Understanding Your Pathology Report in Simple Terms
What Was Removed
Your surgery removed your uterus, cervix, both ovaries, and both fallopian tubes 1.
Uterus Size: Normal
- Your uterus weighed 119 grams and measured 8.6 x 7 x 5 cm 1
- This is within normal size range for a uterus with fibroids—not enlarged 1
- For comparison, a truly large fibroid uterus can weigh over 3000 grams and measure 25+ cm 2
The Fibroids (White Nodules)
You had multiple benign fibroids ranging from 0.7 cm to 4.6 cm in size 1:
- These are non-cancerous smooth muscle tumors that grow in the uterine wall 3, 4
- The pathologist describes them as "white, whorled nodules"—this is the classic appearance of benign fibroids 1
- Importantly, there was no necrosis (dead tissue) or hemorrhage inside the fibroids themselves, which is reassuring 1
The Hemorrhagic Myometrium: What This Means
The largest fibroid (4.6 cm) was surrounded by hemorrhagic myometrium—meaning bleeding in the normal uterine muscle around it 3, 5:
- This hemorrhagic change is commonly seen with fibroids and likely contributed to your heavy menstrual bleeding before surgery 3, 5
- Fibroids disrupt normal blood vessel architecture in the uterus, creating abnormal venous drainage patterns and increased local blood flow 3, 5
- The excessive extracellular matrix production by fibroids affects uterine wall contractility and can cause venous congestion, leading to this hemorrhagic appearance 4
Other Findings
- Thin endometrial lining (<0.1 cm): Normal, especially if you were perimenopausal or postmenopausal 1
- Intraoperative defect (1.2 cm): Expected surgical opening from the procedure 1
- Serosal fibrous adhesion (0.6 cm): Small scar tissue on the outer surface, likely from previous inflammation or surgery 1
Clinical Implications Post-Hysterectomy
Since you've had a complete hysterectomy with bilateral salpingo-oophorectomy, you have achieved definitive resolution of all fibroid-related symptoms 1:
- No risk of fibroid recurrence since the uterus has been removed 1
- The hemorrhagic myometrium finding explains your preoperative bleeding symptoms but has no ongoing implications now 3, 5
Important Long-Term Considerations
Be aware that hysterectomy with ovary removal carries specific long-term health risks that require monitoring 1:
- Increased cardiovascular disease risk 1
- Elevated risk of osteoporosis and bone fractures 1
- Potential increased dementia risk 1
- Discuss hormone replacement therapy options with your physician if you were premenopausal at surgery 1
Bottom Line
Your pathology shows a normal-sized uterus with multiple benign fibroids and bleeding in the surrounding muscle tissue—all consistent with symptomatic fibroids that were appropriately treated with hysterectomy 1. No cancer or concerning features were identified 1.