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Followup To
Question -
Hi there,
I am 24. I don't have any children. I became amenhorric (without explanation) in June 2001, and then I had a hysterectomy in January 2004.
I have a pfannenstiel incision (from a total abdominal hysterectomy two years ago), of which I am extremely ashamed, and have an upcoming appointment with a new gyne next week. I am wondering if you can tell me if there is ANY way to have a pelvic exam without the doctor seeing the scar, with liberal drapes, for example? It has been nearly a year since I have let a doctor see my scar, and the only reason I let previous doctors see it, was because of the debilitating pain I was in. Now that my pain has resolved, I am caught between my emotions and the rest of my medical needs. Last year, when I presented to my GP's office with symptoms of an ulcer, my shame surrounding the scar, prevented him from doing a complete abdominal exam -- it's been quite "debilitating", and I really don't know how to deal with it, unless there's a way to conceal my incision during a gynecological/abdominal exam.
Thank-you
Answer -
Whenever you have a gynecological exam, it is necessary for the doctor to evaluate EVERYTHING including your previous incision, your pelvic exam, your heart, your lungs, your thyroid, your blood pressure, etc. If you are unhappy with your incision, why don't you have it repaired or corrected. It is easy to do and the results will be more satisfying. What, exactly, is embarrassing about the pfannenstiel scar?
Hi again,
I don't think there is anything phsyically wrong with my incision. Its appearance could probably be made more cosmetically appealing (but I don't think there is any keloid formation or hypertrophic nature to the scar, for example). I don't know if other scar treatments such as topical silicones or injectable steroids would be indicated in my case. I also know that in any plastic surgery procedure for scar revision, I would be left with ANOTHER scar, albeit likely smaller.
My issue is more an emotional one. I associate the scar with negative things: the hysterectomy and its ramifications -- specifically loss...the loss of the ability to bear children, the loss of my uterus, and the loss of my father's perception of me as a woman (before my hysterectomy he told me that if I could no longer procreate, then I was no longer a woman).
I have wondered why I have no issue with doctors seeing other scars, such as my appendectomy and cholecystectomy scars, and I have realized that no one told me I wasn't a woman because I didn't have an appendix or a gallbladder. I am NOT comfortable showing a doctor my incision at this point.
I know you said, "[w]henever you have a gynecological exam, it is necessary for the doctor to evaluate EVERYTHING including your previous incision", but bearing in mind my emotional state, would you be able to answer my previous question: I am wondering if you can tell me if there is ANY way to have a pelvic exam without the doctor seeing the scar, with liberal drapes, for example?
Thanks again for your time.
AnswerIf you came to my office for a gyn exam, and you did not allow me to evaluate your abdomen and all scars, I would not see you as a patient. It is poor medical treatment anc can be considered malpractice. I know of no other gyn who would not inspect the scar and palpate the abdomen. Your father did a misservice to you. A hysterectomy in no way causes you not to be a woman. What was the reason for the hysterectomy at 24 years of age? Amenorrhea is not an indication for a hysterectomy. I would suggest that you consult a therapist and work out the problem. I understand the emotional aspects of the problem, but it really is an irrational embarrassment.
