Brief Answer: Decision is yours. Detailed Answer: Hello and welcome, I understand the query very well and it is a common question asked by many patients in my clinic too. My advice to them always is that it all depends on your risk bearing capacity and desire to keep the uterus. The risk of endometrial cancer in simple hyperplasia is very low. So if you feel that the risk is low and are willing for repeated follow ups and biopsies then you may wait and take drugs. Some women feel that they do not want to have any risk at any cost. For them hysterectomy is a good option. We keep the ovaries if they desire. The function of the uterus after menopause is zero. Removing or keeping it does not have any effect on the body. The only issue is that every surgery however skilled the person performing it may be, makes changes in the body. Hysterectomy is a routine but major surgery. So some aches and pains may be there in few women. Hence the decision must come after balancing all the probabilities. The advantages of surgery are that you will not have to worry about the hyperplasia any more. You can take HRT if needed without fear of endometrial cancer. The disadvantages are, it is a surgery and may bring some aches and pains and some complications inherent to the surgery. Uterus will not be there [ not that it makes a difference but some women are not comfortable with this idea]. So first introspect about what you want. Then discuss it with your doctor and then make a decision. We can but guide you about the pros and cons. When I worked in a rural setup I always preferred a hysterectomy in every women with hyperplasia irrespective of the presence of atypia as they would otherwise be lost to follow up and I did not want them to be exposed to the risk of cancer. In the urban setting now, I always provide an option if the patient is willing for follow up. Hope this was helpful. Feel free to ask any further queries and I will be happy to help. Thanks for using HCM. Have a good day. Dr Nilajkumar Bagde Consultant Obstetrics and Gynecology

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Brief Answer: Explained in details Detailed Answer: Hello and welcome back, I personally do not do robotics but do conventional laparoscopy in India. However I can say that robotics is still evolving. The techniques are new but promising. It offers more precision in surgery and greater freedom to the surgeon to perform surgery as compared to laproscopy. So difficult surgeries can be done with greater precision. The disadvantages are similar to any other surgery because ultimately in any way the uterus will be removed. So all complications associated with hysterectomy will hold true irrespective of the route of surgery [ complications may occur in conventional open surgery, laproscopy, laproscopy and vaginal combined as well as robotics]. So there will be formation of scar tissue and the aches and pains related to surgery may be there. It is more time consuming, but this is not an issue in skilled hands. The recovery rate is similar to laproscopy. All of these issues will be discussed before you go for a surgery and clarified by your surgeon. Hope this was helpful. I am here for any further queries. Dr Nilajkumar

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