Clinical, Morphological, and Epidemiological Characteristics of Endometrial Hyperplastic Processes in Sumy Region

Abstract

Endometrial hyperplastic processes take an important place among the gynecological diseases in women of various ages and are one of the most common reasons for admission at inpatient gynecology departments. The urgency of the pathology is due to the significant prevalence of endometrial hyperplastic processes, high incidence of malignancy, prolonged relapsing course, and decreased reproductive function, since these diseases are one of the most common causes of infertility in women of childbearing age. The statistics related to the incidence of endometrial hyperplastic processes in Ukraine is not available. An analysis of case histories and medical records showed that in 40% of cases, endometrial hyperplastic processes were asymptomatic. In 60% of cases, the clinical manifestations of endometrial hyperplastic processes were menstrual disorders, such as dysmenorrhea, oligomenorrhea, menorrhagia, and metrorrhagia. In 30% of cases, endometrial hyperplastic processes were recurrent. The most common concomitant pathologies of the pelvic organs were uterine leiomyoma and endometriosis; the most common concomitant extragenital diseases were hypertension and obesity. Our study and data analysis showed that there is an increasing trend in the incidence of endometrial hyperplastic processes in Sumy region in 2011–2020. The maximum incidence was in 2016. A correlation was found between hyperplasia incidence and age. Thus, the largest number of non-atypical and atypical endometrial hyperplasia cases was observed in women aged 45–55 years. The lowest number of non-atypical endometrial hyperplasia cases was registered in women aged 66+, while atypical hyperplasia cases – in women under 30 years of age. Glandular polyps of the endometrium were most often diagnosed at the age of 31–44; the lowest number of these was found in women over 66 years. Most glandular-fibrous endometrial polyps were observed in women aged 45–55 years, while women under 30 presented with the fewest cases. Fibrous endometrial polyps were most common in older age groups – 66+; the lowest number of such endometrial polyps was found in women under 30 years. We attributed the decreased incidence of endometrial hyperplastic processes in 2020 to the quarantine measures introduced, which, as a consequence, led to the decreased number of diagnosed cases, since they are often asymptomatic.