Hysterectomy with an Ostomy??

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smbitofdynamite

Is there anyone out there that has had a hysterectomy performed while having an ostomy? I have an ileostomy and the gyn says I need a hysterectomy, however, he has no experience performing one with an ostomy patient. I am very uncomfortable with this situation and am having difficulties in finding an experienced doctor. Please, any advice/information would be greatly appreciated.

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Whoa
Nurse
Hey dynamite
I have had patients have it done but usually in conjunction with ostomy surgery. I would request your GYN consult with your surgeon that created your ostomy OR consult with a colorectal surgeon re: any particulars. Perfectly in your bounds (it's YOUR body) to request this...a good doctor would not take offense. Or, could you call your surgeon yourself and have him speak with your GYN?

Was the plan a vaginal hyst. or abdominal approach? First thing that comes to mind is likelihood of adhesions due to prior surgery...other than that I don't know of any specific issues with the ostomy...I'm not sure why you had your ileostomy and that may be something your doctors should discuss. If there was some concern, some physicians have a buddy resource/specialist on call for asst. or call in consult intraoperatively....common at teaching hospitals.

Smart of you to question and think ahead. Hope that helps.
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smbitofdynamite

I had to have my ileostomy due to severe ulcerative colitis, which my surgeon also recommended my rectum being removed. I had this surgery 16 years ago, making me 29 y/o at the time. My surgeon has since retired and I have not (thankin god) had many problems up until this point. The gyn wants to cut me open on my current incision and also tells me that he will have a surgeon assist him because he never has done this before. However, I went for my pre-op testing and he ordered a Fleet enema, which I was always told never to insert anything into my stoma. This is not the only discrepancy that I have run into since I agreed to surgery, so I am not feeling too comfortable with this doctor performing my surgery. I do not feel that he is consulting anyone and I have tried myself to speak to the assisting surgeon, but he has not called me back and it has been 3 weeks. I also had to educate his nurse (who is also his wife) to explain that I have an ileostomy and what it is. She kept insisting that it was hooked up to my bladder. I just am very concerned that my best care is not being thought of.

Whoa
Nurse

I would not commit to this surgery until some questions are answered. Most hysterectomies are elective and hopefully you could postpone this until you feel confident in this surgeon or find another surgeon who also has experience with ostomies. If private health insurance, you could call and request a second opinion.

If his assistant surgeon has colorectal, general, GI or GYN oncology experience creating ostomies, then it sounds like your surgeon is covering his bases for your well-being. But you should find out first.

It is not clear to me if your surgeon has never done a hysterectomy or if it was never done on a patient with an ostomy? What are his concerns?

Bowel preps: new literature out and new trends range from no preop prep at all to clear liquids the day before are more the norm with an ileostomy. No need for a fleets or laxatives. Clear liquids the day or evening before should be enough of a prep.

I hope you educated the wife! I frequently see nurses and interns call urinary diversions ileostomies in their documentation.....they often mix up ileostomy (fecal) with ileal conduit (urinary) diversions. Quite a difference!

It is not unusual to use the same incisional line for another surgery.

It could be your surgeon is very well qualified and very honest, but just is not familiar with ostomies and has an assistant who is familiar there for backup just in case there are adhesions involving your intestines. I'd clarify this....you could probably look up his specialty in a phone book, then ask him.

I'd like to know what you find out.
Whoa
Nurse

Another thought....are you near a teaching hospital? That would be a plus for getting a second opinion as the doctors/professors are usually widely experienced.

 
Staying Hydrated with an Ostomy with LeeAnne Hayden | Hollister
Past Member
Hello Dynamite,
My name is Lori. I have an ileostomy due to pan-ulcerative colitis. I have had 6 major abdominal surgeries and now require a hysto. I would really like to talk to you about this. I sure hope you are still checking this site, as I see you have not replied to your forum post sent in October. I hope you are okay.

Recently, I had a couple of tumors show up on my ovaries and need to have my abdomen opened to have the entire package removed. No babies for me, but I'm okay with that. I won't go into more details, but I really think we can help each other. I am in Canada and thankfully have the best surgeons in Ontario treating me. I have my previous surgeon and a very good gynecologist, both at Mt. Sinai in Toronto, working together to help me. My surgery is required ASAP, so I am on the cancellation list. If no one cancels, I will have my surgery in January. If you would like to compare notes and maybe help each other through this, please contact me here on this site. I check it almost daily.

I hope you are okay and look forward to talking with you.

Lori
smbitofdynamite

Sorry, I have not been checking my emails. Been very busy working but I will be checking more frequently.

sharon
       Hi there ladies, this topic caught my eye. I would never have thought of having my bowel surgeon present when the gyn did my hysterectomy, but it only makes sense to do so to prevent complications. I was 26 years old when my ileostomy was done over the course of three surgeries in that same year. Then, when having endometriosis, the gyn said I needed to have a hysterectomy, so I went with the flow. To make a long story short, I needed more bowel surgery four weeks afterwards (not even healed from the hyst) from adhesions causing my ileostomy to obstruct because he went through my same incision line. Needless to say, my tummy now looks like a road map and now my flanges don't fit properly. My wear time is 1-2 days if I'm lucky and by then they're falling off. And here in Ontario, we have to pay for our supplies. We get $300.00 a year, which pays for a month and a half of my supplies. Please consult your bowel surgeon first before letting another doctor botch up his work.
Past Member

Well, those scars are just a testament to your strength and determination. I would wear them with pride.
Besides, everybody else has a tummy without them, boring I say.
Anybody want to see mine?
Past Member

Hello all.

I too have to be scheduled for a total abdominal hysterectomy, and I also have an ileostomy. I am quite worried about the risks. They have found a large mass on my left ovary, and my cancer antigen blood test was slightly elevated. The gynecologist is also having me get a consult with a GI surgeon who will also be in the operating room with me. I am feeling quite worried about this surgery, more than I was with the ostomy surgeries I have had in the past. Any advice?

Past Member

Oh, and Sharon, I also live in Ontario and live in Guelph, which I will most likely be having surgery at Guelph General.

beatrice

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