Bowel shaving/resection and hysterectomy. Anyone had surgery for these together in one surgery?

[jen2023]

Hi all. I am 46 years old, stage 4 deep infiltrating endo and possibly adenomyosis, had previously an excision surgery to remove chocolate cysts in my 20s. I am due for a hysterectomy, removal of one or both ovaries and a bowel shaving in a months time. I was told there are lots of adhesions between various organs, many are stuck together. It will be done by an experienced endo specialist gyno surgeon, however, no colorectal surgeon will be involved in the bowel surgery as it won't be a bowel resection, only a bowel shaving. My surgeon mentioned if a bowel resection is needed, i would have to back for another surgery as it need a colerectal surgeon. He can only know once they open me up on the day of surgery for a more precise surgical option. I am worried as a bulk of my symptoms are bowel related, however i also understand bowel shaving is the first line surgery, as bowel resection has more risks and complications.

Has anyone had either a bowel shaving or bowel resection or a combined hysterectomy and bowel shaving/resection? Did it help with bowel symptoms and pain (bloating, indigestion, constipation, ibs, pain with bowel movements, etc) or not much difference/worse? Any complications post surgery? I am worried if a bowel shaving is not sufficient and a resection is needed, but i would have to do another surgery. Thanks so much for sharing your experience with me.

[Bexyrich]

Hi jen, I had a total hysterectomy and bowel surgery on Friday. It was revealed by mri that I had bowel noduals and so had colorectal involved. It turns out I only need a bowel shave. I'm home already and although in some discomfort I'm not in the pain I was before.. I'm 39 and felt too young to go through this but I didn't have a choice, for quality of life my surgeon said it was the only thing to do to prevent further surgeries. He is a bsge specialist. Good luck. Xxx

[jen2023 in reply to Bexyrich]

Thanks so much for your response! Glad to hear you are recovering well and the pain level on your bowels has reduced as a result. Regarding hysterectomy: surgeon is recommendeding that at least one ovary (partial hysterectomy)should be left intact so it will help with with hormones and it won't put me into menopause straight away. I am torn about this as i am anxious about menopause, but it also worries me with the possibility of regrowth and further surgery. I have cysts on both ovaries and have cramps on both. Did you have this dilemma too when deciding a full hysterectomy, especially menopause? Perhaps I have an overly-anxious and worry about menopause and the possibility of endo regrowth even with a full hysterectomy as some women experience.

[Endolemon in reply to jen2023]

Hello 🌷

I had total hysterectomy in March. I am 47. Surgeon advised removed ovaries as well to avoid further surgery.

I have been told before the operation possible bowel resection needed and colorectal was present. But bowel was clear of Endo.

I have some symptoms of menopause :hot flashes, memory loss, breathless, anxiety .. So I was prescribed HRT last week.

Wish you easy recovery 💛

[jen2023 in reply to Endolemon]

Thanks for sharing your journey. So glad to hear your bowel had no endo! I hope your hrt helps with your menopause symptoms.

[Bexyrich in reply to jen2023]

I've had both overies removed, it was recommended to me to reduce the risks of further surgeries. I had been on decaptyl 3 weekly for 2 years and have been taking hrt to counter act menopause symptoms. I guess the injection was a trial as to how I would respond to hysterectomy. I know it's only been a few days but I the awful bloating I had before and constant pain isn't there. X

[jen2023 in reply to Bexyrich]

Thanks for letting me know! It gives me hope to hear the positives from bowel shaving. Hope you have a speedy and full recovery. Sending you my best.

[Lindle]

Presumably this is being done in a BSGE endo centre?

[Bookworm3371]

I recently had a total hysterectomy and endo excision, also including bowel shaving. The consent form goes through a range of risks including the possibility of bowel resection, the need for a stoma, HDU/ITU admission (as well as stuff like hematoma, hernia, blood transfusion). My consultant said they need to cover those risks with you but based on my MRI he was fairly confident he could do the shave and not need further bowel involvement - and he was right. It was scary going into it and the first thing I said when I came round in recovery was what incisions do I have, did they get it all. I’m coming up for 3 months post op and doing well, recovery is hard, surgical menopause is something to adjust to as well but I’m glad I had the surgery.

I hope it goes well for you, happy to answer any questions I can x

[jen2023 in reply to Bookworm3371]

Thanks so much for the helpful info on bowel shaving risks and side effects! Glad to hear you are recovering well post op. Any tips for pre/post op preparations, expectations vs reality, especially for bowel shaving and hysterectomy? I have to take care of myself post op as i am single, no family support. It's been tough mentally trying to prepare the surgery by myself. Plus post op will be interesting...

Are you on hrt for menopausal symptoms?

[Bookworm3371 in reply to jen2023]

I’d recommend looking up hysterectomy sisters uk group on FB and hysterectomy on Reddit as they’ve both been really valuable for support and information. Your NHS trust will likely have its own version of the hysterectomy info leaflet online which is helpful for pre and post op advice, and the RCOG has some info too. Biggest advice is that everyone recovers differently so go at your own pace, it’s a big operation and can take a long time to recovery fully, and it goes in waves, some weeks you feel you’ve gone backwards then you leap forwards. Practically, make sure everything is at a good height - I couldn’t bend for a while and hadn’t realised that would be the case so was tricky getting things, if I dropped something it was lost forever. People use those grabber litter picker sticks but I wish I’d known so I could’ve put things like in the kitchen on the worktop.

HRT, I’m on Tibolone and will be until I’m 52 (currently just turned 40). It’s mainly for health benefits such as bone density due to removing ovaries early. I get some hot flushes, but they’re not that bad, my skin is drier and I’m going grey quickly BUT that could’ve happened regardless. Post op you might need someone when you’re discharged if you’ve had a general, and if you have anyone that could help or pop in for the first week or two that might be useful but you’ll find ways around things, I’ve had all kinds of funny systems to work around not being able to lift or bend, and grocery deliveries have been very helpful bringing things in for me etc. Anyway, I hope my ramble is some help! x

[jen2023 in reply to Bookworm3371]

Your advice and experience have been so helpful and top notch! Thanks so much !!!

Thanks so much for the FB group recommendations! I joined them straight away. Great advice on taking it slow post op and that recovery is personal. The height of things recommendation is awesome! Glad to hear your hrt experience is not too bad.

I may have a friend who could help me duscharge and pop in to check ip on me the first week post op, so fingers crossed all will work out.

Sending you my best.

[Thistlegirl49]

I am in a similar situation and was told my endo surgeon would need a kidney specialist and a bowel surgeon present. (He would be removing ovaries at the same time, but they’re also embedded and could not be taken via laparoscopy for endo of appendix in 2023. They did not know until then I had Stage 4 endo.)

ATM - due to risks and complications (e.g I may end up with a colostomy as they can only resect the bowel once, and the possibility of infection) I have opted not to have surgery.

I was told it would take 8-9 hours and 3 specialist surgeons (as above.)

[Lizziedrizz]

I was diagnosed with rectovaginal endometriosis during my subtotal hysterectomy March 2024, my bowel was fused to my cervix plus my rectum and vagina were also fused together, so everything was unstuck during my hysterectomy and I had hoped that would be the end of the bowel and pelvic pain but I was wrong.A few days ago my endo surgeon instantly referred me to a bowel surgeon and specialist endo nurse to talk through the operation and possible complications so I think my endo surgeon is preparing for the worst possible outcome where bowel resection will be needed.