title: Current management of endometrial hyperplasia-a survey of United Kingdom consultant gynaecologists.
abstract: OBJECTIVE
  To determine current practice for the management of endometrial hyperplasia.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.affiliation: Academic Unit of Obstetrics and Gynaecology, Birmingham Women's Hospital, Birmingham B15 2TG, UK. ioannis.gallos@nhs.net
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Gallos
authors.forename: Olumide
authors.initials: O
authors.lastname: Ofinran
authors.forename: M
authors.initials: M
authors.lastname: Shehmar
authors.forename: A
authors.initials: A
authors.lastname: Coomarasamy
authors.forename: Janesh K
authors.initials: JK
authors.lastname: Gupta
mesh_terms: D004714:Endometrial Hyperplasia / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D006113:United Kingdom