The women of reproductive age have efficiency of different methods of treatment of endometrial hyperplasia

Olga Leshchova
In: Perinatology and reproductology: from research to practice · 2026 · vol. 6(1) , pp. 68 · doi:10.52705/2788-6190-2026-01-8 · W7148679271
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This study evaluated endometrial hyperplasia treatments in women of reproductive age, finding hysteroscopic ablation effective for isolated hyperplasia but less so when combined with leiomyoma or adenomyosis.

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This study evaluated the treatment efficiency for endometrial hyperplasia in reproductive-age women, comparing surgical and hormonal interventions across patients with uterine leiomyoma. The results indicated that while progestagens and oral contraceptives showed similar efficacy for isolated adenomyosis, combined oral contraceptives outperformed progestagens for combined hyperplastic diseases. Furthermore, hysteroscopic ablation proved highly effective for isolated hyperplasia but failed significantly when combined with adenomyosis, leading to a high rate of subsequent hysterectomies. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

The objective: to estimate efficiency of different methods of treatment of endometrial hyperplasia for the women of reproductive age. Materials and methods. Surgical treatment is conducted to 445 patients with the uterine leiomyoma, them them: 323 – groups were included in basic, and 122 – in a sub-group I groups of comparison. At 80,9 ± 1,9% cases organ-preserving operations (myomectomy) are executed, in 19,1 ± 1,9% – hysterectomy. Operated laparoscopic access 78,1 ± 2,2 % patients, with the use of laparotomy – 6,4 ± 1,3 %. At 15,6 ± 1,9 % cases to the patients with the submucosal location of node a myomectomy was conducted by the method of operative hysteroscopy. An early and late postoperative period for all patients flowed without complications. To the complex of the conducted researches clinical, laboratory instrumental and statistical methods were included. Results. Pays attention on itself circumstance that efficiency of the use both progestagens and the combined oral contraceptives at isolated adenomyosis was relatively high and practically identical. Less effective treatment of progestagens by comparison to the monophase combined oral contraceptives was in a basic group at the combined hyperplastic diseases of uterus. At the use of endometrial levonorgestrel excretory systems, in 3 from a 31 patient of basic group happened to the expulsion of an IUD, in all last cases of treatment it appeared successful. Obvious advantage of endometrial levonorgestrel excretory systems as compared to other hormonal facilities it is determined by high efficiency in combination with greater duration of treatment and absence of meaningful side effects. Conclusions. Hysterocopic ablation of endometrium had high efficiency at the isolated endometrial hyperplasia – 78%. At their combination with the uterine leiomyoma frequency of successful treatment went down to 50%. In the case of combination of endometrial hyperplasia from adenomyosis and the expected result of treatment was attained a uterine fibroids only in 11,1% cases, and the number of hysterectomy grew to 78,9%, that allows to take afore-mentioned combination of endometrial hyperplasia in the number of contra-indications to hysterocopic ablation of endometrium
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Keywords

endometrial hyperplasia, treatment, reproductive ageAbstract DOI: 10.52705/2788-6190-2026-01-8 УДК 618.17/.5-06:618.14-018-007.6-08-035 The objective: to estimate efficiency of different methods of treatment of endometrial hyperplasia for the women of reproductive age.

Materials

and methods. Surgical treatment is conducted to 445 patients with the uterine leiomyoma, them them: 323 – groups were included in basic, and 122 – in a sub-group I groups of comparison. At 80,9 ± 1,9% cases organ-preserving operations (myomectomy) are executed, in 19,1 ± 1,9% – hysterectomy. Operated laparoscopic access 78,1 ± 2,2 % patients, with the use of laparotomy – 6,4 ± 1,3 %. At 15,6 ± 1,9 % cases to the patients with the submucosal location of node a myomectomy was conducted by the method of operative hysteroscopy. An early and late postoperative period for all patients flowed without complications. To the complex of the conducted researches clinical, laboratory instrumental and statistical methods were included. Results. Pays attention on itself circumstance that efficiency of the use both progestagens and the combined oral contraceptives at isolated adenomyosis was relatively high and practically identical. Less effective treatment of progestagens by comparison to the monophase combined oral contraceptives was in a basic group at the combined hyperplastic diseases of uterus. At the use of endometrial levonorgestrel excretory systems, in 3 from a 31 patient of basic group happened to the expulsion of an IUD, in all last cases of treatment it appeared successful. Obvious advantage of endometrial levonorgestrel excretory systems as compared to other hormonal facilities it is determined by high efficiency in combination with greater duration of treatment and absence of meaningful side effects. Conclusions. Hysterocopic ablation of endometrium had high efficiency at the isolated endometrial hyperplasia – 78%. At their combination with the uterine leiomyoma frequency of successful treatment went down to 50%. In the case of combination of endometrial hyperplasia from adenomyosis and the expected result of treatment was attained a uterine fibroids only in 11,1% cases, and the number of hysterectomy grew to 78,9%, that allows to take afore-mentioned combination of endometrial hyperplasia in the number of contra-indications to hysterocopic ablation of endometrium. Downloads Published How to Cite Issue Section License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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adenomyosis

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