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Cystic ovary, heavy bleeding, overweight. Surgery advised. Complication of hysterectomy?

I am 48 and have had 5 children. I have a 10cm complex cyst on my right ovary . CA125 tests are normal. No fibroids . Surgerical removal has been scheduled. After signifucant pain in my left abdomen my period began early with profuse bleeding - filling 2 nightime pads layered plus a super tampon just during the 10 minute ride to the hospital. I suspected a tubal pregnancy, but pregnancy test was negative. A transvaginal ultrasound revealed a lumpy uterus, 6mm endometrial lining (this was during my period however). During my follow up visit i had a biopsy of the endometrial lining, which revealed polyps. Due to the intense pain from the attemots to insert the probe beyond my cervix i was unable to complete the saline injectuon into the endometrial cavity - i found it excruciating, even though I took an oxycodone pill beforehand (left over from a previous sugery - the obgyn would not prescribe me one pill, even thoughI have a very low tolerance to pain. So, we do not know hiw many polyps. The obgyn is recommending a hystorectomy since i will need sugery for the cyst anyway. I am 100 lbs overweight and am concerned about surgery. Franklt, since lathroscopy involves blowing air into the abdomen, how can they do thus with belly fat in the way? Secondly, while my insurance is good i cannot afford to miss a week or two from work since i am the main breadwinner now. Given these concerns is a hysterectomy still advised?
Asked On : Wed, 27 Mar 2013
Answers:  2 Views:  36
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OBGYN 's  Response
Mar 2013
Thanks for your query.
Firstly, you should go for the endometrial biopsy under anesthesia, so that the procedure is completed.
If the biopsy shows pre malignant changes, hysterectomy is advised.
Also, for intractable bleeding that does not respond to medical management, hysterectomy is advised.
Laparoscopy is a safer alternative, though it is more difficult in overweight people compared to normoweight patients.
Once the air is blown into the abdomen, the fat falls away and the structures inside are visualized.
take care.
Answered: Sat, 20 Jul 2013
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General & Family Physician Dr. Vidya KR's  Response
Hi, Thanks for using HCM.

As your endometrial thickness is 6mm during menstruation, there are polyps in it. and your age is in perimenopausal stage. better to get hystrectomy done.
Laproscopic procedure is advisable, as there will be reduced hospital stay and you can resume to your work early.
Even ovarian cyst can also be managed in a single procedure.
Consult your doctor for examination and management.
Hope I answered your question. Feel free to ask me if you have any further queries.
Wish you good health. Take care.

Dr. Vidya
Answered: Sat, 20 Jul 2013
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