Uterus Bicornis/ Laparoscopy advice needed....

Hiya

Just need a little advice, its been a distressing week to say the least, largely down to some health news that I have received and a not so helpful doctor...

Following a hospital appointment last week, I was told I have what my doctor thinks is Uterus Bicornis. Having done some of my own research, im nervous and worried to say the least. Basically, Iv been booked to have a Laparoscopy in Feb 2010 so that they can do a little more work to diagnose that it really is this and how the outlook is for me. Again, im worried about recovery time etc. My boss is aware of the appointment and has been surprisingly good, but I live alone (my bf has already offered to be around that week) and im unsure of what to expect. My doctor has said I will be briefed on the morning of the operation despite her being completely aware of how nervous I am to even be going to hospital (iv never had anything done in my life!)

I know its pretty rare, but does anyone have any experience at all of this or even the operation process? Some websites say recovery can take 1 week, others say up to a month etc. Also, any experience of conceiving with this condition? Its not something iv been thinking about right now, maybe in a couple of years. Im 24 and my doc has said provided I conceive before I turn 30 I should be ok but it would be high risk and I would need regular check ups!

If anyone can offer any help at all then it would be appreciated. Iv only spoken to my mom and bf about this (as he attended the appointment with me) and whilst they both try to be supportive, they have no idea of this either.

Hi loveme

I'm afraid I'm not going to be very helpful as I don't know anything about this condition, and I've never had an operation, but didn't want to read this and not post. It must have been scary getting this diagnosis but it sounds like you are in good hands and they are quickly getting it sorted out.

I'm not sure whether or not I would recommend googling to find out more about this condition and the operation - because you never know what nonsense you are going to get back from searching this. If you do though, I would just say be careful and selective what you read - only information from trusted sites such as the NHS or BBC. You would probably do this anyway, but I know from experience how much you can wind yourself up more by reading unhelpful opinions / info.

Have a hug


Take care of yourself and try not to worry, make sure you talk to people close to you about this and don't bottle it up. GLad to hear your bf is there to support you too.

Hi Strudel,

Thanks for the post, your right, I havent been helping myself by google searches and my bf completely agrees. Iv been sat at work all day getting really worried that I didnt have the best advice from my doctor. Luckily my bf also thought I was getting too upset and insisted I give it a rest and that he will look through some info with me tonight to keep me calm!!

Im hoping that I get a confimation letter shortly to confirm the details and then if necessary I plan to book a doctors appointment so that I can at least discuss it with them and get the facts before the dreaded date.

Hi Loveme

Sorry to hear your news. I don't know anything about the condition I'm afraid but have just done a quick search on laparoscopy and found this http://www.nhs.uk/conditions/Laparoscopy/Pages/Introduction.aspx and I'm pretty sure there are a few posts on the procedure if you hunt around.

I assume they're doing the lap to have a look and see exactly what is going on so I guess they can't tell you any more about that at the moment, but you should definitely be able to get some more information about the procedure itself.

I'd be tempted to book an appointment with your GP (I assume it was the specialist you saw last week?) and go in with a list of questions and be prepared to tell them exactly how anxious and scared you are about the whole thing. They may not be able to tell you everything but they should be able to fill in some of the gaps. I'd ask them what kind of 'family' of problems this falls into so you can do a search for support groups and the like.

Hope you get some answers
SB

ETA: Grrr, read the thread without being logged in so only saw the first post, sorry if I've doubled up or said something you've already covered.

Good old bf, he sounds like a wise man

Have you found some useful info this evening?

Think defo good idea to book in with GP and bend his/her ear. That's what they are there for

Hi there

I had a laparoscopy to diagnose and treat endometriosis back in April. I have no experience of the condition you've mentioned, but I will try to give you as much info as poss regarding the procedure I had and laparoscopic surgery in general, inc approx recovery times. If you have any more questions, please fire away.

OK, here goes!

A lap basically involves making 2 or 3 small (approx 1.5 cm) incisions. These will usually be made in the belly button, near the pubic bone (around the top of your pubic hair) and sometimes 1 or 2 may be made eslewhere on the abdomen eg near the hip bone in my case.

The surgeon then inflates your abdominal cavity with CO2 to see what's going on, and uses a camera (laparacope) to see your uterus and pelvic cavity, as well as an instrument to move and manipulate organs so they can see everything.

The procedure usually takes somewhere between 15-60 minutes depending on what is done eg if it is purely diagnostic it takes maybe 20 mins, if they need to carry out any treatment, it may take longer.

So, that's an outline of the procedure itself. Although it is key-hole surgery, they are doing a lot inside and I'd say 1 week recovery time is very optimistic from my experience. So now onto recovery:

The CO2 that they use to inflate your abdomen can cause trapped wind in your stomach and also between your shoulder blades; I only experienced this very mildly but for some women it lasts days and is pretty painful. To help avoid it, or at least ease it, the following are good tips: sip peppermint tea; try to get up and about as soon as possible, and try to sit up as much as possible rather than lie down, as this will help get rid of it. You may be bloated, so invest in loose, comfy clothes (another tip: invest in a nighty or dress and large pants that come high up, as trousers, knickers etc can all rub on the incisions which is uncomfortable)

The anaesthetic can make your mouth and lips very dry, so bring some lip salve or vaseline with you and also bring a straw as this will make drinking easier when you first come round.

You will need to go to the loo before they'll even consider discharging you; it's a good idea to call a nurse the first time as you will be unsteady on your feet to begin with. Weeing can be weird at first (mine came out in a very slow trickle for about 3 days after); this is normal and is down to the anaesthetic so don't worry. Constipation can be one issue after GA's, so make sure you get into good habits now, drinking lots of water and eating fruits like grapes, apricots, figs etc; sorry if it's TMI but straining can be very painful after an op and the healthier your bowel movements are before your op, the quicker they should return to normal after.

They tend to use 'dissolveable' stitches during laps. Please be aware that in many cases these do not dissolve and can cause infections so if they haven't dissolved after 5 days, see your GP or practice nurse to get them removed. In my case they used sterostrips so I waited a week before removing them to be safe, and still had a nurse do it in case the wounds hadn't fully healed and they needed redoing. If you have an incision in your belly button, watch this one closely as it can get infected, so if it doesn't seem to be healing, is oozing or sore or red etc, then see your GP.

This all relates mainly to the procedure itself and the first week after the op. In terms of recovery time, it varies massively and is very difficult to estimate, as it can depend on what you've had done, how you personally heal, what level of activity your job involves, etc. As a guide, a week for a purely diagnostic procedure with zero treatment is really the minimum recovery time, and this would be if you're returning to something like a stress-free desk-job. After a week you're still likely to be tired and sore, your wounds are still healing, you're only just getting over the effects of the CO2, etc.

If your job is physical, you could be looking at much longer off work. Similarly, if you have treatment carried out this will prolong recovery time. As a guide, my experience was as follows (I had a diagnostic lap plus laser treatment of widespread endo on ovaries, bladder, etc, and 2 cysts removed from my uterus):

days 1-2: a little sore, so taking painkillers and resting in bed/on the sofa; on my feet but restricted to trips to the loo etc;

days 2-5: moving about a bit more; still sore but better; still staying at home and resting;

day 6: venture into town; very sore and crampy after about 30 mins so sit down and rest and then go home

days 7-14: more improvement; getting out and about for short, gentle, slow walks;

weeks 2-4: little more improvement but nowhere near 100%; still taking painkillers, still restricted to gentle activity;

weeks 4-6: more improvement;

week 6: return to my job at a supermarket on shortened hours and 'light duties'; in a lot of pain which worsens between shifts; my second shift is a disaster; manager tells me to be signed off for a further 2 weeks, then come back on even shorter shifts (3 hours twice a week for the first week);

week 9: return to work; goes better this time though still a little sore esp with lifting etc;

weeks 9-15: up my hours gradually each work, working longer and more frequent shifts;

week 16: finally back to normal hours.

I don't mean to scare you, and I did have fairly extensive work done, plus my job is unavoidably physical; had I had a desk job I'd have been back on (reduced) hours around week 3-4. I'm telling you though to give you an idea of the length of time you CAN be looking at; it is vital you give yourself enough time to fully recover (and that's emotionally as well as physically; I found it very tough dealing with the diagnosis at first as endo cannot be cured, is very painful and obv affects fertility sometimes, so difficult to come to terms with) and to allow your body time to heal. In my case, due to the type of treatment I had, doing too much could have resulted in the surgery doing more harm than good so I was conscious of making sure I gave myself enough time.

But, I would say that really, you're looking at 2 weeks minimum if you have a non-physical job, and anything from 3-4 weeks if your job is more physical; more if they carry out treatment.

What I would do is speak to your employer and ask to be allowed 2 or 3 weeks to begin with (I was able to book a planned authorised absence for my surgery of 3 weeks, then got doctor's certificates every 2 weeks after that). Also start speaking to them about reduced hours and duties on your return. You are, I believe, entitled to 6 weeks of 'rehab' (or reduced) hours after surgery. You might for instance like to consider 3 half days your first week, at times which avoid rush hour (eg 11-3); you may want regular scheduled breaks (eg 15 minures every 2 hours) to give you a rest and chance to take painkillers if necessary.

Hope that helps and if you have any questions I'll do my best to answer xxx

thanks for the posts, all have been helpful, Barbie86.... I could have cried reading your post, it was literally that helpful. Thank you, thats really what I needed to hear and it sounds a lot more honest than a lot of what I have read so far. It is only for them to have a look around at this stage, although I have been told that if they find anything then they will go ahead and operate whilst im under anaesthetic as I have already signed the paperwork. My mom and bf are both planning to come with me and share some of the helping out between them (my bf is booking the week off work bless him) so that should be a big comfort as im a baby at the best of times!
My manager is aware that I am returning for the op in Feb, although she isnt the most approachable person and really makes it difficult to discuss anything which tbh hasnt helped my stress levels lately. I plan to give as much notice as possible, I do a desk job although it can involve stress and im supposed to be working at an exhibition during the week of the treatment so thats likely to need rearranging... its also a male dominated workplace so I would generally prefer to be 100% before I go back in. Will await the letter from the hospital (iv already been told it will fall on a Thursday) and then make a doc appointment to arrange sick notes etc, as my boss is literally the kind who would call on Friday morning saying she needs sick notes like yesterday!
Thank god for Handbag! My mind is finally starting to have some idea of how to go about organising for this. You have all been such a help. Thank you

Glad it was helpful

Re work, my tips would be:

Be as open and honest as possible. You don't need to go into detail, but let them know now when your op is and what it involves, and what the recovery process is like. You might like to briefly outline what the condition is suspected to be and that because it affects your uterus you're concerned about fertility and are feeling very stressed about this at the moment. Explain that while a lap is 'only' keyhole surgery, even a purely diagnostic one is actually major surgery, and that a lot will have gone on inisde and you'll need time to recover from this.

Let them know now how much time (minimum) you'll need off work to begin with. From an employers point of view, forewarned is forearmed; if you give them the worst case scenario (eg tell them you'll need at least 2 weeks if it's purely diagnostic, but that if treatment is carried out they can expect you to be off a minimum of 3 weeks or longer) then they can get cover in place and make arrangements. Also, if you find you need less time and come back sooner, it makes you look dedicated; if you under-estimate and say you'll need a week, then after the op say 'Oh, sorry, I actually need 3', it doesn't look good. Most gynaecologists will sign you off for 2 weeks if you ask them to (the bare minimum they'll sign you off for is 1) so you won't need to worry about doctors certificates until this runs out.

After your op, 'keep in touch' (as my manager likes to say!) with them. As soon as you can, phone them and let them know how the op went, what work was done, and what your return to work plans are. Eg my lap was supposed to be diagnostic, with treatment if necessary. As endo WAS found, I did have treatment, so phoned my employer the following day and explained the situation and that realistically I was going to need at least 4 weeks off, not the 2-3 weeks I had anticipated, and that I'd keep them updated each week. So, let them know what was done as soon as possible and give a rough idea of when you might be back (bordering on pesimistic rather than optimistic; don't give them false hope! lol).

Once your certificate from your gynae has expired, you'll need to visit your GP for another one. Usually for this type of surgery they'll give you them for 1 or 2 weeks, so see how you feel. If you're not feeling much better, you're unlikely to be fit enough to return to work within a week, so ask to be signed off for two weeks. Once you have your certificate, fill it out and photcopy it, then get your mum or boyfriend to drop a copy in to your manager.

When you do feel you are ready to return, you will need to be declared fit to return by your GP (otherwise it's illegal). Phone your manager about a week before and let them know that you plan to return the following week, and ask if you can discuss your return to work with them before you do so. The following are things to consider, and you are well within your rights to demand them:

shorter hours for 6 weeks, building up gradually to normal hours; start very small, and buold up gradually; you might feel fine sitting at home doing nothing, but work can be a different story, so bear this in mind and take it easy and go slow;

frequent breaks to take painkillers and rest; you could ask for this even after the 6 weeks if you feel you need it, taking for eg 3 10 minute breaks and a 30 minute lunch break instead of 1 60 minute lunch break;

lighter duties.

A return to work form must be completed before you start work, so have these things written on the form as part of your conditions of returning. Don't commit yourself or feel you need to come up with a 6-week plan straight away; write that for the first week you will need to do 3 half-days, and then will look to increase this IF POSSIBLE the following week. If this is in writing (along with demands for frequent breaks) it is part of your agreement regarding your return, and they cannot later back-track and say you haven't asked for it as it's there signed and in writing. Don't be too pushy, there are ways of wording things. Say something like 'i'm sure you can understand that as I've had surgery I'm not going to be able to return to my full hours straight away as I'm not yet quite fit enough and don't want to risk my physical health or necessitate further time off. I really want to return to work so I hope you can work with me to make my return as smooth as possible. I just have a few small requests which I think would make my return easier and enable me to work more productively in the circumstances; I hope you can accommodate them or at least reach a compromise as I'm afraid that otherwise I might not be able to return just yet'. This makes you sound amenable, and also proactive: technically THEY should be helping ease you back in, but you've done the work for them and come up with things which will help the process. By frequently mentioning things like surgery, not wanting to jeopardise your health, etc, they will also feel they ahve to agree, particularly if it's in writing, as they would be on seriously dodgy ground if you returned too soon, they didn't help with your requests, and you ended up going off sick due to complications (highly unlikely but the faintest thought of a lawsuit should be enough to make them think twice).

If you feel they are putting you under pressure, there are ways to deal with this. My tip would be to again be honest with them, and say you are feeling under pressure and struggling to cope. If they try to get you to come back on full hours, or try to get you to increase your hours too quickly, or are less than felxible and accommodating with regards to frequent breaks etc, say something like this: 'I think it's a great shame that my requests haven't been met, as they were part of my conditions to return to work. I really don't want to have to take more time off, but if you can't be flexible as you promised, I may have no choice as I don't want to risk complications'.

It sounds a little sly and underhand but it isn't. You aren't outright threatening them, just putting the vague notion out there. After surgery you are entitled to a phased return etc, so don't feel bullied into not having one. Stand your ground and if necessary, get signed off again and get a doctors letter explaining why.

These are worst-case scenraios but employers can be awkward, esp if you don't have outward scars and it's a 'woman's problem', so just be prepared. On the whole my employers were good about everything, but I did have to be firm with them in some situations.

Hope that helps xxx

Thank you, that does help as my employer is not the friendliest person and although she initally asked how last weeks appointment went and I explained the situation (i.e. repeat appointment needed in Feb for operation) I did leave it that I would get back to her when I receive my letter and more info. I made sure I pointed out that it would be for surgery so that she knew it wouldnt be a check up.

I spoke to her again yesterday and asked for a copy of company procedure to understand the sick leave entitlement of the company (Iv worked here 18months but never taken more than a day sick leave so wanted to show I was being a bit proactive about it) so that I can have all the relevant paperwork. Her response "well you shouldnt need more than 7 days so self-certify it". Followed by a blank expression when I said I would need to clarify with my doctor the predicted recovery time as it may be more than 7 days. With it being a small company, she manages our HR and being the only female manager was my first choice of who to really speak to. Iv therefore requested a meeting today with my direct line manager, a man but far more likely to be sensitive and understanding than her and hopefully likely to be more supportive.

I feel so stressed out just thinking about it, I KNOW the the HR manager is exactly the kind to make a big deal of it no matter how much I do to give notice. As for shorter shifts after the surgery.... I cant see her even entertaining the thought for a second. Fingers crossed my other manager is a little more supportive once I explain it to him today.

hi, hope u r feeling better, I had this condition, however I have 2 healthy sons, 28 & 26 yrs. I had a lapor. op here in Germany where I live, it wasn t as grim as I thought and I was up and back at work after 3 weeks. Do not put up with stroppy or unhelpful doctors, explain to him (must be a him or we wouldn t be having this conversation) that us lesser mortals do not understand jargon and either he explains it properly to you or finds you somebody that will do you the politeness of guiding you through this. The op is really just a look around job, they make a tiny hole in your tummy button and 2 tinier holes in the bikini line, don t even need stitches, I think over there u don t even need to stay in hospital, here I was in 3 days, but the insurance system here is different. Hope I helped and wish u well. Honeychile

Thanks for the response Honeychile; just catching up on here as I had the lap. last week so now at home recovering and in a great deal of pain. I was allergic to the type of anaesthetic that was used, so its still taking time to wear off and I havent been able to drive (I had the op 5 days ago).
Diagnosis was definite uterus bicornis bicollis with possible mild endometriosis causing the pelvic pain, however my consultant has now suggested she may wish to do a hysteroscopy as she isnt convinced that it is actually endometriosis. So I dont feel completely at rest or informed at the moment. My main worry related to fertility, which they are being very vague about right now. Really doesnt help!
Thanks for the advice that I have received on here though, its been spot on, iv been signed off work for two weeks so will be around a lot during this time

Hi, if endo is suspected I would urge you to see an endo specialist as it gives me some cause for concern that the cons 'wasn't sure' if it was endo; a specialist should be able to tell; endo can go mis/undiagnosed even during a lap as it shows up in lots of different ways and sometimes can be very difficult to spot. You can find a specialist through the following link: http://www.drfosterhealth.co.uk/consultant-guide/ Remember that under new NHS guidelines you are entitled to pick a cons from within your local Primary Care Trust, so ask your GP what hospitals come under this umbrella and ask for a referral.

I'm afraid I can't help much at all ie the uterus bicornis so I'm hoping your cons will be able to give you more info (I'm hoping you have a follow-up appointment booked?). But I have endo and have had a lap, so if you have any questions at all about either, please fire away.

HTH xxx

Hi, sorry the outcome wasn't better for you, hope you feel better soon, the docs are probably being vague about fertility cos they don't really know!!! I have 2 sons, in between them pair I had a miscarriage, but never knew I had uterus bicornis til the thing was removed, then they all said 'ooh' It is in end effect a heart shaped uterus, that can make a pregnancy difficult & high risk but with careful monitoring and care might be ok. My BF is a surgeon, although viseceral not gyne, I will pick his brains when he gets back and report back to you....