Keep my cervix if I already have pelvic floor dysfunction?
I’m almost 30, I have PCOS. No endo or adeno. Just cysts on my ovaries. I had a low risk dysplasia pap smear about five years ago, it was gone six months later, and my annual paps since then have been normal.
Although I have PCOS I’m planning on keeping my ovaries because my health insurance comes and goes, it’s low income state insurance. If i make too much money I lose my insurance. Right now I’m so low income that I get free health insurance. I’m in the US. I know I would need HRT if i remove the ovaries, but it needs to be prescribed by a doctor. I can’t afford out of pocket doctor appointments and pharmacy costs at times when my insurance isn’t active.
I understand it’s recommended to remove the cervix too if you’ve had an abnormal pap. I’m afraid of prolapse and the cuff. I’ve had pelvic floor issues since I was a teenager. Bloating, constipation, feeling like I always have to pee and cant empty my bladder. Can’t have a bowel movement unless I drink a hot coffee. Pelvic pressure always. In the past I was excessively heavy weight lifting and abusing substances that constipated me. I’ve asked my primary care doctor for a referral for a colonoscopy but they denied it.
I’m scared of having a cuff because my husband bonks into my cervix pretty often. I understand it’s rare but the cuff can rip from this even six years post op. I’d prefer a vaginal hysterectomy to avoid the gas pain from a laparoscopy, I don’t know if the cuff would be best for me because I might prolapse or break the cuff.
Also worried about if I need another surgery in the future due to the hysterectomy, like cervix removed or cuff repaired, it might be at a time when I’m not covered by insurance.
I started doing pelvic floor exercises i learned from youtube. I’m hoping to go to a pelvic floor therapist after the surgery.
Just to clarify I’m covered by insurance right now, and my surgery consultation is soon. If my income increases just a little bit I will lose insurance. This probably will happen in January 2027.
Any advice is appreciated so much