Friday, May 2, 2008 - New servers are in! Click-in for more info!
VoyForums

Saturday, May 17, 05:16:24am [ VoyUser Login optional ] [ Contact Forum Admin ] [ Main index ] [ Post a new message ] [ Search | Check update time | Archives: 1, 2, [3] ]

[ Next Thread | Previous Thread | Next Message | Previous Message ]

Date Posted: 00:46:57 02/25/06 Sat
Author: Jill
Subject: Re: Hyperplasia with atypia
In reply to: Helen 's message, "Hyperplasia with atypia" on 16:00:38 02/23/06 Thu

Hello land welcome.
The first step in the treatment of endometrial hyperplasia is a thorough evaluation of the endometrium by means of a D&C; this is essential in order to assess the presence of atypia. Hyperplasia without atypia often regresses spontaneously, after D&C or progestin treatment. Progestin, such as provera, is given continuously, either by mouth or long acting injections. A D&C is repeated after 3-4 months of treatment to demonstrate resolution of the hyperplasia. Failure of hyperplasia without atypia to resolve (even if no atypia is found) after repeat D&C is cause for concern. A second course of medical therapy may then be tried consisting of high dose progestins. Following this course of treatment another D&C is performed.

Hyperplasia with atypia is considered precancerous. It is best treated surgically with hysterectomy. However, if a patient desires future pregnancy, a trial of hormonal treatment may be given. If a lower dose progestin regimen fails to clear hyperplasia with atypia, the patient may be given a choice between high dose progestin given continuously over a period of three months or hysterectomy. Failure of the high dose progestin treatment course to completely resolve the hyperplasia with atypia is a clear indication for hysterectomy. Resolution of the hyperplasia on the repeat D&C offers the patient the opportunity to try and conceive. However, she will require close medical supervision with repeat biopsies to monitor the endometrium until pregnancy. The D&C after completion of progesterone treatment should be delayed about a month following completion of the progesterone course of treatment in order not to miss a treatment failure.

In pre-menopausal women before, high dose progestin treatment with close monitoring is an accepted alternative to hysterectomy in cases of hyperplasia with atypia. In the post-menopausal woman with endometrial hyperplasia with atypia hysterectomy is recommended.

Recently, there have been several encouraging reports of resolution of hyperplasia following endometrial ablation (by hot water balloon, laser or resectoscopic endometrial resection). In some cases, even atypical
hyperplasia was successfully eliminated. However, at the present time, larger studies are needed to determine the overall success of such treatment modalities before we can accept them as routine alternatives in women who refuse progesterone treatment or hyterectomy.

Hope this helps.
Jill

[ Next Thread | Previous Thread | Next Message | Previous Message ]
[ Contact Forum Admin ]

Forum timezone: GMT-8
VF Version: 2.94, ConfDB:
Before posting please read our privacy policy.
VoyForums(tm) is a Free Service from Voyager Info-Systems.
Copyright © 1998-2008 Voyager Info-Systems. All Rights Reserved.