This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Gynaecological oncology, Subject name: Gynaecology & Obstetrics
What should the initial management of atypical hyperplasia be? 
Select and explain. 
A. Cyclical progestogens, B. Continuous progestogens, C. MIRENA, D. Hysterectomy
D: Hysterectomy
Answer: D: Hysterectomy 
Explanation: 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