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Does Vaginal Bleeding Require Uterus Removal In An Elderly Patient?
Posted on
Thu, 25 Jan 2018
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Thu, 25 Jan 2018
Answered on
Thu, 2 Aug 2018
Last reviewed on
Question : Hi,
My aunt is 61 years old and she is suffering from bleeding problems. She encountered menopause since 15 years. The first bleeding occurred last August 2017 and it was for 10 days. When consulted a doctor they suggested for Uterus removal. Please suggest the best that can be done.
P.S. She is diabetic and is on insulin.
My aunt is 61 years old and she is suffering from bleeding problems. She encountered menopause since 15 years. The first bleeding occurred last August 2017 and it was for 10 days. When consulted a doctor they suggested for Uterus removal. Please suggest the best that can be done.
P.S. She is diabetic and is on insulin.
Brief Answer:
Needs proper evaluation.
Detailed Answer:
Hello,
Thanks for posting your query.
At age 61, all bleeding from the uterus has to be taken very seriously. In women presenting with post menopausal bleeding, as many as 15% have pre-cancerous or cancerous changes of the uterus.
Here is exactly what needs to happen:
1. She needs a visit to a OB/GYN and an examination
2. During this exam they need to perform an endometrial biopsy and PAP smear
3. She then needs an ultrasound to look at the ovaries and the endometrial lining
If the biopsy is normal and the 'lining' of the uterus is 4mm or less, then there is absolutely no concern for cancer. In case a cancer is detected then surgical removal will be needed depending on the severity of the problem.
Of note, the most common cause of bleeding after menopause is related to the 'thinnin' and fragility of the lining of the uterus, followed by polyps of the uterus (which are common).
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal
Needs proper evaluation.
Detailed Answer:
Hello,
Thanks for posting your query.
At age 61, all bleeding from the uterus has to be taken very seriously. In women presenting with post menopausal bleeding, as many as 15% have pre-cancerous or cancerous changes of the uterus.
Here is exactly what needs to happen:
1. She needs a visit to a OB/GYN and an examination
2. During this exam they need to perform an endometrial biopsy and PAP smear
3. She then needs an ultrasound to look at the ovaries and the endometrial lining
If the biopsy is normal and the 'lining' of the uterus is 4mm or less, then there is absolutely no concern for cancer. In case a cancer is detected then surgical removal will be needed depending on the severity of the problem.
Of note, the most common cause of bleeding after menopause is related to the 'thinnin' and fragility of the lining of the uterus, followed by polyps of the uterus (which are common).
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi Doc,
The Biopsy result is negative for the patient. The first bleeding occurred on last November, it was stooped after 10 days , again it happened on the month of January.
The local doctor said after CT scan and Ultrasound that it is due to bulky uterus and suggested for a removal of the organ. Please suggest.
I have attached the reports.
The Biopsy result is negative for the patient. The first bleeding occurred on last November, it was stooped after 10 days , again it happened on the month of January.
The local doctor said after CT scan and Ultrasound that it is due to bulky uterus and suggested for a removal of the organ. Please suggest.
I have attached the reports.
Brief Answer:
Surgery can be avoided for bulky uterus.
Detailed Answer:
Hello.
Thanks for writing again.
I have seen all the attached reports. The endometrium shows cystic hyperplasia. Only bulky uterus is not an indication of hysterectomy and it does not cause a bleeding. If endometrial biopsy is normal then the bleeding can be due to fragile mucosa and the surgery can be avoided.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Surgery can be avoided for bulky uterus.
Detailed Answer:
Hello.
Thanks for writing again.
I have seen all the attached reports. The endometrium shows cystic hyperplasia. Only bulky uterus is not an indication of hysterectomy and it does not cause a bleeding. If endometrial biopsy is normal then the bleeding can be due to fragile mucosa and the surgery can be avoided.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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