[Hysteroscopic diagnosis and follow-up of adenomatous hyperplasia and therapeutic consequences].

63 cases of adenomatous endometrial hyperplasia (1st-3rd degree) were diagnosed by hysteroscopy and D&C at the Department of Obstetrics and Gynaecology of the University of Greifswald from January 1991 to December 1994. In 40 patients with adenomatous hyperplasia (2nd-3rd degree) a hysterectomy was performed. 23 patients presenting with 1st degree hyperplasia were treated continuously with gestagenes for a period of 6 months. In those cases we performed a repeated diagnostic hysteroscopy and D&C to check the success of hormonal treatment. In 92.5% of tall cases the histological diagnoses of a lower degree adenomatous hyperplasia, cystic glandular hyperplasia or of a normal endometrium were made after hysterectomy. Only in one patient (2.5%) an endometrial carcinoma developed from an adenomatous hyperplasia (3rd degree). There was no progression to observe of adenomatous hyperplasia after hormonal therapy with gestagenes. We conclude that in those cases a hysterectomy has not necessarily to be carried out. However, in adenomatous hyperplasia of 3rd degree hysterectomy has to be the treatment of choice, because there is an increased risk of invasion.