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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Do The Findings In Cone Biopsy And Ultrasound Suggest And How To Treat This Condition?

I am going to try and make this short as possible. I am 37 and have been having long cycles with blood clots, some very large. For this reason I went to the Dr. My cycles last the majority of the month. Basically my body is in reverse. I have a cycle for two weeks (if not three), no cycle for one week (or less) and then start for two more weeks if not three. I do have in between spotting as well. This has been going on for 5-8 months. When I am asked the last day of my last cycle I can’t answer it because I am so irregular and all the bleeding in between causes me to not know if it is a true cycle or not. Confusing!! I have had many apt and biopsies here is where I am at. Intimacy is pretty much impossible at this point due to all the blood and it does cause pain as well. I am even having trouble using tampons due to discomfort. Birth control pills have not helped at all!!! The pain is so bad I am left bent over until it stops.

My plan was to have a small procedure done to burn the lining and make it stop. Also making me not fertile but this is ok, I do not want more kids. Due to the cone biopsy results I was told I can no longer have the smaller procure. After much talk it came to here are my option- hormone treatment (NO WAY) or hysterectomy. Hormone treatment is not an option. I tried everything for years in my 20’s when I was having issues and nothing worked, side effect, I was a hot mess full of fluctuating homers and crying etc. I never want to go through that ever again.

Cone Biopsy Findings: Endometrial Hyperplasia and my cells are stacking on top of one another as well not just growing side by side. No Cancer so this si GREAT. At first they thought they found pre cancer but after another biop they found no cancer.

Ultrasound: Done but have not seen Dr to have results explained. What I do know is my right ovary measures 1.90 ml volume and left is 12.97 ml volume. The only thing I do know is ovaries do vary from left to right in size but should not be more than a 2-1 ratio.

My questions:

Based on ultrasound ovary size differences is it odd to have such a massive size difference? This is more then a 2-1 ratio

Could this size difference be part of the problem or the entire problem?

Why is an ablation not an option just because I was said to have Endometrial Hyperplasia?

We jumped from ablation to hysterectomy just based on that. I will take part that I refuse to take hormone therapy.

Wed, 15 Jan 2014
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,
First I will discuss about the ovaries.
Yes, there is lot of discrepancy between the size of two ovaries.
The size of left ovary is very much larger than the right ovary.
A large sized ovary is seen in cases of cystic change in the ovary or in cases of malignancy.
The ultrasound will throw light of cause of ovarian enlargement.
Ovarian neoplasms can cause abdominal distention when size is very large and menstrual irregularities.
Benign cysts are common in ovaries and do not require any interference till symptoms appear.
Malignancy has to be ruled out.
However, in your case it appears that endometrial hyperplasia is the cause of menstrual irregularities and not ovarian neoplasm.
If you have completed your family, hysterectomy is the best option because chances of cancer or malignancy are high in cases of endometrial hyperplasia.
Hysterectomy is a permanent cure for the abnormal bleeding.

Thanks and take care
Dr Shailja P Wahal
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What Do The Findings In Cone Biopsy And Ultrasound Suggest And How To Treat This Condition?

Hello and welcome to HCM, First I will discuss about the ovaries. Yes, there is lot of discrepancy between the size of two ovaries. The size of left ovary is very much larger than the right ovary. A large sized ovary is seen in cases of cystic change in the ovary or in cases of malignancy. The ultrasound will throw light of cause of ovarian enlargement. Ovarian neoplasms can cause abdominal distention when size is very large and menstrual irregularities. Benign cysts are common in ovaries and do not require any interference till symptoms appear. Malignancy has to be ruled out. However, in your case it appears that endometrial hyperplasia is the cause of menstrual irregularities and not ovarian neoplasm. If you have completed your family, hysterectomy is the best option because chances of cancer or malignancy are high in cases of endometrial hyperplasia. Hysterectomy is a permanent cure for the abnormal bleeding. Thanks and take care Dr Shailja P Wahal