Endometrial hyperplasia medical therapy: Difference between revisions
| Line 15: | Line 15: | ||
</div>|B02=<div style="width: 9em; padding:0.2em;">'''Surgery'''</div>}} | </div>|B02=<div style="width: 9em; padding:0.2em;">'''Surgery'''</div>}} | ||
{{familytree |boxstyle=background: #DCDCDC; | | | | | | |!| | | | | | | |!| | |}} | {{familytree |boxstyle=background: #DCDCDC; | | | | | | |!| | | | | | | |!| | |}} | ||
{{familytree |boxstyle=background: #DCDCDC; | | | | | | |!| | | | | | | C01 | | |C01=<div style="width: 9em; padding:0.2em;">'''[[Hysterectomy]]''' </div> | {{familytree |boxstyle=background: #DCDCDC; | | | | | | |!| | | | | | | C01 | | |C01=<div style="width: 9em; padding:0.2em;">'''[[Hysterectomy]]''' </div>}} | ||
{{familytree |boxstyle=background: #DCDCDC; | | | | | | |!| | | | | | | | | | |}} | {{familytree |boxstyle=background: #DCDCDC; | | | | | | |!| | | | | | | | | | |}} | ||
{{familytree |boxstyle=background: #DCDCDC; | |,|-|-|v|-|^|v|-|-|v|-|-|.| | | |}} | {{familytree |boxstyle=background: #DCDCDC; | |,|-|-|v|-|^|v|-|-|v|-|-|.| | | |}} | ||
{{familytree |boxstyle=background: #DCDCDC; | D01 | D02 | D03|| D04 | D05 |C01=<div style="width: 9em; padding:0.2em;">'''[[Hysterectomy]]''' </div>C01=<div style="width: 9em; padding:0.2em;">'''[[Hysterectomy]]''' </div>C01=<div style="width: 9em; padding:0.2em;">'''[[Hysterectomy]]''' </div>C01=<div style="width: 9em; padding:0.2em;">'''[[Hysterectomy]]''' </div>C01=<div style="width: 9em; padding:0.2em;">'''[[Hysterectomy]]''' </div>}} | |||
{{familytree/end}} | {{familytree/end}} | ||
Revision as of 19:14, 15 March 2016
|
Endometrial hyperplasia Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Endometrial hyperplasia medical therapy On the Web |
|
American Roentgen Ray Society Images of Endometrial hyperplasia medical therapy |
|
Risk calculators and risk factors for Endometrial hyperplasia medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [3]
Overview
Progesterone therapy is the preferred drug for the treatment of benign hyperplasia. The management of endometrial hyperplasia depends upon the desire for future childbearing(medscape)
Medical Therapy
- Patients with endometrial hyperplasias without atypia are treated conservatively, whereas patients with atypical hyperplasia/endometrioid intraepithelial neoplasia are treated surgically.[1]
Treatment of endometrial hyperplasia | |||||||||||||||||||||||||||||||||||
Conservative
| Surgery | ||||||||||||||||||||||||||||||||||
| {{{ D01 }}} | {{{ D02 }}} | {{{ D03}}} | {{{ D04 }}} | {{{ D05 }}} | |||||||||||||||||||||||||||||||
Treatment of endometrial hyperplasia is individualized, and may include hormonal therapy, such as cyclic or continuous progestin therapy, or hysterectomy.[2]
The implications for treatment are obvious: hyperplasias without atypia should generally be treated conservatively (normalization of the cycle through weight loss, metformin; oral contraceptives; cyclical gestagens; gestagen IUD). Preventive hysterectomy should only be considered in exceptional cases (e.g., extreme obesity without any prospect of weight loss) 1, 4. The surgery should be done as a total hysterectomy, i.e., it must include removal of the cervix 4.
Treatment of atypical hyperplasia/endometrioid intraepithelial neoplasia should generally consist of total (not supracervical) hysterectomy 1, 4. Conservative treatment with high-dose gestagens and close histological monitoring should only be considered in exceptional cases (when the patient wants to have children, satisfactory compliance) 1, 4, 6.
observation, hormonal treatment, or hysterectomy) [3]
EH (unopposed oestrogen effect, benign hyperplasia) is often treated symptomatically with short term progestins, follow up ultrasonography, and/or tissue resampling.[3]
References
- ↑ Emons G, Beckmann MW, Schmidt D, Mallmann P, Uterus commission of the Gynecological Oncology Working Group (AGO) (2015). "New WHO Classification of Endometrial Hyperplasias". Geburtshilfe Frauenheilkd. 75 (2): 135–136. doi:10.1055/s-0034-1396256. PMC 4361167. PMID 25797956.
- ↑ [1] Howard A Zacur, Robert L Giuntoli, II, Marcus Jurema, "Endometrial Hyperplasia" from UpToDate Online (accessed 5-26-07)
- ↑ 3.0 3.1 Baak JP, Mutter GL (2005). "EIN and WHO94". J Clin Pathol. 58 (1): 1–6. doi:10.1136/jcp.2004.021071. PMC 1770545. PMID 15623473.