come up with for having it done before. I'd much rather have one more intense recovery period than to need to go in for two separate procedures, but saving money would be nice.

[Bimmer Guy]

I've finally settled on getting bottom surgery in the future. My only question at the moment is if anyone knows of pros/cons associated with getting a full hysto (to include uterus, ovaries, and cervix) BEFORE surgery or AS PART OF the bottom surgery procedures.

I'm really interested in the medical and healing aspects if anyone knows. My insurance would potentially cover the hysto as a standalone procedure not associated with bottom surgery, which is about the only benefit I can come up with for having it done before. I'd much rather have one more intense recovery period than to need to go in for two separate procedures, but saving money would be nice.

This is something I have been wondering as well, as I just recently scheduled with Crane for bottom surgery, which includes hysto.  Since my bottom surgery is in 9 months, I am thinking he will tell me it is best to do it at the same time (plus, he probably would have mentioned it at the consult that I should do it separately).  If I knew I had a year between surgeries, I would probably seek to do it separately.  They say it is pretty rough going if you add the hysto to the bottom surgery (or at least the meta).  I am actually forming a list of questions by email today to send to his staff and I will include this one.   

[FTMax]

I am actually forming a list of questions by email today to send to his staff and I will include this one.

Thanks bud! Crane is my first choice if I get better health insurance options through work in the future (otherwise planning on Dr. Miro in Belgrade), so it would be nice to hear his take on it.

[jonjon]

Although i cant give you an exact answer to your question now, I can confirm that I will be having hysto done during my phalloplasty. My phalloplasty is being done in stages, with stage 2 being my next op (next week!!!) and my hysto is being done then as well as vaginectomy.

I will do my best after recovery to let you know if a hysto done at this stage is a plus or not!

[Bimmer Guy]

Thanks bud! Crane is my first choice if I get better health insurance options through work in the future (otherwise planning on Dr. Miro in Belgrade), so it would be nice to hear his take on it.

Hey, ftmax.  Sorry for the delay in follow up.  I heard from Crane's office and they actually scheduled me for a phone appointment with Crane due to all the questions I had! 

I will circle back to this after I talk with him in mid-July.  Even though it won't make a difference in my case (I will be getting it done at time of meta), it will be a good question for the community to know straight from a surgeon's mouth.

[kenton_07]

Personally, I had my hysto done prior to my phalloplasty. THANK GOODNESS! I could not imagine recovering from my phallo and having the same recovery that I had with my hysto at the SAME TIME. The hysto recovery wasn't terrible, but I my abdominal strength was hindered since I had it abdominally. I would've had a tougher time getting up and walking after surgery if I had them at the same time. This could be due to the fact that I did have my hysto done abdominally. However, I'm glad I did them separately. I was able to have my hysto done close to home so I was able to recovery comfortably. I can't speak for those who have them done at the same time, but I feel like having them done at separate times was a good decision.

My mom and my aunt who had hysterectomies done in their lives thought it would be best to split it up just based on their experiences and I listened to them. Insurance was another reason why I got the hysto done at home also although insurance covered my phallo.

[Bimmer Guy]

Personally, I had my hysto done prior to my phalloplasty. THANK GOODNESS! I could not imagine recovering from my phallo and having the same recovery that I had with my hysto at the SAME TIME. The hysto recovery wasn't terrible, but I my abdominal strength was hindered since I had it abdominally. I would've had a tougher time getting up and walking after surgery if I had them at the same time. This could be due to the fact that I did have my hysto done abdominally. However, I'm glad I did them separately. I was able to have my hysto done close to home so I was able to recovery comfortably. I can't speak for those who have them done at the same time, but I feel like having them done at separate times was a good decision.

My mom and my aunt who had hysterectomies done in their lives thought it would be best to split it up just based on their experiences and I listened to them. Insurance was another reason why I got the hysto done at home also although insurance covered my phallo.

From my research, there appears to be a big difference in healing time and pain if you have it abdominally versus laparoscopically or through the vagina (whatever that one is called).  Crane said I may have to do it abdominally since I have had other abdominal surgeries.  It is the GYN surgeon's decision, but with the two colon resections I have had there is scar tissue in there.  He/she may feel that they need to check it out, so I would then have to have it abdominally, rather than the other simple procedures mentioned above.  The other two have MUCH easier recoveries.  I also will run out of trans health insurance money if I do the hysto.

I originally did not care to have a hysto as my reproductive organs  don't bother me, but Crane said without a hysto, I can't get a vaginectomy.  Without a vaginectomy, there is an additional 10% chance of fistulas/strictures in my UL (so I would be at 20% chance of complications per Crane statistics).  Therefore, I told his office I wanted the hysto and vaginectomy.

Today I started leaning towards not having a hysterectomy.  Having a history of colon cancer, I am a bit concerned about getting cut back open.  Who knows what other cancer cells are still floating around there and if disturbing the organs will create future cancers?  If I can get around the dysphoria of not having a vaginectomy (I think I can), then I may skip it.  Have a lot of time to decide.  It is hard to make that decision though, if I don't know the type of hysto the surgeon will require.

Kenton, can I ask why you had the abdominal one?  Also, how much time was there between your hysto and your phallo?  Thanks so much for sharing your story.

[kenton_07]

I had abdominal because the OBGYN felt most comfortable doing that technique. I also had a scar from a urological surgery when I was a kid. I think due to that surgery and since there is a risk after hysto of prolapse (which has something to do with the bladder falling into the empty space where the prior organs were, not 100% sure though) she decided to do it abdominal. I also requested that she remove the upper third of the vagina per request of my phallo surgeon so that could also be a reason.

I had my hysto August 2014 and I was originally scheduled for phallo in January 2015 but waiting for insurance approval pushed it to May 2015. The reason I initially wanted January was because I would be on break from college. I'm not sure that there needs to be a big gap between those two surgeries.

Also, you mention your concern because of your colon cancer history. Leaving the ovaries/female organs inside may put you at a greater risk for ovarian cancer etc. I'm not a doctor but there seems to be a universal notion that you should get the organs removed within 10 years of being on testosterone because of that risk. However, I'm not sure that your previous history would affect that.

Honestly, recovery from hysto wasn't terrible. Hysto and pallo together, not so sure. It is just that the surgeon cuts through your abdomen which is the muscle that is used for laughing etc and you don't notice how involved that area of your body is until it is affected by something such as a surgery. Keep in mind if Crane plans on doing it abdominal, you have to deal with it at the same time as your other pain which could be beneficial but it could also cause more stress. I was very stressed during my recovery just from worrying about possible complications and that was without dealing with the hysto recovery. It also takes a huge toll on your body. After going through phallo, that procedure alone was taxing enough for my body. Each person handles and recovers the surgeries differently although I consider myself a tough bird.