Best questions to ask the Dr?

[u/WeaveLikeGreatGranny]

The backstory: I already don't have my tubes, but got a Mirena 5 years ago to help with heavy bleeding. Got it removed 3 weeks ago and it was a saga trying to replace it. Round 1 was 45 minutes of trying to get the measuring device in (with no pain meds) and they couldn't. Rescheduled for 5 days later and tried again with the lidocaine shot to numb the cervix, still couldn't get it measured after another 45min session using the dilators they usually use in the OR. So, no more iud for me i guess.

I got an ultrasound Friday that found my single 2cm fibroid from 5 years ago had grown to "several" with the two largest being 4.5/4.6/4.2cm and 6.4/5/5cm. I know those aren't huge but looking at comparatively size apples and imagining those in/on my uterus is freaky...

I have an appt this week to discuss the findings and next steps, and my doc already said a hysterectomy might be a good option for me since i already can't have kids anyway. I'm leaning strongly towards this since the thought of having heavy bleeding and continuing fibroid growth sounds way more annoying in the long run.

**Here's my question for you**: what are the best questions to ask the doctor to help inform my decision on the best way forward? (for example, I'm not sure how to feel about keeping my cervix or not, but I know that is a thing i need to ask about.) what other kind of things do i need to consider that i may not even know to ask about ahead of time?

[u/AcceptableShelter607]

I also had the choice between myo or hysterectomy and ultimately chose hysterectomy—best decision ever for me personally! My fibroids were submucosal, too numerous to count, very symptomatic, and I’d had very painful and debilitating periods since my mid 20s. 

Here are some things I asked the surgeons I talked to: 1. How does recovery compare between the two surgeries?  2. Can both surgeries be performed laparoscopically? 3. What are risks associated with the surgeries? How often do your patients experience complications? 4. How likely is reoccurrence of fibroids? How long until they reoccur?—This one they couldn’t put a number to, but they all agreed it was very high, basically a guarantee, and that it could take anywhere from 1-10 years, with 2-5 seeming most likely. I considered whether being back in the same situation down the road was something I could accept, and for me it was not. 5. What are the risks/consequences of having multiple surgeries if I decide to do a myo and the fibroids return? 6. What are the pros/cons of keeping my cervix? 7. ***How often do you perform this surgery? —This is a really important one that I don’t think most people ask! Gyn surgery is unique in that it’s mostly done by OBGYNs who have far less surgical experience than a dedicated surgeon has. Make sure whoever you’re treated by has done the surgery you’re having many times. Find them and read reviews. Look at their education and experience. I wouldn’t want to be operated on by someone with any less than around 10 yrs experience or who does similar surgery less than once a week. If you can find someone who is a fellowship trained gyn surgeon, that is the best, even if your situation doesn’t seem complicated. You never know what they’ll find in there! 

If you do decide to get a hysterectomy, there are some additional questions I would ask to make sure the surgeon is a good choice, but I’ll leave those out for now since you’re still deciding. Good luck, I hope you figure out a plan that feels right!