Ectopic surgery - what should I expect?

* Can people please only respond to this if you've either had an ectopic or have medical experience. Thanks *

I will have surgery tomorrow afternoon for an ectopic in my right tube. My HCG yesterday at 21dpo was 602. I have no idea what that means in terms of size.

We meet the doctor tomorrow to discuss it. I know it will be surgery which I'm happy about. I didnt want methotrexate. Anyway, hopefully it's via a small incision. Hopefully they can save the tube.

What will recovery be like? Is it like a D&C? Or worse? Am I likely to get AF immediately? When will I be allowed to drive? I'll ask the doctor these questions but I'd like to be prepared before I go in.

am I right to assume it will be under GA? It's not something I want to be awake for.

How long after can we TTC? We used Clomid this cycle. Assuming we try that again, is that ok or can it affect things at all? Though given the side effects I get, we wont be keen to try it again. I dont know if we jump to IVF yet, but that feels on the cards.

Anything else I should know?

thanks

Hi, sorry to hear you are going through this, sending you strength and best wishes for an easy recovery.

I have had an ectopic, when I was 19. I can tell you about my experience, which may be different to yours, but should answer some questions. I had emergency surgery as my ectopic ruptured and I had internal bleeding, so it all happened very fast. I had a GA, and the surgery was keyhole- an incision in my belly button for the camera, one above my right hip that they removed the tube through, and one on my pubic line that they had a drain in for a few days. They kept me fairly well sedated the next day because I was very agitated (anxiety issues).

My recovery was fairly fast physically, tiny scars which have now disappeared, and I was out of hospital quickly, back to work in a week. I had to have a follow up blood test to make sure HCG was 0. Given that your tube hasn't ruptured, I'm not sure whether they try to save it or not... I hope they do :)

I could drive after I stopped taking pain relief (2-3 days), and I think AF came back shortly after, was light and not like a normal one. The dr told me not to TTC until I had a "normal" AF.

I can't help in relation to clomid, I have some study background relating to endocrinology, and I can't think of any negative impact, but I am in no position to offer medical advice! I was worried as I have PCOS, and thought that having one less tube, plus erratic or non existent ovulation would mean that I'd need IVF because I just couldn't see how I could be lucky enough to conceive naturally. I got pg quickly (after a loooong break) using soy iso to bring on ovulation, pre seed and temping. I wish I could tell me 6 years ago not to worry and to relax, that I would have a baby one day...

My only other advice is to make sure you do whatever it is you need to, to help you come to terms with it. I was attached to the idea of being pregnant by the time they figured out I was having an ectopic, and it took me a long time to come to terms with it. I felt betrayed by my body, like it had let me down. I also felt like I had no control, this thing was happening and I couldn't stop it.

I hope nothing I have said offends you, or makes you uncomfortable. I have had a happy ending to my journey (so far), even though I had a distressing time. It sounds like you have the benefit of time to ask questions and understand the process, which I wish I had. All the best at the doctors, I hope that they can help you through this as easily as possible :)

Thanks for that frog. It's really helpful.

it turns out a side effect of Clomid is increased risk of ectopic, as the fallopian tube doesnt contract enough to pass the egg through. Yeah, great. Well we wont be using that again.

Oh, I had no idea about that with clomid... I can see why you would be dubious about using it in future.

Hi hun,

With my ectopic my tube ruptured so my surgery will probably be different to you yours. I had a laporoscopy which has left me with a long scar above my bikini line (I guess like a ceaser). It all happened very quickly as I too had internal bleeding ...... I couldn't drive and get around for a while - not sure if it was due to my scar????? Had bleeding on and off for a week or so.. then AF came back 6 weeks after the bleeding stopped.

I was told different things about ttc, wait 6 months, wait 3 months but a lovely nurse said - You can try when you feel emotionally ready too....

My heart breaks for you, how much pain should one person endure????

Here if you need anything hun xoxox

Sending much love and strength

I'll be back soon just need to fire up the computer I'm on my iPod. Ive had an ectopic pregnancy and also worked as a theatre nurse so may be able to answer any questions you have.

L&B I am so sorry your going through this on top of everything else you have already endured. What BS!

I had an ectopic pregnancy in 2009 and another pregnancy they suspected was ectopic earlier that year acept it resolved on its own. Mine was not diagnosed until after 8weeks in which time it was to late for methotrexate although I probably would not have gone down that road anyway. I know alot about the drug if you do want to know anything about it but I wouldn't recommend it due to a slight higher risk of NT defects and the fact it takes longer to ttc again.

I had complications during surgery with my blood presure and bleeding but apart from that the surgery was fairly straight forward and I had a 2 day stay afterwards. It was definately under a general and they would not perform that surgery any other way. If you have had a lap and dye or laparoscopy it is basically the same except a little bit longer as they remove the tube and the pain for me having both done before was much worse after the ectopic surgery. Really think if you want your tube saved as there is quite a high rate that a tube repaired will result in another ectopic pregnancy. My tube could not be saved which I am glad about as it was damaged which is why I had the ectopic pregnancy in the first place. It was also causing m/c as it had been sick for a while and was releasing toxins which caused me to 1 not get pregnant and when I did I would m/c. The most likely reason for you would be the clomid as you explained above.

The surgery itself for me was very long. It usually would be about an hr if your tube hasn't ruptured and about 2hrs if it had. This is not including time before and after in recovery. If your tube is going to be repaired (the pregnancy removed and tube sewn back together) it again will be longer. Also when this happens there is a chance they do not get all the pregnancy tissue and your repaired tube can still rupture days/weeks later so you will need a repeat BHCG to make sure its coming back to less then 5.

After my surgery I had a patient controled analgesia machine so I could administer my own pain relief. After the initial few hours I was comfortable if I didn't move but needed to go to the toilet alot due to having so much fluid for low blood presure. I would definately recommend a catheter as everytime I went to the loo I was in agony and would vomit the whole way there and back.

As for recovery at home it took me a good week to get up of the couch and start doing stuff I normally would. I resigned from my job as I had then been ttc for 2years and had discovered why I couldn't get pregnant and emotionally could not return to my job as a midwife. I got a new job quickly and started work as a theatre nurse 8weeks later. I developed an infection 3weeks post surgery and was on antibiotics for 3weeks which caused further complications (a bowel abcess) so my lengthy recovery time was not normal.

I was still bleeding 17days after my surgery and I do remember ovulating again that day. I normally ovulated on day 17 so my cycle was basically completely back to normal as soon as my tube was removed. I also felt very fertile that cycle but was not up to DTD due to the surgical incisions and then the bowel abcess. We were advised not to ttc for 3cycles which we stuck to and in that time I had further surgery to try and repair my remaining tube which was also damaged. We were recommended IVF if we didn't conceive within 6months following the 2nd surgery. I ended up falling pregnant 11cycles after that 2nd surgery and have since had my DD without IVF. If I was not booked for further surgery 6weeks later to flush my remaining tube and remove adhesions I would not have waited the 3cycles. I may very well have tried straight away. I do know of a few people personally who have conceived the cycle post tube removal.

If your remaining tube is normal your fertility will not be reduced by half. It is possible for the remaining tube to catch eggs from both sides so although fertility maybe reduced slightly provided your remaining tube is normal fertility shouldn't be much different from before. As your ovary is not joined to the tube the fimbria (hairy things on the end of your tube) can still sweep the egg released from a tubeless side over to it so you can still conceive despite the egg coming from the opposite side (if your tube was removed completely) Your ovaries also don't take it in turn to ovulate so you can ovulate from one side for many months before your alternative side releasing an egg. As for IVF if you go down that path having only one tube or 2 will not efect the chances of IVF been successful. The only thing is IVF does increase your chance of ectopic pregnancy but that is for everyone not just those who have had an ectopic pregnancy before.

Let me know if there is anything else you want to know. I'll be thinking of you xxx

My surgery was keyhole under GA and much like frog described, although it wasn't done on an emergency basis and they managed to save my tube.

My physical recovery was pretty quick and I'm pretty sure AF was back by about the 6 week mark. I was back driving again the day after my surgery but TBH I don't recall whether that was because I didn't have a choice and so disobeyed dr's orders (I was living on my own) or if it was ok. My partner at the time was living overseas and the pregnancy had been unplanned so resuming TTC was not something I asked about.

I had some issues with scar tissue over the next few years and whenever I O'd from the right side it hurt like hell. I had another keyhole surgery where they went in and decided they could do a scraping and clean it up a bit rather than remove the tube. I was told however that my chances of conceiving from that side were pretty slim, basically non existent. I've had 10 pregnancies all up and know for a fact that Miss A was conceived after I O'd from the right ovary.

The O'ing pain did decrease but never disappeared.

Good luck for your surgery today. Will be thinking of you

ETA: Physically it was worse than a D&C for me. I felt quite bruised and battered afterwards and for a couple of days. The GA was also a lot heavier for the ectopic than it was for the D&C, and so that will likely leave you feeling a lot groggier and a bit off for a couple of days, depending on how you cope with GAs.

HTH

I too have found I have a lot of pain on my left side when Both ovulating and with AF. Funny thing with me however is my ectopic was the right side and with it I had left sided pain which apparently happens (pain in the opposite side to where the problem is)

Thanks for all your input. I was reading it heading into surgery & it helped. The doctor removed the right tube. He said he used to try to just remove the pregnancy and save the tube, but found it caused scarring and reocurring ectopics. It went relatively quickly and I went home 3.5hours after surgery.

today is 4 days passed surgery and I woke up feeling fine. Which means I overdid things and now I feel terrible. It may be because I've run out of panadeine forte and AF arrived with a vengence. I dont feel well enough to drive yet. The biggest thing is not being able to bend down or carry things, so I cant even put a load of washing on. DH is home this week which is great but he's away next week so I hope I am able to do more things then.

as the physical pain improves, the emotional pain is kicking in. We lost another baby and part of my fertility. It just sucks. I feel like I cant do anything right.

L&B life has been so cruel to you over the last few years. Saying I am so sorry just doesn't cut it. I'm hoping like hell for you that you get to take your baby home soon. Thinking of you xxx

L & B, I haven't been on for so long. In fact I smiled when I saw your name with moderator underneath it. I'm so sorry you are going through this..........

Mildez - can i ask you about an incision scar as I cant really ask the doctor. The right side hurts like I've been stabbed/punched. I had the stitches out 3 days after surgery and the nice plastic thingies replaced by little strips of gauze. They dropped off about day 4 and I put some of those waterproof bandaid things over 3 of the incisions. I took them all off tonight. The right one still doesnt look completely closed so I've put another bandaid thingy over it. It's not a big one so I'll replace it tomorrow. The other incisions look ok.

should i be worried or make an appt with the doctor soon? Or is this normal? I'll be 10 days post surgery tomorrow.

I think it sounds ok. It sounds like the skin is not closed properly so you can probably see the layer underneath the skin maybe which does happen. It should heal normally still just take a little longer. You will have internal stitchers also. As for the pain if it seems to be getting worse not better you should get that checked out. Got to run to work.

Thanks Mildez. That sounds about right. The pain is actually getting better. I'm just overdoing it which is making it worse.