From cone biopsy to hysterectomy?


I have had heavy periods and many fibroids for about 12 years now, and have been repeatedly advised since then to have a hysterectomy. Since this would only be to ‘improve the quality of my life’ and since I didn’t find that enough of an issue, I never had the procedure done.

In March 2020 I had to have a LEEP done because abnormal cells had been found in my cervix, which ended up being CIN3. Some of my next pap smears came back as having only HSIL, until July 2021, when the pap smear again showed HSIL and possible carcinoma, and I was recommended a cone biopsy, which I had done in late August 2021. The margins then were clear, and it turned out there was no cancer. Now, however, it seems the CIN3 has come back, and because I have these other period problems as well, my gynaecologist has now recommended a hysterectomy.

It seems uncommon to have a hysterectomy for CIN3, and I find it emotionally demanding, so I was wondering whether others have been in the same situation and have any advice? Since I have quite a bit of history now, should I just go ahead with the hysterectomy? I am 48.

Thanks so much for reading.

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Hello Anja , yes women have Hysterectomy for CIN3 when is reocureent there is normally about 2 or 3 Lletz and Cone that can be done but next step is Hysterectomy. Some women actually prefer Hysterectomy if 1 Lletz is not successful simply because of the peace of mind of knowing that it will simply not come back. You still need to do a test for abnormalities in the vagina after Hysterectomy but I believe the changes of that are very very low.
I had treatment for CIN3 and CGIN and for now it looks like it has worked. But I didn’t have clear margins and did lots of research on Hysterectomy and definitely if I needed one will get it done having continuous monitoring is very stressful .Have you asked how they will do the Hysterectomy? I believe for CIN3 there’s no need for abdominal Hysterectomy and a you could do less invasive faster recovery one .take care

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Dear Anna,

Welcome to the forum! As Hop1 has said, this is not an uncommon course of action for recurrent CIN3, which is only one step away from being invasive cancer. Given your age (48) you will be expected to enter peri-menopause soon, if you haven’t already. I wish I’d been offered a hysterectomy instead of a cone biopsy for recurrent cell changes when I was in my early 40s, because I went on to develop cancer years later. Better to get it before there is any chance of spread - makes the chances of success stronger PLUS you could ask about a vaginal or a laparoscopic hysterectomy, which are far less invasive. If there’s no actual cancer, abdominal hysterectomy is not needed. :tada:


By the way, my mother had a a hysterectomy for fibroids when she was in her late 40s and it gave her a new lease of life as she’d never realised how much it impinged on her life. She’s 90 now, so it was abdominal in those days, but she was up and about in no time - that’s my mum though! X


Thanks so much for your responses, @Hop1 and @jacks133. These were very helpful.

I have been reluctant to go ahead with this, as even the mere thought of losing my uterus somehow has given me enormous emotional and mental strain (even though both my sister and mum have gone through it, and were totally fine with it). But if there is a good enough reason, I will of course do it. Your messages have really helped me to put things into perspective.

I do think they’ll remove only my uterus and cervix if I decide to go ahead, but I should get confirmation of that on Monday.

Thanks so much for your support.

Totally get it when my doctor mentioned Hysterectomy as a possible option for me if results were not good I felt a complete sense of lost she asked if I wanted more kids and I said definitely not she then said well then you definitely don’t need the uterus for anything then it will just cause you problems. I am very sure I don’t want anymore but still the idea of having the uterus removed is a difficult one. But health is more important than anything so is definitely a good decision the option of cancer is just too much to play with. Take care and let us know how you get on

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Thanks, @Hop1. It feels good to read a message from someone who does understand. I’ll let you know how it goes.