Resectoscopic surgery in 10 women with abnormal uterine bleeding and atypical endometrial hyperplasia.
OBJECTIVE
To evaluate the role of the resectoscope in the diagnosis and treatment of women with abnormal uterine bleeding (AUB) and atypical endometrial hyperplasia.


METHODS
Retrospective case series (Canadian Task Force classification III-3).


METHODS
University-affiliated teaching hospital.


METHODS
Ten women. Intervention. Hysteroscopic evaluation after preoperative endometrial biopsy indicated simple hyperplasia without atypia, complex hyperplasia with atypia, or inadequate specimen.


RESULTS
Atypical hyperplasia was confirmed in eight patients after total endomyometrial resection. Hysterectomy was offered to all patients but accepted by only two: one for bilateral ovarian serous cystadenomas and the second for a granulosa cell ovarian tumor. No residual endometrium was found in hysterectomy specimens. Seven women were amenorrheic and well 1 to 9 years after resection. An additional patient with amenorrhea died from colon cancer 2 years after resection.


CONCLUSIONS
Resectoscopic surgery confirmed or detected atypical endometrial hyperplasia in eight women and excluded it in two patients with AUB and a previous diagnosis of simple hyperplasia, atypical hyperplasia, or inadequate specimen. Skillful resectoscopic surgery may be an alternative to hysterectomy in selected patients with atypical hyperplasia who are compliant with regular and long-term follow-up.
Vilos
George A
GA
Department of Obstetrics and Gynecology, St. Joseph's Health Care, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada.
Harding
Paul G
PG
Ettler
Helen C
HC
D000368:Aged; D004714:Endometrial Hyperplasia / Q000601:surgery*; D004717:Endometrium / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000601:surgery*