Treatment of Atypical Endometrial Hyperplasia in a Woman Not Wishing to Preserve Fertility
Clinical Scenario
This protocol applies to women with atypical endometrial hyperplasia who do not wish to preserve fertility and are suitable candidates for surgery.
Why Surgical Management Is Recommended
Atypical endometrial hyperplasia carries a significant risk of underlying malignancy or progression to cancer. When fertility preservation is not desired and the patient is surgically fit, this risk warrants a definitive surgical approach rather than conservative management.
Approach (partial — full protocol required)
Surgical removal of the uterus is the recommended treatment, with a preferred minimally invasive technique; additional procedures may be indicated depending on menopausal status. Full detail on the specific operation, approach selection, and intraoperative decisions is in the complete protocol.
References
- Women with atypical hyperplasia should undergo a total hysterectomy because of the risk of underlying malignancy or progression to cancer.
- A laparoscopic approach to total hysterectomy is preferable to an abdominal approach as it is associated with a shorter hospital stay, less postoperative pain and quicker recovery.