Current management of endometrial hyperplasia-a survey of United Kingdom consultant gynaecologists.

Abstract

OBJECTIVE:

To determine current practice for the management of endometrial hyperplasia.

STUDY DESIGN:

We carried out a web-based survey of all UK consultant gynaecologists, from the Royal College of Obstetricians and Gynaecologists (RCOG) database, to evaluate the current practice and to enquire whether a trial between oral progestogens and LNG-IUS for endometrial hyperplasia is required.

RESULTS:

We sent 1090 email invitations and 411 (37.7%) responded to this survey. In total, 338 consultant gynaecologists, who manage patients with endometrial hyperplasia, responded to all items of the survey. The oral progestogens (33.2%) and the LNG-IUS (52.1%) were the most popular choices for managing complex endometrial hyperplasia. The majority of the gynaecologists would explore two conservative choices before embarking into performing a hysterectomy for this condition (130, 52.6%). However, for atypical hyperplasia, the majority of the gynaecologists would perform a hysterectomy (273, 83.2%) and would only consider LNG-IUS or oral progestogens as a second or third option. Two hundred forty-four (72.2%) responded that an RCT for oral progestogens versus LNG-IUS for the management of endometrial hyperplasia is required. There were 171 (50.6%) gynaecologists that would be willing to randomise in such an RCT.

CONCLUSION:

Our survey shows that complex endometrial hyperplasia is managed conservatively in UK, with oral progestogens or LNG-IUS, and atypical endometrial hyperplasia is managed with hysterectomy. An RCT, between oral progestogens and LNG-IUS for endometrial hyperplasia, is required to identify the optimum therapy.

• Authors: Ioannis D Gallos, Olumide Ofinran, M Shehmar, A Coomarasamy, Janesh K Gupta
• Journal: European journal of obstetrics, gynecology, and reproductive biology (Eur J Obstet Gynecol Reprod Biol) Vol. 158 Issue 2 Pg. 305-7 (Oct 2011) ISSN: 1872-7654 [Electronic] Ireland
• PMID: 21658836 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Topics

• Endometrial Hyperplasia (diagnosis, therapy)
• Female
• Health Care Surveys
• Humans
• Internet
• United Kingdom