Hi, If Both Ovaries Are Unremarkable In Appearance But A

Hi, if both ovaries are unremarkable in appearance but a 2.5cm anechoic follicle is present in the left ovary. Together with likely adenomyosis (bulky and heterogenous uterus esp. posterior uterine wall) and 2.1cm intramural fibroid in the left anterior wall which does not affect the endometrium, is there a need for total hysterectomy with bilateral removal of ovaries? Patient is 50 years old