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Diagnosed with complex endometrial hyperplasia. Atypia and endometrial polyp removed. Suggested hysterectomy. Help?

Mar 2016
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Practicing since : 2011
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I am a 54 year old white woman who had a d&c 3 weeks ago. I have been diagnosed with complex endometrial hyperplasia with atypia and an endometrial polyp was removed. My doctor is recommending a hysterectomy involving the removal of my cervix, uterus, 2 ovaries and fallopian tubes. It would be an abdominal procedure because I am 120 pounds overweight and I had a slow recovery from the d&c. I also have had 7 polyps removed during a colonoscopy in 2012. And a benign adenoma was found. In addition I also have a adenoma above my adrenal gland that has remained the same size for the past year. It was an incidental finding but is now monitored with a yearly cat scan. I feel that with my history and the fact that my 83 year old Dad has survived 3 types of cancer, colon cancer in the sigmoid, bladder cancer and prostrate cancer and my younger brother has survived stage 1 stomach cancer that my most prudent decision would be to have the hysterectomy at the end of August which is 6 weeks from my d&c. I also had a d&c 4 years ago and was diagnosed with endometrial hyperplasia and no cancer was found. What would you recommend if I were your patient?
Posted Fri, 23 Aug 2013 in Vaginal and Uterus Health
Answered by Dr. S Patra 57 minutes later

Thanks for writing to us on Healthcare Magic. Following is my comment regarding your query:

With positive family history for different types of cancer among first degree blood relations, you have always risk for development of endometrial carcinoma in future from current uterine pathology. Presence of complex endometrial hyperplasia with atypia has higher chance for that.

In this circumstance, best and definite treatment option is total abdominal hysterectomy with removal of both sided ovaries and fallopian tubes (TAH + BSO). It is the gold standard choice in your age (54 years). This will eliminate certain risks of future cancer. Here, I would also give you the same recommendation.

Kindly, consult with your gynecologist to proceed the necessary investigations to complete the operation at scheduled time.

After that, you can opt for hormone replacement therapy (HRT) for few years to eliminate post menopausal symptoms. Other supportive treatment may be needed.

Hope, it helps for your information. If you have any other query, you can freely ask me.

Wish your good health and take care yourself.

Dr Soumen
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