What should the initial management of atypical hyperplasia be?: (A) Cyclical progestogens, (B) Continuous progestogens, (C) MIRENA, (D) Hysterectomy
Answer is D. Women with atypical hyperplasia should undergo a total hysterectomy because of the risk of underlying malignancy or progression to cancer.A laparoscopic approach to total hysterectomy is preferable to an abdominal approach as it is associated with a shoer hospital stay, less postoperative pain and quicker recovery.Reference: RCOG Guidelines on endometrial hyperplasia