Treatments and Outcomes of Endometrial Hyperplasia in Bangkok Metropolitan Administration Medical College and Vajira Hospital

Abstract

Treatments and Outcomes of Endometrial Hyperplasia in Bangkok Metropolitan Administration Medical College and Vajira Hospital

Anusorn Triwitayakorn MD

Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital

Objective: To study the types of treatment and their outcomes in patients with endometrial hyperplasia in Bangkok Metropolitan Administration Medical College and Vajira Hospital.

Study design: Retrospective descriptive study.

Subjects: One hundred and forty-two patients with histologically proved endometrial hyperplasia attending endocrine clinic, Department of Obstetrics and Gynecology, BMA Medical College and Vajira Hospital during January 2002 to December 2006 were enrolled.

Methods: Medical records of the enrolled patients were retrospectively reviewed. Data on types of endometrial hyperplasia, treatment options and at least one-year treatment outcomes were analyzed and reported.

Main outcome measures: Types of endometrial hyperplasia, treatment options and outcomes.

Results: Approximately seventy-seven percent of the patients had simple hyperplasia without atypia and were treated with cyclic progesterone therapy or expectant after curettage. The major treatments of complex hyperplasia without atypia were cyclic progesterone therapy or hysterectomy. Most patients with both simple and complex hyperplasia with atypia underwent hysterectomy. Recurrence of abnormal uterine bleeding was observed in 54.2% and 30.3% of the simple hyperplasia without atypia patients who had expectant and received cyclic progesterone therapy for 6 months, respectively.

Conclusion: Treatment options of endometrial hyperplasia should be tailored to individuals according to types of endometrial hyperplasia, age and desire for pregnancy. Cyclic progesterone therapy with long-term follow up until menopause is mandatory to prevent the excessive uterine blood loss, repeated curettage and the progression to carcinoma.

Vajira Med J 2008 ; 52 : 15 - 22