|Discussion in 'All Categories' started by asha bajaj - Apr 5th, 2014 1:35 am.|
|I am 53 year old female . I had undergone surgery for pituitary adenoma with acromegaly in jan 2006 followed by my menopause in 2006 itself. after which I had experienced bleeding in july 2013 only in form of mild spotting but since jan 2014 I am having bleeding episodes at irregular intervals. I have consulted a gynaec who advised me to take PRIMOLUT-N ie levonoestrogen twice daily for pd of 21 days intervals since august 2013.
so I would like to take your advise whether hysterectomy is compulsory in my case, what are the other alternatives if I don't want surgery and what it is the time duration required for recovery post surgery and complications associated with this disease
re: simple endometrial hyperplasia without atypia by Dr.J S Chowhan - Apr 5th, 2014 3:57 am
Dr.J S Chowhan
|Dear Asha Bajaj
The post menopausal bleeding is associated with high risk of cancaer,you must get Endometrial biopsy done.If biopsy is negative then Hystrectomy is the treatment,if the biopsy is positive then the treatment is again surgical. Surgical treatment should consist of, at least, cytologic sampling of the peritoneal fluid, abdominal exploration, palpation and biopsy of suspicious lymph nodes, abdominal hysterectomy, and removal of both ovaries (bilateral salpingo-oophorectomy). Lymphadenectomy, or removal of pelvic and para-aortic lymph nodes, is sometimes performed for tumors that have high risk features, such as pathologic grade 3 serous or clear-cell tumors, invasion of more than 1/2 the myometrium, or extension to the cervix or adnexa. Sometimes, removal of the omentum is also performed.
Women with endometrial cancer should not have routine surveillance imaging to monitor the cancer unless new symptoms appear or tumor markers begin rising. Imaging without these indications is discouraged because it is unlikely to detect a recurrence, improve survival, and because it has its own costs and side effects.
Abdominal hysterectomy is recommended over vaginal hysterectomy because it affords the opportunity to examine and obtain washings of the abdominal cavity to detect any further evidence of cancer.
Women with stage 1 disease who are at increased risk for recurrence and those with stage 2 disease are often offered surgery in combination with radiation therapy. Chemotherapy may be considered in some cases, especially for those with stage 3 and 4 disease. Hormonal therapy with progestins and antiestrogens has been used for the treatment of endometrial stromal sarcomas.
Dr J S Chowhan
World Laparoscopy Hospital
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