Comparative Analysis Of Preoperative And Postoperative Findings In Patients With Endometrial Hyperplasia: A Clinical Study

Aim and Objective: The objective of this study is to compare preoperative and postoperative findings in patients diagnosed with endometrial hyperplasia, focusing on clinical symptoms, histopathological features, co-morbidities, surgical outcomes, and recurrence rates. This analysis aims to identify significant differences between hyperplasia with and without atypia, contributing to improved management strategies and clinical decision-making in patients undergoing treatment for endometrial hyperplasia. Methodology: This observational study was conducted at Amrita Institute of Medical Sciences in Kochi, Kerala, over two years (July 2019 to July 2021) and approved by the institutional ethical committee. It included 68 women diagnosed with endometrial hyperplasia via endometrial biopsy who were planned for hysterectomy, and excluding those on tamoxifen or hormone replacement therapy. Data on age, menopausal status, time between biopsy and hysterectomy, and histopathological findings were collected and reviewed by a single pathologist, using WHO criteria for classification. Result: In this study of preoperative and postoperative findings in endometrial hyperplasia, the mean age of patients with hyperplasia with atypia was 49.20 years (n=41) compared to 50.95 years for those without atypia (n=27), with no significant difference in mean endometrial thickness (12.5 mm vs. 11.05 mm, p=0.547). Cystic spaces were more prevalent in the without atypia group (48.1% vs. 24.4%, p=0.063). Postoperatively, complications were low and comparable across groups, with infection rates of 7.3% in atypia and 7.4% in without atypia. The recurrence rates were similar at 12.2% for hyperplasia with atypia and 11.1% for without atypia (p=0.857), indicating that atypia did not adversely affect long-term outcomes. Follow-up symptoms showed a low prevalence of ongoing heavy menstrual bleeding (10.0% for atypia vs. 7.4% for without atypia) and other irregularities, suggesting effective symptom management through surgical intervention. Conclusion: In conclusion, the study indicates that preoperative and postoperative findings in endometrial hyperplasia, whether atypical or non-atypical, show no significant differences in clinical profiles or outcomes. Both groups exhibited similar mean ages, endometrial thickness, and low rates of postoperative complications. The recurrence rates were also comparable, with 12.2% in the atypical group and 11.1% in the non-atypical group, suggesting that the presence of atypia does not negatively affect long-term outcomes. Overall, these results highlight the effectiveness of surgical intervention for endometrial hyperplasia.