My personal opinion, if you are not having symptoms with using the vinegar, I would say, no surgery. "Natural" things are always better than medical intervention, if it works. I am a believer in alternative methods which have proven success. Surgery puts you at risk for all kinds of things and no matter what, your body won't be the same again.
As an RN, I know that intervention, whether medical or surgical is not always "optional" and is necessary for so many things, but the longer you can get by, the better. Surgery can put you at risk for complications of anesthesia, blood clots, adhesions, bleeding, infection and pain, etc.
In my opinion, IF you go the surgery route, I would say, have a complete hysterectomy, not leave the ovaries, at your age of 46, you are nearing menopausal age anyway. Removing the ovaries improves chance that you won't develop ovarian cancer down the road, especially if anyone genetically related to you has ovarian or breast cancer, which can be hormonally related.
In my oncology experience, I have seen several ovarian cancer patients who had "partial hysterectomies" to save the ovaries because their GYN talked them into it to stave off the effects of early menopause. Ovarian cancer is not a disease of the elderly, I know plenty of women who were diagnosed in their 20's and 30's.
Vinegar has many great purposes besides medicinal or cooking. Though I don't currently know the name of it, there is a great book about vinegar and it's uses.