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Trans-vaginal ultrasound showed anteverted uterus with heterogeneous masses, endometrial polyp with an undetected ovary. Is hysterectomy advisable?

case is 50 years old . Transvaginal ultrasound has following results : 1. uterus size is 7.81 x 6.48 x 5.84 cm ( anteverted) abnormalities : 5 well circumscribed heterogenous masses : M1- posterofundal intramural with subserous component 4.13 x 4.83 x 5.01 cm M2- left posterolateral intramural with submucous component 2.05 x 1.99 x 2.10 cm M3- left posterolateral intramural with subserous component 1.41 x 1.24 x 1.52 cm M4- anterofundal intramural 2.21 x 2.08 x 2.39 cm M5 - anterior lower segment subserous 1.18 x 0.91 x 0.91 cm 2. Endometrium : 2.6 mm linear Abnormality : Within the endometrial cavity is an echogenic structure measuring 1.04 x 0.75 x 0.54 cm suggestive of an endometrial polyp 3. Ovaries : Normal right ovary . Left ovary not visualized Question : Should I undergo hysterectomy . LMP is Dec 2011
Asked On : Mon, 16 Jul 2012
Answers:  1 Views:  297
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OBGYN 's  Response
Hello dear,

The most important factor that decides the need for hysterectomy is symptoms. If you are having any symptoms, then you have two options - medical and surgical.

Since you are 50 yrs, you must be about to reach menopause, or may have already attained it, you can opt for medical treatment. You will be given monthly or weekly injections, which will relieve you of symptoms, but they will not treat the fibroids. The fibroids will still be there, but they will not cause any symptoms.

If you are symptomatic you may also opt for hysterectomy. If the ovaries are found normal at the time of surgery, then opt for preservation of ovaries.

One important thing, if you go for medical treatment, then you must get the polyp removed by D&C and get a histopathology done. The polyp may be hiding some malignancy.

Hope I have answered your query.
Take care.
Dr Juhi
Answered: Mon, 16 Jul 2012
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