Organ preserving method in the management of atypical endometrial hyperplasia

The problem of organ preservation in the management of atypical endometrial hyperplasia (AEH) comes about especially in patients of reproductive age. Two hundred and fifty-four women with a diagnosis of AEH were hospitalized in our clinic from the period 1991 to 2000. Of those, atypical endometrial hyperplasia with normal uter and appendages was found in 192 women. The remaining 62 patients had diseases of the cervix, corpus uteri, ovaries and oviducts and were subjected to radical hysterectomy. To define the possible sparing tactics of management, 192 women with AEH were divided into two groups. The patients in Group were administered hormonal therapy during a three month period (17alpha OPC - 12.5 g, Depo-Provera - 6 g). If a clinical effect and histological pathomorphism were achieved the patients were subjected to an additional three months of hormonotherapy. Of a total of 96 patients in the first group, 36 (37.5%) who were prescribed hormonotherapy were found to also have mastopathy and endocrine pathology dysfunction of the thyroid gland, and were additionally administered iodine-containing preparations. After completion of the effective hormonotherapy three patients had a normal pregnancy and delivery. Conservative management proved to be effective in 96.4% and ineffective in seven (3.6%) cases. These seven patients were subjected to surgical treatment. All patients in Group 2 were subjected to radical hysterectomy.