Dr. Mavani Jimesh Himatbhai
Obstetrics and Gynecology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My mother is facing pain at periodical time since 6 months and period facing two times in a month and it remains for 4 to 6 days. Although she never faced this situation before. My mother's age is 52 years now. What should she do now. Already visited two gynecologist and they advised us to prepare for operation. As per their instruction checked the ultrasonography test, acknowledged us about the ovarian tumor and advised us for immediate operation. And we also checked the blood pressure, ECG , chest X-ray, thyroid, HIV test. Everything is fine except blood sugar and blood pressure. Now blood sugar and blood pressure are under control, physician also prescribed tablet Astyfer (400) for pressure and Insulin for blood sugar applying for 4-6-4 units (BB-BL-BD) per day, it is running since 10 days.
The first gynecologist prescribed Trapic 650 for 5 days (1 per day), Protera 40 for 14 days (1 per day), and syrup Inozyme for 7 days (2 times per day). Next time, he also prescribed the Trapic 650 for 5 days and Protera 40 for 5 days and Metformin SR (1000) for 14 days (1 per day) also, and advised us to visit after 2 months for next checking. But we decided to check up another gynecologist after 45 days later of the last gynecologist visit. The second doctor advised us for operation and also prescribed for test of blood sugar, thyroid, ECG, chest X-ray, HIV, reports also attached. He prescribed tablet Stamlo (5), Zentel (400) 1 tablet, Astyfer XT for 20 days (one tablet per day). Astyfer is running now. I request you to kindly check the attached report and advise me what to do now.
Hello,
Welcome to icliniq.com.
From your history, it is obvious that your mother definitely has to go through the operation and remove the uterus. However, one thing is that there is nothing I found like ovarian tumor or something like that in USG (attachment removed to protect patient identity). I have seen all the reports except first which is not loading. Menses normally ceases at around 40 to 45 years of age or sometime it may extent up to 48 to 50 years of age. So if your mother is menstruating up till 52 years of age with USG suggestive of fibroid uterus with adenomyotic changes, your mother must have to remove her uterus and send for the examination that whether there is carcinoma or not. And if not then nothing to worry. And if positive then may need another operation or chemotherapy.
In your mother's case if carcinoma is there, there are more chances that it would be endometrial carcinoma or adenocarcinoma of uterine muscles. I do not know how there is a doubt about ovarian carcinoma. And if there is chance or good reason for suspecting than than your mother must have to do CT scan of abdo pelvis and some other blood test also. Rest of the test which are done is prerequisite for operation. Mostly they will remove ovaries also along with the operation at the same time, as there is a chance of ovarian carcinoma in future. And during past life and at 52 years of age there is also no role of ovaries remain. Before operation the sugar level and blood pressure should be under control so what they are giving you. And physician fitness and/or anesthetic fitness will required before operation. So better to get it done as early as possible. It is because if there is endometrial carcinoma also than why to give it a chance to grow. It is better that you remove it on first place.
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Obstetrics and Gynecology
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