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Dr. Andrew Rynne

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Exp 50 years

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How long does the hysterectomy operation for atypical endometrial hyplasia ademoysis last ?

im 31 im having a hysterectomy in 3 weeks for atypical endometrial hyplasia ademoysis. I have a cervical prolapse. I have pcos and non pcos ovarian cysts . The consultant has asked me to think whether i want to keep ovaries or not. All the articles i have read say ovaries should be removed. I have been told mine produce mininmal progesterone and excessive estrogen. Also when i had my hysteroscopy they said i was suitable for vag hysterectomy when it was thought only polypoid endrometrium will this still be the case if so how long should i expect to be in theatre. only found out tues def hysterectomy got date for op 2 days later so no chance to ask questions yet.
Mon, 16 Jan 2012
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OBGYN 's  Response
Hi ,
In case of atypical endometrial hyperplasia if you have completed your family then ideally the ovaries should be removed.You are only 31 that's why your doctor must have asked you to decide as it will cause premature menopuse but in my opinion NDVH (non descent vaginal hysterectomy ) or TLH ( total lap hysterectomy ) with bilateral salpingoopherectomy (BSO) should be done.
Best wishes
Take care
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Anonymous's  Response
Sorry Im New to all this can someone tell me these types of hysterectomys are done. the NDVH TLH BSO.
OBGYN Dr. Minoo Bhagia's  Response
NDVH is non descent vaginal hysterectomy means you remove the uterus , cervix and if required ovaries also from vaginal route .In this case it is not necessary to have prolapse
and VH is vaginal hysterectomy done for prolapse with repair of the pelvic floor.
TLH is total laparoscopic hysterectomy done from the abdominal route with the help of laparoscope.In NDVH there are no marks on abdomen.In TLH there will be port marks.
BSO is bilateral salpingoopherectomy means when you remove ovaries and adenexae along with uterus and cervix.
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doctor1 MD

Dear Dr. I am so glad I found you website. I am struggling with adecision whether or not I should go for a hysterectomy and really happy that Ican ask your advise from this website. Thank you so much for offer such greatservices. It is so thoughtful. Here is my history. I was always bleeding since my first period. In2002, I was diagnosed as endometrial hyperplasia with atypia. Becauseof my strong desire to have a baby, my Dr. put me on progesterone treatment and wasfollowed up by D & Cs and biopsies. After many months on 200mg progestrone , the hyperplasia was controlled but as long as I was not on progestrone, I would bleeding irregular again. Iwas monitored very closely in the past years with biopsy and D & Cs. The sample of endometrium of those biopsies showed complex hyperplasia a few times, simple hyperplasia a few times and the best time was Proliferative endometrium. None of them with atypia. Meanwhile, I was struggled with fertility treatment. I was pregnant from my 3rd IVF cycle in 2007but sadly lost my twin babies at 20 month due to prelabour. I kept bleeding after delivery and a biopsy 4 months later showed complex hyperplasia without atypia. In 2009, I did mylast IVF cycle and that results my daughter. Again, I kept bleeding after delivery.A biopsy at 2 month check up after delivery showed complex hyperplasia again no atypia. I was then put on prometrium but a oncologist suggest a D & C . I stopped prometrium right away and did the D & C a week after. Since i only stopped prometrium for about a week, the results should be distorted. The results showed no hyperplasia at all. My Dr. was not sure how much the prometrium might have distort the results. Anyway, as no hyperplasia was found in D & C, I was put on Marina IUD to prevent it. I kept spotting for 5 months after that. I asked for a biopsy so they took off the IUD and did a biopsy in the same day. Results shows no hyperplasia and my lining responsed to the drug from IUD well. But again, I am worried that doing a biopsy at the same day that IUD is off may covered the real situation of my uturs. I am not sure if i should make a decision based on that biopsy result. It was a year ago. Anyway, I was then put in another IUD. This time I kept spotting for 9 month. even now, the continue spotting stopped 3 months ago, but I still have spotting for a day or two sometimes. My Dr. said it may because I am a little person and the progestrone supplied by IUD is too large dose for me. Since I am done with having more baby, My Dr. gave me two options: 1: continue prevent hyperplasia with IUD. They said theoretically it should work but no 100%guarantee. Bad side is they can t do a regular biopsy check up with a IUD in. 2: hysterectomy. I am 41 this year. My last biopsy was a year ago ( when they took off the first IUD), the result showed no hyperplasia. In your opinion, shall I do a hysterectomy? Is IUD proved work well for control hyperplasia? Is it normal to spotting that long with IUD ? Sorry for the longmail. Thank you so much for your time and again I really appreciate yourthoughtful service. I am looking forwardto hear from you.

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