HDC = Hysteroscopy, dilatation and endometrial curettage.
All the patients were referred to undergo BS as their BMI fulfilled
criteria based on national healthcare guidelines. Pre-operative
preparation was done for all patients based on a standard pathway,
including review by members of a multidisciplinary team, blood tests,
upper gastro-intestinal endoscopy and two weeks of meal replacement with
a very low-calorie diet (VLCD). All patients underwent laparoscopic
sleeve gastrectomy (LSG) and there were no complications from BS. After
BS, all patients had EC regression within six months based on histology
on HDC (Table 3). After BS, the mean time taken for EC regression was
3.2 months. For three patients (1, 3 and 4), there was normalization of
endometrial cells. The other two patients (2 and 5) had regression to
complex hyperplasia. Patient 2 still had simple endometrial hyperplasia
10 months after BS, while follow-up duration for patient 5 is still very
short. Patients are instructed about contraception and to avoid
conceiving for at least twelve months after BS. Two patients (1 and 3)
underwent IVF 12 months after BS, with patient 1 successfully
conceiving. There are no maternal or fetal complications during the
gestation period up to the end of the follow-up period.
Table 3: EC regression after BS.