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Re: GYNECOLOGIC: Endometrial hyperplasia without atypia, Simple and Complex, plus cystic ovaries
From: Richard Chudacoff, MD (anonymous@obgyn.net)
Fri, 27 Apr 2007 17:14:25 -0500 (CDT)
In my opinion if you do not want to have the hysterectomy, which is a
fine choice, then you should at minimum have a comprehensive D&C. The
office biospy at best will sample 10% of the uterus. If the endometrial
biopsy is negative for malignancy, then you have a 3% of still having an
endometrial carcinoma. You cannot say 3% base on an in-office pipelle
curet sample. If negative then your gynecologist might want to use a
Mirena IUS since the oral progesterone did not work. Another option
would be endometrial ablation, which can also be done as an office
procedure. But remember, 3% is not 0%. As you are overweight you are
at an increased risk for endometrial carcinoma. Caught early a simple
hysterectomy is curative
At Thu, 26 Apr 2007, Toni Gandel wrote:
>
>Hello, Thank you for offering to give me your advise. I am in NO
>discomfort and want to keep my organs if at all possible. So far the
>gyno community is advising me to have a hysterectomy and oorephectomy
>but my own internet research has told me that my risk factor for this
>developing into endometrial cancer is about 2% which in my estimation is
>very small. I am 57years old (today) and was first diagnosed 1 1/2
>years ago (D & C and hystoscopy) complex endo hyperplasia without
>atypia. I rejected that gyno who wanted me to have a hysterectomy and
>found one who gave me what I wanted which was bio-identical hormone
>progesterone quantity based on hormone level checked through saliva
>testing lab and despensed through a compounding pharmacy. After 6
>months on cream I had an ultrasound which showed my ovaries were covered
>in cysts as well as the uterine lining still thicker than normal, sorry
>I don't have the exact mm, but I know it wasn't extreme, just over the
>normal range. That gyno wanted to get me into the operating room but I
>rejected and went to another gyno now who did an in office biopsy and
>this time the pathology came back not only complex but simple and
>complex still without atypia. So, I am wonding since I have been off
>the hormone for 6 months, this slight improvement maybe is just that my
>condition is improving with time and if I give it long enough it will
>just work it's way to normal. I am schedueled to have another
>transvaginal ultrasound next week. I have been to the H.E.R.S (HERS
>foundation) website and wow all of the possible miserable side effects
>of having a hysterectomy really scared me terribly but every gyno just
>wants me to have it all removed. Oh, I have just had a heavy 1 week
>bleed but that was after 11 months and being that I have no pain or
>symptoms I can certainly live with these once a year bleeds until it
>clears up. Yes, while I hate to admit it I am 50lbs overweight, 5'6"
>and 198lbs. I would very much appreciate your opinion. Thank you very
>much, Toni
--
Richard Chudacoff, MD, FACOG
Las Vegas International Center for Advanced Gynecologic Care
(Specializing in Minimally and Non-Invasive Surgery)
3150 N Tenaya Way # 270
Las Vegas, NV 89128
Tel: (702) 360-9630
Fax: (702) 228-2343
email:
richard.chudacoff@obgyn.net
rchudacoff@mylinuxisp.com
rchudacoff@deployedmedical.com
rchudacoff@lasvegasgyncenter.com
All responses are for education purposes only. They are not intended
to diagnose, treat or change treatment for any disease, condition or
medical malady. I also do not guarantee response to private emails.
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