BRIP1 Gene Mutation

I have just gone through bilateral breast cancer surgery and in the process had the gene mutation testing completed.  I discovered that I carry a BRIP1 gene mutation which research says puts me at a high risk for ovarian cancer.  I met with a surgeon who said the newest research is putting the BRIP1 gene mutation 3rd in order of gene mutations that carry the biggest risk.  The general consensus from my breast cancer surgeon, the new surgeon, and my oncologist is that I should do a prophylactic bilateral oopherectomy.  I am pre-menopausal and very worried about all of the research I have read about dementia, osteoporosis, and other worrying side effects of having your ovaries removed.  

I think I'm coming here to find out if anyone else tested positive for the BRIP1 gene mutation and also to help understand the side effects I will face.  I cannot have hormone replacement therapy because my breast cancer was estrogen receptor positive.  

Is worrying about the side effects ridiculous in the face of a gene mutation that increases my risk of ovarian cancer?  

Comments

  • LorettaMarshall
    LorettaMarshall Member Posts: 662 Member
    Trailrunner~Btr 2 B safe than sorry! Listen 2 your doctors :)

    Dear “Trailrunner”

    Not to downplay the serious surgery you’ve had because I know many women who have had Breast Cancer.  My own sister had one of her breasts removed, and thank God the cancer never returned.  So from that standpoint, I can understand you have been through a lot of emotional and physical suffering already.  And now, you find that you are indeed in a place where another cancer might just occur.  I know you pray, as we do when we read a letter like yours, that this surgery will be totally successful without evidence of metastasis in some other organ later on.  Your anxiety is understandable. 

    May I answer your last question FIRST?  In a word, take it from a Stage IV Ovarian Cancer patient, if I had my “druthers”, give me the possibilities of dementia and osteoporosis any day.  I would rather be “stooped over” with osteoporosis rather than too weak to stand up straight from a terminal cancer. 

    When I was 36, I had my uterus removed.  At that time I was having heavy periods and my gynecologist said, “You are through childbearing, and you could have a hysterectomy.  At that time he gave me a pamphlet explaining what a hysterectomy involved.  In the booklet was a list of questions, and one was just what you are worried about.  The question was:

    “Will it make me lose my mind?”—The answer:  “NOT UNLESS YOU WERE GOING TO ANYWAY!”

    There is only one regret that comes from hindsight and current research.  My gynecologist called me to express his sorrows when he learned that I had been diagnosed with Peritoneal Carcinomatosis and also Ovarian Cancer.  He told me that now it is believed that Ovarian cancer begins in the fallopian tubes, and that he is no longer “tying tubes”, he is removing them.  How I wish this had been general medical knowledge way back then.  My hysterectomy did NOT result in dementia nor osteoporosis.  I have some osteoporosis that did not come on till I was in my 70s.  By that time many women will have that even if they never had a hysterectomy.  Now to be totally honest, I had to include reference 3 from Mayo Clinic, but Ovarian cancer would be far less likely if your doctors remove everything.  You will NOT be less of a woman just because you’ve had some of your “female anatomy” removed—better some “missing parts” rather than no parts at all, I say! 

    So bottom line for you will be—risk suffering dementia and poor posture—or possibilities of being diagnosed with terminal Ovarian cancer sometime later in life.  For me the choice would be a “no-brainer”.  I would follow the advice of your doctors.  To me I would think that the hysterectomy would serve as a “preventative maintenance” surgery designed to greatly limit the potential possibility of a deadly diagnosis of Ovarian cancer later in life. 

    “Too soon old—too late smart—NOT really”

    Loretta (Peritoneal Carcinomatosis/Stage IV Ovarian Cancer) 

    __________________________________________________________ 

    1.      https://hub.jhu.edu/2017/10/23/ovarian-cancer-starts-in-fallopian-tubes/

    “What causes ovarian cancer? New study suggests the root may be found in the fallopian tubes

    Researcher says treatment for this deadly disease may have stalled in part because scientists 'have been studying the wrong tissue of origin'…

     Vanessa Wasta -  Published Oct 23, 2017

     The root of many ovarian tumors may be found in the fallopian tubes, a new study from Johns Hopkins suggests. The findings provide potential insights into the origin of ovarian cancer and suggest new ways for the prevention and intervention of this disease.

    Some scientists have suspected that the most common form of ovarian cancer may originate in the fallopian tubes, the thin fibrous tunnels that connect the ovaries to the uterus.

    The fifth-largest cause of cancer deaths in women, ovarian cancer is generally diagnosed too late in most patients, and fewer than 30 percent of women with the disease survive beyond 10 years…”

    ___________________________________________

    2.       https://www.mayoclinic.org/diseases-conditions/dementia/expert-answers/oophorectomy/faq-20058326

    Ovary removal (oophorectomy): A risk factor for dementia?

     If I have my ovaries removed before I'm 50, will I be more likely to have dementia when I get older?

    Answers from Jonathan Graff-Radford, M.D.

    You might, but more research is needed to know for sure. Ovary removal (oophorectomy), often done in conjunction with a hysterectomy, has a dramatic effect on your body before menopause. This abrupt loss of your ovaries is also called surgical menopause, because it triggers all the changes of menopause.

    Your ovaries produce most of your body's estrogen, a reproductive hormone that has many functions beyond regulating your menstrual cycle. Estrogen may protect your brain from age-related changes that can lead to cognitive impairment and dementia.

    Some studies have suggested that an early oophorectomy may increase your risk of Alzheimer's disease, other types of dementia or cognitive decline. Some research suggests that you may help offset this risk by taking hormone therapy (HT) until you reach a natural age of menopause.

    More research will be needed before doctors can know for sure whether an oophorectomy will increase your risk of dementia and whether HT is necessary.

    That's why it's important to talk with your doctor before deciding to have an oophorectomy.

    Ask your doctor:

    • What condition the surgery is treating
    • What other treatment options there are
    • Whether you're close to menopause
    • Whether you'll be a candidate for HT

     For some women, an oophorectomy is worth the long-term risks.

    If you carry one of the genetic mutations that make you likely to develop breast and ovarian cancers, for example, this surgery may save your life — even if you don't take HT.

    With

    Jonathan Graff-Radford, M.D.

    _________________________________________________________ 

    3.      https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/expert-answers/ovarian-cancer/faq-20057780

    Ovarian cancer: Still possible after hysterectomy?

     Is ovarian cancer still possible after a hysterectomy?

    Answers from Yvonne Butler Tobah, M.D.

    Yes, you still have a risk of ovarian cancer or a type of cancer that acts just like it (primary peritoneal cancer) if you've had a hysterectomy.

    Your risk depends on the type of hysterectomy you had:

    • Partial hysterectomy or total hysterectomy. A partial hysterectomy removes your uterus, and a total hysterectomy removes your uterus and your cervix. Both procedures leave your ovaries intact, so you can still develop ovarian cancer.

     

    • Total hysterectomy with salpingo-oophorectomy. This procedure removes your cervix and uterus as well as both ovaries and fallopian tubes. This makes ovarian cancer less likely to occur, but it does not remove all risk.

    You still have a small risk of what's called primary peritoneal cancer. The peritoneum is a covering that lines the abdominal organs, and is close to the ovaries. Since the peritoneum and ovaries arise from the same tissues during embryonic development, it's possible that cancer could result from the cells of the peritoneum.

    Currently, there are no effective screening tests for ovarian cancer in women with an average risk of the disease. If you're concerned about your risk, discuss your options with your doctor.

    With

    Yvonne Butler Tobah, M.D.”

    _____________________End of references__________________

  • Trailrunner
    Trailrunner Member Posts: 11

    Trailrunner~Btr 2 B safe than sorry! Listen 2 your doctors :)

    Dear “Trailrunner”

    Not to downplay the serious surgery you’ve had because I know many women who have had Breast Cancer.  My own sister had one of her breasts removed, and thank God the cancer never returned.  So from that standpoint, I can understand you have been through a lot of emotional and physical suffering already.  And now, you find that you are indeed in a place where another cancer might just occur.  I know you pray, as we do when we read a letter like yours, that this surgery will be totally successful without evidence of metastasis in some other organ later on.  Your anxiety is understandable. 

    May I answer your last question FIRST?  In a word, take it from a Stage IV Ovarian Cancer patient, if I had my “druthers”, give me the possibilities of dementia and osteoporosis any day.  I would rather be “stooped over” with osteoporosis rather than too weak to stand up straight from a terminal cancer. 

    When I was 36, I had my uterus removed.  At that time I was having heavy periods and my gynecologist said, “You are through childbearing, and you could have a hysterectomy.  At that time he gave me a pamphlet explaining what a hysterectomy involved.  In the booklet was a list of questions, and one was just what you are worried about.  The question was:

    “Will it make me lose my mind?”—The answer:  “NOT UNLESS YOU WERE GOING TO ANYWAY!”

    There is only one regret that comes from hindsight and current research.  My gynecologist called me to express his sorrows when he learned that I had been diagnosed with Peritoneal Carcinomatosis and also Ovarian Cancer.  He told me that now it is believed that Ovarian cancer begins in the fallopian tubes, and that he is no longer “tying tubes”, he is removing them.  How I wish this had been general medical knowledge way back then.  My hysterectomy did NOT result in dementia nor osteoporosis.  I have some osteoporosis that did not come on till I was in my 70s.  By that time many women will have that even if they never had a hysterectomy.  Now to be totally honest, I had to include reference 3 from Mayo Clinic, but Ovarian cancer would be far less likely if your doctors remove everything.  You will NOT be less of a woman just because you’ve had some of your “female anatomy” removed—better some “missing parts” rather than no parts at all, I say! 

    So bottom line for you will be—risk suffering dementia and poor posture—or possibilities of being diagnosed with terminal Ovarian cancer sometime later in life.  For me the choice would be a “no-brainer”.  I would follow the advice of your doctors.  To me I would think that the hysterectomy would serve as a “preventative maintenance” surgery designed to greatly limit the potential possibility of a deadly diagnosis of Ovarian cancer later in life. 

    “Too soon old—too late smart—NOT really”

    Loretta (Peritoneal Carcinomatosis/Stage IV Ovarian Cancer) 

    __________________________________________________________ 

    1.      https://hub.jhu.edu/2017/10/23/ovarian-cancer-starts-in-fallopian-tubes/

    “What causes ovarian cancer? New study suggests the root may be found in the fallopian tubes

    Researcher says treatment for this deadly disease may have stalled in part because scientists 'have been studying the wrong tissue of origin'…

     Vanessa Wasta -  Published Oct 23, 2017

     The root of many ovarian tumors may be found in the fallopian tubes, a new study from Johns Hopkins suggests. The findings provide potential insights into the origin of ovarian cancer and suggest new ways for the prevention and intervention of this disease.

    Some scientists have suspected that the most common form of ovarian cancer may originate in the fallopian tubes, the thin fibrous tunnels that connect the ovaries to the uterus.

    The fifth-largest cause of cancer deaths in women, ovarian cancer is generally diagnosed too late in most patients, and fewer than 30 percent of women with the disease survive beyond 10 years…”

    ___________________________________________

    2.       https://www.mayoclinic.org/diseases-conditions/dementia/expert-answers/oophorectomy/faq-20058326

    Ovary removal (oophorectomy): A risk factor for dementia?

     If I have my ovaries removed before I'm 50, will I be more likely to have dementia when I get older?

    Answers from Jonathan Graff-Radford, M.D.

    You might, but more research is needed to know for sure. Ovary removal (oophorectomy), often done in conjunction with a hysterectomy, has a dramatic effect on your body before menopause. This abrupt loss of your ovaries is also called surgical menopause, because it triggers all the changes of menopause.

    Your ovaries produce most of your body's estrogen, a reproductive hormone that has many functions beyond regulating your menstrual cycle. Estrogen may protect your brain from age-related changes that can lead to cognitive impairment and dementia.

    Some studies have suggested that an early oophorectomy may increase your risk of Alzheimer's disease, other types of dementia or cognitive decline. Some research suggests that you may help offset this risk by taking hormone therapy (HT) until you reach a natural age of menopause.

    More research will be needed before doctors can know for sure whether an oophorectomy will increase your risk of dementia and whether HT is necessary.

    That's why it's important to talk with your doctor before deciding to have an oophorectomy.

    Ask your doctor:

    • What condition the surgery is treating
    • What other treatment options there are
    • Whether you're close to menopause
    • Whether you'll be a candidate for HT

     For some women, an oophorectomy is worth the long-term risks.

    If you carry one of the genetic mutations that make you likely to develop breast and ovarian cancers, for example, this surgery may save your life — even if you don't take HT.

    With

    Jonathan Graff-Radford, M.D.

    _________________________________________________________ 

    3.      https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/expert-answers/ovarian-cancer/faq-20057780

    Ovarian cancer: Still possible after hysterectomy?

     Is ovarian cancer still possible after a hysterectomy?

    Answers from Yvonne Butler Tobah, M.D.

    Yes, you still have a risk of ovarian cancer or a type of cancer that acts just like it (primary peritoneal cancer) if you've had a hysterectomy.

    Your risk depends on the type of hysterectomy you had:

    • Partial hysterectomy or total hysterectomy. A partial hysterectomy removes your uterus, and a total hysterectomy removes your uterus and your cervix. Both procedures leave your ovaries intact, so you can still develop ovarian cancer.

     

    • Total hysterectomy with salpingo-oophorectomy. This procedure removes your cervix and uterus as well as both ovaries and fallopian tubes. This makes ovarian cancer less likely to occur, but it does not remove all risk.

    You still have a small risk of what's called primary peritoneal cancer. The peritoneum is a covering that lines the abdominal organs, and is close to the ovaries. Since the peritoneum and ovaries arise from the same tissues during embryonic development, it's possible that cancer could result from the cells of the peritoneum.

    Currently, there are no effective screening tests for ovarian cancer in women with an average risk of the disease. If you're concerned about your risk, discuss your options with your doctor.

    With

    Yvonne Butler Tobah, M.D.”

    _____________________End of references__________________

    Loretta, 

    Loretta, 

    It's taken me almost a month to write back, but your reply meant a lot to me.  In fact, as terrible as it sounds, your response is exactly what I  needed to hear.  Why am I so worried about the side effects of losing the hormone production when I am at increased risk of having ovarian cancer.  My surgery is scheduled for March 19th.  It's for the full monty, as I call it...salpingo oophorectomy and hysterectomy.  The hysterectomy is because my anti-estrogen medication increases my risk of uterine cancer.  

    I also greatly appreciate what you say that losing my female parts does not mean I am less of a woman.  As a friend said to me, I'll still have two X chromosomes.  That's probably too simplistic, but the point is made.  I'll still be a woman. 

    I am so sorry that you are battling Stage IV ovarian cancer.  If there is anything I can say or do, please tell me.  

    Thank you again for your words and advice.  

  • LorettaMarshall
    LorettaMarshall Member Posts: 662 Member
    Happy 2 know U R running down the right trail! :)

    Hello again Trailrunner ~ So good to hear from you.  You’re “on the right trail!” 

    First of all – you’ve already heard from me, but since you said you would appreciate hearing from anyone—I’m back.

     I’ve just tried to give you some additional helps.  Below my name is an NIH link to know how to pronounce all those “big medical words”.  Not too many ladies will ask, “Hi – how did your bilateral salpingo-oophorectomy go?”  MY WHAT?  SurprisedBut we all know the common lingo – fallopian tubes – ovaries – hysterectomy!  That was part of my Cytoreductive Surgery as well.  I’m glad you’ve made the wise decision to take precautions to help ward off any potential recurrence of cancer.  You’re a wise woman! I’m certain you have made the right choice.  Just clear your calendar for however long the doctors suggest, so that you can fully recuperate.  When I had my uterus removed at age 36, my mama said, “Now Loretta you had better take the time to recuperate.  I’ve seen women jump up and not take the time for the body to recuperate, and they were back in the hospital in a year.  A dear relative came to stay with me for 6 weeks and did most of the “heavy lifting.” I never had a problem. Moral of that story—“Listen to your mama and find someone to help you!”  Don't try to be a "superwoman!" as soon as you get home!Wink

    But back then there was only the "abdominal incision!  Moreover, patients could smoke in their rooms.  I was in a semi-private room and the lady next to me was a smoker!  It caused me to cough and that hurt something awful.  Glad that smoking in hospitals is no longer permissable.  And in one reference that I was reading, patients undergoing this surgery were to stop smoking at least 2 weeks prior to the surgery.  

    Below are a few references that may help you understand just what will be removed and how.  After you review these, you might want to talk to one of your nurses or your oncologist, and ask “Exactly what will the procedure involve, and what is the technical name?”

     As for me, just pray that my current chemo regimen of Carboplatin/Paclitaxel (Taxol) will prove to be somewhat positive, because I’ve decided I’m not running down anymore rabbit trails.  After all, Stage IV is Stage IV. 

     

    I’ve marked my calendar for March 19th so know that I will be praying for all things to go well for you on that date.

     

    Don’t be afraid!

     

    Love Loretta

    ________________________________________________________   

     

    1.      Here is an NIH (National Cancer Institute) dictionary that I find helpful to understand all the big medical terms the doctors throw at us as though we are totally familiar with everything that they are saying:

    https://www.cancer.gov/publications/dictionaries/cancer-terms/def/bilateral-salpingo-oophorectomy

    ________________________________________________________ 

    2.      https://www.medicinenet.com/laparoscopically_assisted_vaginal_hysterectomy/article.htm#what_is_a_laparoscope

    What is a hysterectomy?

    hysterectomy is the removal of the uterus (womb). For certain conditions, the Fallopian tubes and ovaries are also removed.

    The most common medical reasons for doing a hysterectomy include benign fibroid tumors of the uterus, abnormal uterine bleeding, endometriosis, genital prolapse, and chronic pelvic pain. Some women choose to have a hysterectomy for other reasons, including other types of tumors. Uterine cancer is an uncommon, but important reason for doing a hysterectomy.

    What is a laparoscope?

    A laparoscope is a viewing tube through which structures within the abdomen and pelvis can be seen. A small surgical incision (cut) is made in the abdominal wall to permit the laparoscope to enter the abdomen or pelvis. Additional tubes can also be pushed through the same or other small incisions allowing the introduction of probes and other instruments. In this way, surgical procedures can be performed without the need for a large surgical incision.

    What is laparoscopically assisted vaginal hysterectomy (LAVH)?

    Laparoscopically assisted vaginal hysterectomy (LAVH) is a surgical procedure using a laparoscope to guide the removal of the uterus and/or Fallopian tubes and ovaries through the vagina (birth canal). (A different procedure, called a laparoscopic hysterectomy, is entirely performed using a laparoscope and other instruments inserted through tiny abdominal incisions, and the uterus, Fallopian tubes etc. are removed in tiny portions.)

    Not all hysterectomies can or should be done by LAVH. In certain situations, a laparoscopic hysterectomy (see above) may be sufficient. In other cases, an abdominal hysterectomy or a vaginal hysterectomy (without laparoscopy) is indicated. The surgeon determines the appropriate procedure for each individual case based upon the reason for the hysterectomy and the medical history and condition of the patient.

    How is LAVH performed?

    During LAVH, several small incisions (cuts) are made in the abdominal wall through which slender metal tubes known as "trocars" are inserted to provide passage for a laparoscope and other microsurgical tools. The laparoscope acts as a tiny telescope. A camera attached to it provides a continuous image that is magnified and projected onto a television screen for viewing.

    In the course of LAVH, the uterus is detached from the ligaments that attach it to other structures in the pelvis using the laparoscopic tools. If the Fallopian tubes and ovaries are to be removed, they are also detached from their ligaments and blood supply. The organs and tissue are then removed through an incision made in the vagina.

    What are the disadvantages of LAVH?

    LAVH can be a longer operation and more expensive than a vaginal hysterectomy and, under certain circumstances, it can be more dangerous.

    What are the advantages of LAVH?

    The incisions in an LAVH are relatively small. The scarspain, and recovery time from LAVH are usually significantly less than with an abdominal hysterectomy, which requires both a vaginal incision and a 4-6 inch (10-15 cm) long incision in the abdomen). LAVH is similarly less physically traumatic than a routine vaginal hysterectomy. When LAVH is feasible, it has distinct advantages.  It can allow for a vaginal hysterectomy in patients who have not had children…”

    ________________________________________________ 

    3.      https://www.summitmedicalgroup.com/library/adult_health/obg_laparoscopy_assisted_vaginal_hysterectomy/

    “ UTERUS REMOVAL BY LAPAROSCOPICALLY ASSISTED VAGINAL HYSTERECTOMY

    View image - https://www.summitmedicalgroup.com/media/db/relayhealth-images/laparo_3.jpg

    View image - https://www.summitmedicalgroup.com/media/db/relayhealth-images/female_3.jpg

    WHAT IS A LAPAROSCOPICALLY ASSISTED VAGINAL HYSTERECTOMY (LAVH)?

    A vaginal hysterectomy is surgery to remove the uterus through the vagina. It is a way to take the uterus out through a cut in the vagina instead of a cut in your belly. The ovaries or fallopian tubes (other female organs) may also be removed when the uterus is removed.

    The uterus (womb) is the muscular organ at the top of the vagina. Babies grow in the uterus, and menstrual blood comes from the uterus. If you were having menstrual periods before the surgery, you will no longer have them after the operation. Without your uterus you will not be able to get pregnant.

    When a vaginal hysterectomy is assisted with laparoscopy, your healthcare provider uses a tool called a laparoscope to help with the removal. A laparoscope is a lighted tube with a camera that is placed through a small cut near your belly button. When laparoscopy is used, you will have only small cuts in your belly. This means you will probably have less pain after this operation than if your uterus was removed through a larger cut in your belly, and recovery is usually faster. Some healthcare providers may use a robot to help with this type of hysterectomy.

    This procedure does not leave a large visible scar. (You may have very small scars from the 2 or 3 tiny cuts in your belly that were used to place tools into your belly.)

    WHEN IS IT USED?

    There are many reasons why your healthcare provider may recommend surgery to remove your uterus. Some of the problems that may be treated with a hysterectomy are:

    • Abnormal vaginal bleeding that has not been controlled with other treatments
    • Noncancerous growths in the uterus called fibroids
    • Abnormal growth of uterine tissue outside the uterus (endometriosis)
    • A uterus that has dropped down into the vagina and is causing a problem
    • Precancerous or cancerous cells on the cervix (opening to the womb) or in the uterus
    • Pelvic pain that has not been controlled with other treatments

    Ask your healthcare provider about your choices for treatment and the risks.

    HOW DO I PREPARE FOR THIS PROCEDURE?

    1. Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
    2. Follow your provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
    3. You may or may not need to take your regular medicines the day of the procedure. Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Tell your healthcare provider about all medicines and supplements that you take. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
    4. Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
    5. Your healthcare provider may ask you to take an enema or medicine to clean out your bowel before the procedure.
    6. Follow any other instructions your healthcare provider gives you.
    7. Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

    WHAT HAPPENS DURING THE PROCEDURE?

    The procedure is usually done at the hospital.

    You will be given a regional or general anesthetic to keep you from feeling pain. A regional anesthetic numbs the lower part of your body while you stay awake. General anesthesia relaxes your muscles and you will be asleep.

    Your healthcare provider will make a small cut near your bellybutton. Your belly will be inflated with carbon dioxide gas. This helps your provider see your organs. Your healthcare provider will put a laparoscope through the cut. The scope is used to see the uterus and guide other tools through other small cuts in your belly. Your provider will make a cut in the vagina and remove the uterus through the vagina. The ovaries or fallopian tubes (other female organs) may also be removed. The laparoscope and other tools are then removed and the cuts in your belly are closed.

    If ligaments and other tissue around the vagina have stretched from aging or childbearing, your provider may also repair the walls of the vagina. The top of the vagina is then sewn closed.

    WHAT HAPPENS AFTER THE PROCEDURE?

    1.       You may sometimes go home the same day as your surgery, or you may stay in the hospital for 1 to 3 days.

    2.       You may need to go home with a catheter in your bladder until the bladder is working normally again. Your healthcare provider will decide when the catheter can be removed during a follow-up visit.

    3.       You may have some pain, nausea, or vomiting right after the procedure. Your healthcare provider may give you medicine to help these problems.

    4.       Sometimes the gas used to inflate your belly will cause pain in your right shoulder. It usually goes away after a day or two of bed rest.

    5.       Eating fruits and vegetables and drinking extra fluids may help you avoid constipation. Constipation is common after surgery because of some medicines and inactivity. If diet and extra fluids are not enough to avoid constipation, your provider may recommend a stool softener or a laxative. Check with your healthcare provider if constipation keeps being a problem.

    6.       If your ovaries are removed, menopause will start right away if you haven’t already had menopause. Your healthcare provider may prescribe medicine, such as hormone therapy, to help relieve some of the symptoms of menopause. Be sure to discuss any concerns you have about these effects and treatments with your provider before the surgery.

    Ask your healthcare provider:

    1. How long it will take to recover
    2. What activities you should avoid, including how much weight you can lift, and when you can return to your normal activities
    3. How to take care of yourself at home
    4. What symptoms or problems you should watch for and what to do if you have them

    Make sure you know when you should come back for a checkup.

    WHAT ARE THE RISKS OF THIS PROCEDURE?

    Your healthcare provider will explain the procedure and any risks. Some possible risks include:

    • Anesthesia has some risks. Discuss these risks with your healthcare provider.
    • You may have infection, bleeding, or blood clots.
    • Your bladder, rectum, or the tubes leading from your kidneys to your bladder (ureters) might be injured and need surgical repair.
    • You may get a hernia, which is a weakness in the tissue in the top of the vagina that could bulge into the vagina long after the surgery.

    There is risk with every treatment or procedure. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.

    Developed by RelayHealth.
    Published by RelayHealth.
    Copyright ©2014 McKesson Corporation and/or one of its subsidiaries. All rights reserved…”

    ________________________________________________ 

    4.      https://www.youtube.com/watch?v=ZZnbQYggvyQ

    DR RK Mishra - Published on Apr 28, 2012

    This video demonstrate Vaginal Part of Laparoscopic Assisted Vaginal Hysterectomy. For more educational laparoscopic video visit World Laparoscopy Hospital.

     There are three major approaches to remove the uterus: through the abdomen (abdominal hysterectomy -- AH), through the vagina (vaginal hysterectomy -- VH), or through the vagina with the aid of a laparoscope (laparoscopic assisted vaginal hysterectomy -- LAVH). The majority of physicians perform the abdominal hysterectomy through a large transverse or vertical incision, despite the fact that the vaginal hysterectomy has fewer complications and has a shorter overall recovery period due to the lack of a large incision. For more information log on to: http://www.laparoscopyhospital.com

    Notice

    Age-restricted video (based on Community Guidelines)

    ___________________________________________________ 

     5.      http://wcs-stl.com/laparoscopic-assisted-vaginal-hysterectomy/

     “…LAVH combines laparoscopy and hysterectomy. Laparoscopy is used to look into the abdomen at the reproductive organs. Hysterectomy is surgery to remove the uterus.

    LAVH involves the use of a small, telescope-like device called a laparoscope. The laparoscope is inserted into the abdomen through a small cut. It brings light into the abdomen so that your medical provider can see inside. Tiny instruments are also inserted to perform the procedure. Ligaments that support the uterus are cut with these instruments, and the uterus is removed vaginally.

    The benefits of LAVH include a short post-operative recovery time, which can be as little as a few hours after the surgery, to a day or two depending on your condition. Also, many patients can return to work and normal activities within 1 to 2 weeks. Most patients appreciate that LAVH has better cosmetic results, with only tiny scars…”

    _______________________________________________________________ 

    6.      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2673000/

    “Total Laparoscopic Hysterectomy: 10 Steps Toward a Successful Procedure

    Jon I Einarsson, MD, MPH and Yoko Suzuki, MD Author information ► Copyright and License information ►

     

    Abstract - Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies. In this review, the authors outline the 10 steps to a successful laparoscopic hysterectomy.

    Key words: Total laparoscopic hysterectomy, Laparoscopic supracervical hysterectomy, Minimally invasive gynecological procedure

    Hysterectomy is one of the most commonly performed surgical procedures in the United States, with 570,000 cases performed in 2006.1 Vaginal hysterectomies have been performed successfully for almost 2 centuries, and more recently Reich and colleagues2 introduced the laparoscopic hysterectomy. However, despite the advent of these minimally invasive procedures, abdominal hysterectomy remains the most common surgical approach, with well over half of hysterectomies being performed via a laparotomy.3

    Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies.46 In light of these findings, a recent review concluded that vaginal hysterectomy is preferable to abdominal hysterectomy and that a laparoscopic hysterectomy should be attempted when vaginal hysterectomy is not possible.6 The vaginal approach is less expensive, but may be challenging in patients with a history of an adnexal mass, endometriosis, pelvic pain, and prior abdominal surgery, or in patients with a narrow pubic arch or poor vaginal descent…”

    __________________________________________________ 

    7.      http://www.med.umich.edu/1libr/Gyn/BSO.pdf

    [my note:  This is a PDF file telling you what will be done for a Laparoscopic Bilateral Salpingo-Oophorectomy, but it has detailed information on preparation for this surgery which is basic info that you may find helpful.]

    ___________________________________________________ 

    8.      https://www.ncbi.nlm.nih.gov/pubmed/17329946

    “[A comparative analysis of hysterectomies]…Abstract The objective of this study was to evaluate and compare operative and postoperative results and differences among laparoscopic, vaginal, and abdominal hysterectomies performed at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital…

    CONCLUSIONS:

    Abdominal hysterectomy was the most common procedure performed.

    The type of hysterectomy influenced the rate of complications--the lowest complication rate was after laparoscopic and vaginal hysterectomies. The amount of blood loss depended on the type of hysterectomy--the lowest was during laparoscopic hysterectomy.

    Abdominal hysterectomy required on average a longer hospital stay compared with laparoscopic and vaginal hysterectomies.”

    __________________________________End of references______________________

     

  • Wifers
    Wifers Member Posts: 3
    Confused About BRIP 1

    I tested positive for BRIP 1 gene mutation.  My doctor and OBGYN at home indicated that it would be best for me to consider a hysterectomy.  I met with a hospital that has a clinic for paople that are at high risk of Ovarian cancer and they told me that I should wait until I am 45.  A mass was also found on my breast and after the biospy the results were benign.  I am afraid that if I wait for a few more years that it could be something that would be in a stage 4. 

    I have many of the symptoms of ovarian and breast cancer, and I am just confused and scared. 

  • LorettaMarshall
    LorettaMarshall Member Posts: 662 Member
    Wifers~Confusion warranted-References that may B helpful

    Dear “Wifers”

    Your confusion re BRIP 1 is understood.  The most I can do is to find some articles that explain more thoroughly what you are facing.  Based on what I read, you are at “higher risk” of developing Ovarian cancer or Breast cancer.  I also see that it is something that can be inherited, and that both men and women can carry this gene.  Since I don’t know your age or if you are married with children I would think that would also have to be figured into the equation.  Since Ovarian doesn’t wait till one is 45 to appear in their body, I’m not sure why that age factor was given to you.  It might be because of the stats found here:  https://www.cancercenter.com/cancer-types/breast-cancer/risk-factors “...Aging: On average, women over 60 are more likely to be diagnosed with breast cancer. Only about 10 percent to 15 percent of breast cancers occur in women younger than 45. However, this may vary for different races or ethnicities…”

    One thing I do know is that now it is believed that Ovarian cancer begins in the fallopian tubes.  For that reason, my gynecologist says he no longer ties one’s tubes, he takes them OUT.  Wish I had known this at age 36 when I only had my uterus removed.  With “period” problems and not planning on having more children, I decided to have a hysterectomy.  But that was over 40 years ago now.  I will soon be 80 years old.  However, I was diagnosed with a Stage IV cancer the first time I went to my local ER.   The possibility of a hernia was “my diagnosis.”  Well not quite—unless you spell hernia as “Peritoneal Carcinomatosis”.  I had no prior pains along the road to make me think I had anything wrong with my female organs.  But I am one to attempt to lift anything I think needs to be “moved.”  Well, if my husband is around, I always ask him, but in a pinch, I just “do it myself.”  So I’m glad I went to have my supposed hernia checked out.

    So while it is still possible to have Ovarian cancer though one has already had their ovaries removed, had I known then, what I know now, I would have had it everything removed.  Hot flashes were minor!  https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/expert-answers/ovarian-cancer/faq-20057780

    I’m just sharing my experience.  I have no idea what BRIP 1 is all about, so I’m not qualified to state anything categorically.  I just thought that I would share some references with you that might help to clear up some of your confusion.   It does make it more difficult to make a decision when one doctor tells you one thing, and yet another group says something different.  I would say, “Let your “gut” be your guide.  Research this gene mutation as best you can—then make a decision instead of being in a constant stage of limbo.  Seems there are plenty of laparoscopic hysterectomies being performed today, and I would opt for that procedure quite naturally.   But seems your choices are “surgery” or “gamble on not having either Ovarian or Breast cancer.

    Wish I could help you more, but “BRIP 1” is definitely “above my pay grade.”  I’m only comfortable sharing my personal experience on what has taken place in my life relative to Stage IV Ovarian Cancer.  For everything else I try to find references that might be helpful.

    Loretta (Peritoneal Carcinomatosis/Ovarian Cancer Stage IV, DX November 2012)

    ____________________________________________________________ 

    1.       https://mysupport360.com/associations/genes/brip1-gene-mutations/

    “BRIP1 Gene Mutations…

    SURVIVOR SNAPSHOT

    Take this hereditary cancer survivor snapshot to learn if your cancer diagnosis might have been related to an inherited gene mutation…


    View All Associated Genes
                BRCA1 and BRCA2 Gene Mutations

    BRIP1 ASSOCIATED CANCER RISKS

    BRIP1 gene

    Associated Syndrome Name: BRIP1-associated Cancer Risk (Women only)

    BRIP1 Summary Cancer Risk Table

    Cancer

    Genetic Cancer Risk

    Ovarian

    High Risk

    BRIP1 gene Overview

    BRIP1-associated Cancer Risk (Women only) 1, 2, 3, 4

    • Women with BRIP1 mutations are believed to have a significantly increased risk for ovarian cancer.
    • At this time, there are no known cancer risks for men due to mutations in BRIP1.
    • Some studies have found that women with BRIP1 mutations have an increased risk for breast cancer. However, there are other studies showing no increase in risk. The data are not conclusive at this time and there are currently no medical management recommendations that address this possible risk.
    • Although there are high cancer risks for patients with mutations in BRIP1, there are interventions that may be effective at reducing these risks. Guidelines from the National Comprehensive Cancer Network (NCCN) that may apply are listed below. Since information about the cancer risks associated with BRIP1 mutations is relatively new, and there is still some uncertainty about the best ways to reduce these risks, it may be appropriate to interpret these results in consultation with cancer genetics experts in this emerging area of knowledge.

    …The overview of medical management options provided is a summary of professional society guidelines as of the last Myriad update shown on this page. The specific reference provided (e.g., NCCN guidelines) should be consulted for more details and up-to-date information before developing a treatment plan for a particular patient. This overview is provided for informational purposes only and does not constitute a recommendation. While the medical society guidelines summarized herein provide important and useful information, medical management decisions for any particular patient should be made in consultation between that patient and his or her healthcare provider and may differ from society guidelines based on a complete understanding of the patient’s personal medical history, surgeries and other treatments…

    BRIP1 gene Cancer Risk Table

    Cancer Type

    Age Range

    Cancer Risk

    Risk for General Population 5

    Ovarian

    To age 801, 3

    5.8%

    1.0%...”

    Information for Family Members

    The following information for Family Members will appear as part of the MMT for a patient found to have a mutation in the BRIP1 gene.

    A major potential benefit of my Risk genetic testing for hereditary cancer risk is the opportunity to prevent cancer in relatives of patients in whom clinically significant mutations are identified. Healthcare providers have an important role in making sure that patients with clinically significant mutations are informed about the risks to relatives, and ways in which genetic testing can guide lifesaving interventions.

    In rare instances, an individual may inherit mutations in both copies of the BRIP1 gene, leading to the condition Fanconi Anemia, Complementation Group J (FANCJ). This condition is rare and includes physical abnormalities, growth retardation, progressive bone marrow failure and a high risk for cancer. The children of this patient are at risk of inheriting FANCJ only if the other parent is also a carrier of a BRIP1 mutation. It may be appropriate to screen the spouse/partner of this patient for BRIP1 mutations.7

    At this time, there are no known cancer risks for men due to mutations in BRIP1…”

    _______________________________________________________ 

    2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2561321/

    “A novel breast cancer-associated BRIP1 (FANCJ/BACH1) germ line mutation impairs protein stability and function…”

    __________________________________ 

    3.      https://www.ambrygen.com/sites/default/files/web/understanding_your_results/cancer/brip1_uyr_positive.pdf

    “Understanding Your Positive BRIP1 Genetic Test Result information for patients with a pathogenic mutation or variant, likely pathogenic…”

    _____________________End of references___________________

     

         
           
           
                 

     

  • Wifers
    Wifers Member Posts: 3

    Happy 2 know U R running down the right trail! :)

    Hello again Trailrunner ~ So good to hear from you.  You’re “on the right trail!” 

    First of all – you’ve already heard from me, but since you said you would appreciate hearing from anyone—I’m back.

     I’ve just tried to give you some additional helps.  Below my name is an NIH link to know how to pronounce all those “big medical words”.  Not too many ladies will ask, “Hi – how did your bilateral salpingo-oophorectomy go?”  MY WHAT?  SurprisedBut we all know the common lingo – fallopian tubes – ovaries – hysterectomy!  That was part of my Cytoreductive Surgery as well.  I’m glad you’ve made the wise decision to take precautions to help ward off any potential recurrence of cancer.  You’re a wise woman! I’m certain you have made the right choice.  Just clear your calendar for however long the doctors suggest, so that you can fully recuperate.  When I had my uterus removed at age 36, my mama said, “Now Loretta you had better take the time to recuperate.  I’ve seen women jump up and not take the time for the body to recuperate, and they were back in the hospital in a year.  A dear relative came to stay with me for 6 weeks and did most of the “heavy lifting.” I never had a problem. Moral of that story—“Listen to your mama and find someone to help you!”  Don't try to be a "superwoman!" as soon as you get home!Wink

    But back then there was only the "abdominal incision!  Moreover, patients could smoke in their rooms.  I was in a semi-private room and the lady next to me was a smoker!  It caused me to cough and that hurt something awful.  Glad that smoking in hospitals is no longer permissable.  And in one reference that I was reading, patients undergoing this surgery were to stop smoking at least 2 weeks prior to the surgery.  

    Below are a few references that may help you understand just what will be removed and how.  After you review these, you might want to talk to one of your nurses or your oncologist, and ask “Exactly what will the procedure involve, and what is the technical name?”

     As for me, just pray that my current chemo regimen of Carboplatin/Paclitaxel (Taxol) will prove to be somewhat positive, because I’ve decided I’m not running down anymore rabbit trails.  After all, Stage IV is Stage IV. 

     

    I’ve marked my calendar for March 19th so know that I will be praying for all things to go well for you on that date.

     

    Don’t be afraid!

     

    Love Loretta

    ________________________________________________________   

     

    1.      Here is an NIH (National Cancer Institute) dictionary that I find helpful to understand all the big medical terms the doctors throw at us as though we are totally familiar with everything that they are saying:

    https://www.cancer.gov/publications/dictionaries/cancer-terms/def/bilateral-salpingo-oophorectomy

    ________________________________________________________ 

    2.      https://www.medicinenet.com/laparoscopically_assisted_vaginal_hysterectomy/article.htm#what_is_a_laparoscope

    What is a hysterectomy?

    hysterectomy is the removal of the uterus (womb). For certain conditions, the Fallopian tubes and ovaries are also removed.

    The most common medical reasons for doing a hysterectomy include benign fibroid tumors of the uterus, abnormal uterine bleeding, endometriosis, genital prolapse, and chronic pelvic pain. Some women choose to have a hysterectomy for other reasons, including other types of tumors. Uterine cancer is an uncommon, but important reason for doing a hysterectomy.

    What is a laparoscope?

    A laparoscope is a viewing tube through which structures within the abdomen and pelvis can be seen. A small surgical incision (cut) is made in the abdominal wall to permit the laparoscope to enter the abdomen or pelvis. Additional tubes can also be pushed through the same or other small incisions allowing the introduction of probes and other instruments. In this way, surgical procedures can be performed without the need for a large surgical incision.

    What is laparoscopically assisted vaginal hysterectomy (LAVH)?

    Laparoscopically assisted vaginal hysterectomy (LAVH) is a surgical procedure using a laparoscope to guide the removal of the uterus and/or Fallopian tubes and ovaries through the vagina (birth canal). (A different procedure, called a laparoscopic hysterectomy, is entirely performed using a laparoscope and other instruments inserted through tiny abdominal incisions, and the uterus, Fallopian tubes etc. are removed in tiny portions.)

    Not all hysterectomies can or should be done by LAVH. In certain situations, a laparoscopic hysterectomy (see above) may be sufficient. In other cases, an abdominal hysterectomy or a vaginal hysterectomy (without laparoscopy) is indicated. The surgeon determines the appropriate procedure for each individual case based upon the reason for the hysterectomy and the medical history and condition of the patient.

    How is LAVH performed?

    During LAVH, several small incisions (cuts) are made in the abdominal wall through which slender metal tubes known as "trocars" are inserted to provide passage for a laparoscope and other microsurgical tools. The laparoscope acts as a tiny telescope. A camera attached to it provides a continuous image that is magnified and projected onto a television screen for viewing.

    In the course of LAVH, the uterus is detached from the ligaments that attach it to other structures in the pelvis using the laparoscopic tools. If the Fallopian tubes and ovaries are to be removed, they are also detached from their ligaments and blood supply. The organs and tissue are then removed through an incision made in the vagina.

    What are the disadvantages of LAVH?

    LAVH can be a longer operation and more expensive than a vaginal hysterectomy and, under certain circumstances, it can be more dangerous.

    What are the advantages of LAVH?

    The incisions in an LAVH are relatively small. The scarspain, and recovery time from LAVH are usually significantly less than with an abdominal hysterectomy, which requires both a vaginal incision and a 4-6 inch (10-15 cm) long incision in the abdomen). LAVH is similarly less physically traumatic than a routine vaginal hysterectomy. When LAVH is feasible, it has distinct advantages.  It can allow for a vaginal hysterectomy in patients who have not had children…”

    ________________________________________________ 

    3.      https://www.summitmedicalgroup.com/library/adult_health/obg_laparoscopy_assisted_vaginal_hysterectomy/

    “ UTERUS REMOVAL BY LAPAROSCOPICALLY ASSISTED VAGINAL HYSTERECTOMY

    View image - https://www.summitmedicalgroup.com/media/db/relayhealth-images/laparo_3.jpg

    View image - https://www.summitmedicalgroup.com/media/db/relayhealth-images/female_3.jpg

    WHAT IS A LAPAROSCOPICALLY ASSISTED VAGINAL HYSTERECTOMY (LAVH)?

    A vaginal hysterectomy is surgery to remove the uterus through the vagina. It is a way to take the uterus out through a cut in the vagina instead of a cut in your belly. The ovaries or fallopian tubes (other female organs) may also be removed when the uterus is removed.

    The uterus (womb) is the muscular organ at the top of the vagina. Babies grow in the uterus, and menstrual blood comes from the uterus. If you were having menstrual periods before the surgery, you will no longer have them after the operation. Without your uterus you will not be able to get pregnant.

    When a vaginal hysterectomy is assisted with laparoscopy, your healthcare provider uses a tool called a laparoscope to help with the removal. A laparoscope is a lighted tube with a camera that is placed through a small cut near your belly button. When laparoscopy is used, you will have only small cuts in your belly. This means you will probably have less pain after this operation than if your uterus was removed through a larger cut in your belly, and recovery is usually faster. Some healthcare providers may use a robot to help with this type of hysterectomy.

    This procedure does not leave a large visible scar. (You may have very small scars from the 2 or 3 tiny cuts in your belly that were used to place tools into your belly.)

    WHEN IS IT USED?

    There are many reasons why your healthcare provider may recommend surgery to remove your uterus. Some of the problems that may be treated with a hysterectomy are:

    • Abnormal vaginal bleeding that has not been controlled with other treatments
    • Noncancerous growths in the uterus called fibroids
    • Abnormal growth of uterine tissue outside the uterus (endometriosis)
    • A uterus that has dropped down into the vagina and is causing a problem
    • Precancerous or cancerous cells on the cervix (opening to the womb) or in the uterus
    • Pelvic pain that has not been controlled with other treatments

    Ask your healthcare provider about your choices for treatment and the risks.

    HOW DO I PREPARE FOR THIS PROCEDURE?

    1. Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
    2. Follow your provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
    3. You may or may not need to take your regular medicines the day of the procedure. Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Tell your healthcare provider about all medicines and supplements that you take. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
    4. Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
    5. Your healthcare provider may ask you to take an enema or medicine to clean out your bowel before the procedure.
    6. Follow any other instructions your healthcare provider gives you.
    7. Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

    WHAT HAPPENS DURING THE PROCEDURE?

    The procedure is usually done at the hospital.

    You will be given a regional or general anesthetic to keep you from feeling pain. A regional anesthetic numbs the lower part of your body while you stay awake. General anesthesia relaxes your muscles and you will be asleep.

    Your healthcare provider will make a small cut near your bellybutton. Your belly will be inflated with carbon dioxide gas. This helps your provider see your organs. Your healthcare provider will put a laparoscope through the cut. The scope is used to see the uterus and guide other tools through other small cuts in your belly. Your provider will make a cut in the vagina and remove the uterus through the vagina. The ovaries or fallopian tubes (other female organs) may also be removed. The laparoscope and other tools are then removed and the cuts in your belly are closed.

    If ligaments and other tissue around the vagina have stretched from aging or childbearing, your provider may also repair the walls of the vagina. The top of the vagina is then sewn closed.

    WHAT HAPPENS AFTER THE PROCEDURE?

    1.       You may sometimes go home the same day as your surgery, or you may stay in the hospital for 1 to 3 days.

    2.       You may need to go home with a catheter in your bladder until the bladder is working normally again. Your healthcare provider will decide when the catheter can be removed during a follow-up visit.

    3.       You may have some pain, nausea, or vomiting right after the procedure. Your healthcare provider may give you medicine to help these problems.

    4.       Sometimes the gas used to inflate your belly will cause pain in your right shoulder. It usually goes away after a day or two of bed rest.

    5.       Eating fruits and vegetables and drinking extra fluids may help you avoid constipation. Constipation is common after surgery because of some medicines and inactivity. If diet and extra fluids are not enough to avoid constipation, your provider may recommend a stool softener or a laxative. Check with your healthcare provider if constipation keeps being a problem.

    6.       If your ovaries are removed, menopause will start right away if you haven’t already had menopause. Your healthcare provider may prescribe medicine, such as hormone therapy, to help relieve some of the symptoms of menopause. Be sure to discuss any concerns you have about these effects and treatments with your provider before the surgery.

    Ask your healthcare provider:

    1. How long it will take to recover
    2. What activities you should avoid, including how much weight you can lift, and when you can return to your normal activities
    3. How to take care of yourself at home
    4. What symptoms or problems you should watch for and what to do if you have them

    Make sure you know when you should come back for a checkup.

    WHAT ARE THE RISKS OF THIS PROCEDURE?

    Your healthcare provider will explain the procedure and any risks. Some possible risks include:

    • Anesthesia has some risks. Discuss these risks with your healthcare provider.
    • You may have infection, bleeding, or blood clots.
    • Your bladder, rectum, or the tubes leading from your kidneys to your bladder (ureters) might be injured and need surgical repair.
    • You may get a hernia, which is a weakness in the tissue in the top of the vagina that could bulge into the vagina long after the surgery.

    There is risk with every treatment or procedure. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.

    Developed by RelayHealth.
    Published by RelayHealth.
    Copyright ©2014 McKesson Corporation and/or one of its subsidiaries. All rights reserved…”

    ________________________________________________ 

    4.      https://www.youtube.com/watch?v=ZZnbQYggvyQ

    DR RK Mishra - Published on Apr 28, 2012

    This video demonstrate Vaginal Part of Laparoscopic Assisted Vaginal Hysterectomy. For more educational laparoscopic video visit World Laparoscopy Hospital.

     There are three major approaches to remove the uterus: through the abdomen (abdominal hysterectomy -- AH), through the vagina (vaginal hysterectomy -- VH), or through the vagina with the aid of a laparoscope (laparoscopic assisted vaginal hysterectomy -- LAVH). The majority of physicians perform the abdominal hysterectomy through a large transverse or vertical incision, despite the fact that the vaginal hysterectomy has fewer complications and has a shorter overall recovery period due to the lack of a large incision. For more information log on to: http://www.laparoscopyhospital.com

    Notice

    Age-restricted video (based on Community Guidelines)

    ___________________________________________________ 

     5.      http://wcs-stl.com/laparoscopic-assisted-vaginal-hysterectomy/

     “…LAVH combines laparoscopy and hysterectomy. Laparoscopy is used to look into the abdomen at the reproductive organs. Hysterectomy is surgery to remove the uterus.

    LAVH involves the use of a small, telescope-like device called a laparoscope. The laparoscope is inserted into the abdomen through a small cut. It brings light into the abdomen so that your medical provider can see inside. Tiny instruments are also inserted to perform the procedure. Ligaments that support the uterus are cut with these instruments, and the uterus is removed vaginally.

    The benefits of LAVH include a short post-operative recovery time, which can be as little as a few hours after the surgery, to a day or two depending on your condition. Also, many patients can return to work and normal activities within 1 to 2 weeks. Most patients appreciate that LAVH has better cosmetic results, with only tiny scars…”

    _______________________________________________________________ 

    6.      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2673000/

    “Total Laparoscopic Hysterectomy: 10 Steps Toward a Successful Procedure

    Jon I Einarsson, MD, MPH and Yoko Suzuki, MD Author information ► Copyright and License information ►

     

    Abstract - Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies. In this review, the authors outline the 10 steps to a successful laparoscopic hysterectomy.

    Key words: Total laparoscopic hysterectomy, Laparoscopic supracervical hysterectomy, Minimally invasive gynecological procedure

    Hysterectomy is one of the most commonly performed surgical procedures in the United States, with 570,000 cases performed in 2006.1 Vaginal hysterectomies have been performed successfully for almost 2 centuries, and more recently Reich and colleagues2 introduced the laparoscopic hysterectomy. However, despite the advent of these minimally invasive procedures, abdominal hysterectomy remains the most common surgical approach, with well over half of hysterectomies being performed via a laparotomy.3

    Vaginal and laparoscopic hysterectomies have been clearly associated with decreased blood loss, shorter hospital stay, speedier return to normal activities, and fewer abdominal wall infections when compared with abdominal hysterectomies.46 In light of these findings, a recent review concluded that vaginal hysterectomy is preferable to abdominal hysterectomy and that a laparoscopic hysterectomy should be attempted when vaginal hysterectomy is not possible.6 The vaginal approach is less expensive, but may be challenging in patients with a history of an adnexal mass, endometriosis, pelvic pain, and prior abdominal surgery, or in patients with a narrow pubic arch or poor vaginal descent…”

    __________________________________________________ 

    7.      http://www.med.umich.edu/1libr/Gyn/BSO.pdf

    [my note:  This is a PDF file telling you what will be done for a Laparoscopic Bilateral Salpingo-Oophorectomy, but it has detailed information on preparation for this surgery which is basic info that you may find helpful.]

    ___________________________________________________ 

    8.      https://www.ncbi.nlm.nih.gov/pubmed/17329946

    “[A comparative analysis of hysterectomies]…Abstract The objective of this study was to evaluate and compare operative and postoperative results and differences among laparoscopic, vaginal, and abdominal hysterectomies performed at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital…

    CONCLUSIONS:

    Abdominal hysterectomy was the most common procedure performed.

    The type of hysterectomy influenced the rate of complications--the lowest complication rate was after laparoscopic and vaginal hysterectomies. The amount of blood loss depended on the type of hysterectomy--the lowest was during laparoscopic hysterectomy.

    Abdominal hysterectomy required on average a longer hospital stay compared with laparoscopic and vaginal hysterectomies.”

    __________________________________End of references______________________

     

    Thank you

    Loretta,

    God Bless you, I hope you are feeling well.  Thank you so much for your response and advise, I have received many signs telling me that I should go through with this procdeure.  I know that BRIP 1 is a fairly new gene mutation, but all cancer cells began as fairly new with little knowledge as to how to treat it at some point. 

    I will be going through the surgery, I have two beautiful sons who are are my world and wonderful husband.  I owe it to them to take care of myself  and make sure that I am there for their future and my future grandchildren.

  • LorettaMarshall
    LorettaMarshall Member Posts: 662 Member
    Wifers said:

    Thank you

    Loretta,

    God Bless you, I hope you are feeling well.  Thank you so much for your response and advise, I have received many signs telling me that I should go through with this procdeure.  I know that BRIP 1 is a fairly new gene mutation, but all cancer cells began as fairly new with little knowledge as to how to treat it at some point. 

    I will be going through the surgery, I have two beautiful sons who are are my world and wonderful husband.  I owe it to them to take care of myself  and make sure that I am there for their future and my future grandchildren.

    Wifers~My opinion~U've made the wiser choice! God bless you!

    Good morning "Wifers"

    "Dr. Marshall" (aka Loretta) agrees with your decision to have the complete hysterectomy.  Seems to me the safest thing you can do at this point.  Recovering from a hysterectomy is by far the better choice.  Recovering from Ovarian cancer is another problem much bigger!  You have a lot to live for.  You've got a job raising 2 boys--I know--I raised three.  I never thought they would be "raising me" at age 79.  I'll be 80 February 12th.  Now they are here for me and my husband anytime we ask for their help.  And the older we become--the weaker and sicker we seem to become.  So "enjoy" your youth.  A sudden diagnosis that may turn out to be cancerous makes you far more appreciative of the "good times" we were having and didn't realize that at any given moment, those days may put us in a "daze".  Hope you have a wonderful long life of joy with your family.  Stick together, give the boys a hug for me!  

    Love Loretta

  • Wifers
    Wifers Member Posts: 3

    Wifers~My opinion~U've made the wiser choice! God bless you!

    Good morning "Wifers"

    "Dr. Marshall" (aka Loretta) agrees with your decision to have the complete hysterectomy.  Seems to me the safest thing you can do at this point.  Recovering from a hysterectomy is by far the better choice.  Recovering from Ovarian cancer is another problem much bigger!  You have a lot to live for.  You've got a job raising 2 boys--I know--I raised three.  I never thought they would be "raising me" at age 79.  I'll be 80 February 12th.  Now they are here for me and my husband anytime we ask for their help.  And the older we become--the weaker and sicker we seem to become.  So "enjoy" your youth.  A sudden diagnosis that may turn out to be cancerous makes you far more appreciative of the "good times" we were having and didn't realize that at any given moment, those days may put us in a "daze".  Hope you have a wonderful long life of joy with your family.  Stick together, give the boys a hug for me!  

    Love Loretta

    Thank you so very much

    Thank you so very much

  • Metz2019
    Metz2019 Member Posts: 1
    BRIP1

    good evening - I realize your post is old but wondering how things went. No cancer yet but worried and planning on going in and having a hysterectom.

     

    thoughts welcomed