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Respected Madam I am 70. Although you are very busy. Will you kindly help me with your suggestions My Sister, Patient Age -46, Suffering from Endometriosis along with Suspected Adenomyosis (?) ,ALTHOUGH AS PER USG REPORT NO ABNORMALITY IN UTERUS 1) Patient now Asymptomatic, Presently /Practically not much of a Problem 2) Tablet Endosis was taken for 6 months. 3) Two doctors have advised Hysterectomy, One doctor not agreeing. 4) .As there is not much of a problem now, if left in this condition whether the disease can worsen and lead to bigger problem 5) Hysterectomy with bilateral oophorectomy is the last line of treatment for endometriosis. The treatment usually depends upon the severity of the symptoms. If patient is asymptomatic then whether OPERATION is required 6) Once she attains menopause gradually whether the disease will become dormant because of lack of hormones 7) Whether Moderate Endometriosis can be treated with medication at this age 8) What is this Adenomyosis, Is it a tumour (?). As per my knowledge in Adenomyosis tissues/growth are inside the uterus and in endometriosis it is outside of the uterus 8) Whether Hysterectomy is a permanent cure for Endometriosis. 10) But Cyst size has Increased as seen from last USG report compared with last but one report? Comparison of Last Two USG Reports LAST REPORT LAST BUT ONE REPORT endometrial Thickness 8.3 mm 7.1 mm Right Ovary Normal 22X16 Normal Left Ovary Greater than 35X25 (45 X) Greater than 35X25 Left Ovary Contains Chocolate Cysts Cyst Size 28X24 23X23 As Hysterectomy with bilateral oophorectomy will have forced Menopause it may have side effects like hot flushes etc Any medication that can be taken now to remove slight uneasiness in abdomen With thanks and regards.

2 Doctors Answered
Better she goes for hysterectomy with bilateral ooherectomy as the problem can worsen if menopause is delayed for her. She will be relieved of her problem.
At46 with increasing cyst size and symptoms hysterectomy is a final solution howvever conservative mgt with dinoegest maybe tried for relief and that pt is perimenopausal.
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