Report Showed Complex Endometrial Hyperplasia Without Atypia. Suggest Treatment?
Follow the guideline.
Detailed Answer:
Hello,
Thanks for writing to us on Healthcare Magic. Followings are my comments regarding your query:
First thing, positive family history of cancer among first degree blood relations has always greater risk for development of endometrial carcinoma in future from current uterine pathology.
If untreated, about 10% patients will progress to endometrial cancer in presence of Complex Endometrial Hyperplasia without Atypia
TREATMENT: Progesterone therapy can be started initially with above uterine pathology to regress endometrial hyperplasia to some extent.
However, best and definite treatment option is total abdominal hysterectomy with removal of both sided ovaries and fallopian tubes (TAH + BSO) in women who have completed her family. It is the gold standard choice in your age (45 years). This will eliminate certain risks of endometrial cancer in future.
Kindly, consult with your gynecologist to proceed the necessary investigations to complete the operation at scheduled time. In the mean time, you would take progesterone as mentioned above and iron supplements to correct anemia.
After that, you can opt for HRT) for few years to eliminate post menopausal symptoms.
Hope, above information is quite helpful to you. Let me know, if you need any clarification.
Wish your good health and take care yourself.
Regards,
Dr Soumen
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Definite treatment is hysterectomy.
Detailed Answer:
Hello,
Thanks for follow up query.
1) Your first treatment option is progesterone supplement to regress endometrial hyperplasia to some extent as it is without atypia at present.
With above presentation, I prefer to treat my patients by medroxyprogesterone acetate (MPA) initially. You can consult with your gynecologist regarding this.
However, definite treatment is hysterectomy (TAH + BSO) to eliminate future risk of endometrial carcinoma. It is mandatory in your case and you have family completed.
2) Endometrial hyperplasis is needed to monitor closely at periodic interval till you have undergone the operation.
Best method of monitoring is Trans vaginal ultrasound scan with endometrial biopsy through D & C. Pap smear test is required on yearly basis.
Hope, I have answered your query. If you do not have any other query, you can close the discussion.
All the best. Good luck.
Regards,
Dr Soumen
Details are below.
Detailed Answer:
Hello,
Thanks for your additional queries.
Endometrial ablation is a technique which is used to destroy uterine lining tissue when patient does not want hysterectomy or typical indication is not obtained. It is an alternative and temporary procedure to hysterectomy.
It is quite effective (about 80%) in treating endomerial hyperplasia or abnormal uterine bleeding. However, it may recur and more than 20% patients require hysterectomy additionally.
Endometrial tissue is not viable soon after undergoing ablation as it is already destroyed. However, it should be monitored at 6 months interval through above tests to check any type of hyperplasia (recurrence) or growth to exclude relative risk.
Hope, I have cleared your all doubts. Be well & stay healthy.
Regards,
Dr Soumen