Abstract

Background: Endometrial hyperplasia (EH), is categorized into EH without atypia, with atypia. EH carries risk of concomitant endometrial cancer (EC) potential for development of EC in future. Objective: Study was conducted to know about cases of complex EH (CEH) with or without atypia, especially in context of body mass index (BMI), hypertension, and diabetes. Methodology: Study was conducted at rural tertiary care centre. Only inpatient cases of histopathologically proved EH, CEH with atypia, CEHA, without atypia CEH over 9 years were included. Results, Comments, Conclusion: There were 33cases of EH, 29 of CEHA, 4 only CEH. Twenty six (78.7%) patients were premenopausal, 7 (21.3%) postmenopausal. Seven women were around 40 years, 18 (54.5%) 40-49 years, 7(21.2%) of 50-59 years, (CEH) one (3%) 63yrs old, youngest 26 years old. Mean age of CEHA was 44.17 ± 6.4 years, CEH 41.5 ± 9.1 years. Mean parity of EH patients was 2.63, with CEHA 2.63 and for CEH 2.5. Only 2 (6.1%) women had never been pregnant, 2 (6.1%) had one birth, most women 87.87% had many births. Of 7 postmenopausal women who had CEH-A, two (33%) were postmenopausal for 6-10 years. Almost all women 27 (81.8%) had presented with abnormal uterine bleeding (AUB), only compliant, (23 CEH-A and 4 CEH). One had lower abdominal pain (CEH –A) as leading complaint. Fifteen (45.4%) women with CEHA were obese. BMI for CEH cases was 25.9 ± 3.3 kg/m2 for CEHA 29.2 ± 3.5 2, insignificant difference. Two (6.06%) women had hypertension (one CEH-A, one CEH), 2 (6.06%) patients had diabetes (both CEH-A), 2 (6.06 %) diabetes and hypertension (CEH-A). Of 33 patients, 25 (75.7%) underwent abdominal hysterectomy with bilateral salpingo- oophorectomy (TAH+BSQ,) 2 (6.06%), vaginal hysterectomy, 2 (6.06%) received progesterone therapy, 4 (12.12%) were lost. Of 7 women of 50-59 years, 6 with CEH-A, 5 had TAH + BSO, one did not take any therapy, one of CEH had TAH+ BSO, one 63 years, with CEH-A had TAH + BSO. For prevention of EC it is essential to keep high vigil for symptoms signs, provide appropriate treatment.