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Objective:To explore the effect of Mirena assisted progesterone capsule in the treatment of endometrial polyps after hysteroscopic polypectomy (TCRP).Methods:One hundred and two patients with endometrial polyps treated with TCRP in Shapingba District People′s Hospital of Chongqing City from September 2018 to September 2019 were randomly divided into observation group and control group, with 51 cases in each group. In the control group, levonorgestrel intrauterine system was placed in the uterine cavity after operation, and the observation group was given progesterone capsule for 3 menstrual cycles on the basis of the control group. The curative effect, endometrial thickness, menstrual condition (menstrual period and menstrual volume) before and after treatment were compared between the two groups; and the endometrial tyrosine kinase growth factor receptor (C-kit), C-kit ligand stem cell factor (SCF) and aldehyde dehydrogenase 1(ALDH1) levels before and after treatment were compared between the two groups.Results:After treatment for 3 menstrual cycles, the total effective rate in the observation group was higher than that in the control group: 96.08% (49/51) vs. 82.35% (42/51), χ2 = 4.99, P<0.05. After treatment for 3 menstrual cycles, the endometrial thickness, menstrual period and menstrual volume in the observation group were shorter than those in the control group: (0.50 ± 0.09) cm vs. (0.63 ± 0.12) cm, (5.08 ± 0.64) d vs. (6.14 ± 0.79) d, (182.27 ± 15.04) ml vs. (236.17 ± 17.18) ml, the differences were statistically significant ( P<0.05). After treatment for 3 menstrual cycles, the levels of C-kit, SCF and ALDH1 in the observation group were shorter than those in the control group: 0.11 ± 0.02 vs. 0.18 ± 0.03, 0.20 ± 0.04 vs. 0.29 ± 0.05, 0.13 ± 0.03 vs. 0.20 ± 0.04, and the differences were statistically significant( P<0.05). The recurrence rate 12 months after treatment in the observation group was lower than that in the control group: 2.08% (1/48) vs. 17.07% (7/41), χ2 = 4.38, P<0.05. Conclusions:The treatment of levonorgestrel intrauterine system combined with progesterone capsule has a positive effect on the recovery of endometrium and menstruation after TCRP for endometrial polyps. It can regulate the expression of related factors in endometrial tissue and reduce recurrence.
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Background: Menopause is defined according to WHO as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. It is defined as uterine bleeding occurring after at least 1 year of amenorrhoea. Considering the high accuracy of hysteroscopy in evaluation of postmenopausal bleeding, the present study was carried out with an aim to evaluate hysteroscopic findings in women with postmenopausal bleeding in order to assess the causes of PMB and to determine their prevalence in our population.Methods: This was a prospective observation study, comprising of total number of 50 postmenopausal women attending gynae OPD at department of obstetrics and gynecology, Command Hospital (CH), Lucknow, Uttar Pradesh. The data obtained for the purpose of study was fed into computer using Microsoft excel 2013 software.Results: A total of 50 women with complaints of postmenopausal bleeding were enrolled in the study. Maximum number of women had achieved menopause between age 46 and 50 years. Hysteroscopy had an accuracy of 94% for detection of polyps. Hysteroscopy had an accuracy of 90% for detection of atrophy. For fibroid, hysteroscopy had an absolute sensitivity, specificity, positive predictive, negative predictive and accuracy value (100%).Conclusions: The findings of present study suggested that hysteroscopy has a useful role in evaluation of postmenopausal bleeding especially in the diagnosis of polyps and fibroids. Given fewer number of cases, the usefulness of hysteroscopy in evaluation of endometrial cancer and hyperplasia could not be established adequately. Further studies on larger number of sample size will help in providing more useful and confirmatory information.
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Background: Endometrial polyp is a hyperplastic structural abnormality of the uterine cavity and is one of the most commonly found intrauterine abnormalities. The endometrial polyp is mostly asymptomatic and sometimes diagnosed only during infertility investigation. The influence of endometrial polyps on female infertility is not completely understood, however, due to the possibility of endometrial polyps influencing fertility, their removal is usually performed in women undergoing infertility treatment.Methods: This meta-analysis was performed through an electronic search using MEDLINE, PubMed in October 2017, bringing together the terms of interest in order to select studies that would compare polypectomy and expectant management for endometrial polyps in sub fertile women. Four articles were selected according to the inclusion and non-inclusion criteria.Results: Five variables were collected from the selected articles to be compiled and analyzed (rate of live births per transferred embryo, chemical pregnancy rate, spontaneous abortion rate, implantation rate and clinical pregnancy rate), none of which showed any difference statistically significant in conduct.Conclusions: The data concluded that there is no statistical significance between expectant management and polypectomy.
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ABSTRACT BACKGROUND: Endometrial polyps are common in postmenopausal women, and the effect of tamoxifen use (a risk factor for endometrial polyps) on their pathogenesis is unclear. OBJECTIVES: To evaluate the expression of hormone receptors and markers for proliferation/apoptosis (Ki-67 and Bcl-2) in endometrial polyps in postmenopausal users and nonusers of tamoxifen. DESIGN AND SETTING: Cross-sectional analytical study in a tertiary-level academic hospital. METHODS: 46 women (14 tamoxifen users and 32 nonusers) with postmenopausal bleeding underwent hysteroscopic resection of endometrial polyps. Polyp samples were immunohistochemically assessed for detection of Ki-67, Bcl-2 and estrogen and progesterone receptors. RESULTS: Analysis on the glandular component of the polyps revealed progesterone receptor expression in the polyps of 96.9% of the nonusers of tamoxifen, and 92.3% of the tamoxifen users (P = 0.499). All polyps in nonusers and 92.3% of those in users were also positive for estrogen receptors (P = 0.295). Ki-67 was expressed in 75% of the polyps in the tamoxifen users and 82.8% of those in the nonusers. All endometrial polyps expressed Bcl-2. CONCLUSIONS: The immunohistochemical analysis on endometrial polyps demonstrated that, although tamoxifen is considered to be a risk factor for endometrial polyps, there were no significant differences in the expression of hormone receptors between users and nonusers of tamoxifen. There were no between-group differences in Ki-67 and Bcl-2 expression, and all patients displayed inhibition of apoptosis by Bcl-2, thus supporting the theory that polyps develop due to inhibition of apoptosis, and not through cell proliferation.
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Humans , Female , Tamoxifen/adverse effects , Postmenopause , Endometrium , Polyps , Case-Control Studies , Cross-Sectional Studies , Estrogen Antagonists/adverse effectsABSTRACT
PURPOSE: To evaluate factors associated with endometrial pathology during tamoxifen use in premenopausal breast cancer (BC) patients.MATERIALS AND METHODS: We reviewed the medical records of premenopausal BC patients treated with tamoxifen who underwent endometrial biopsy with or without hysteroscopy. Clinical characteristics were compared between women with endometrial pathology (endometrial hyperplasia or cancer) and those with normal histology or endometrial polyps.RESULTS: Among 284 endometrial biopsies, endometrial hyperplasia was diagnosed in 7 patients (2.5%), endometrial cancer was diagnosed in 5 patients (1.8%), normal histology was noted in 146 patients (51.4%), and endometrial polyp was present in 114 patients (40.1%). When comparing women with endometrial cancer (n=5) to women with normal histology, abnormal uterine bleeding was more common (p=0.007), and endometrial thickness was greater (p=0.007) in women with endometrial cancer. Chemotherapy for BC was also more common in patients with endometrial cancer (p=0.037). When comparing women with endometrial polyps and those with endometrial hyperplasia or cancer, the presence of abnormal uterine bleeding was more common in patients with endometrial hyperplasia or cancer (p<0.001); however, tamoxifen duration and endometrial thickness did not differ significantly between the two groups.CONCLUSION: In premenopausal BC patients treated with tamoxifen, abnormal uterine bleeding, increased endometrial thickness, and chemotherapy for BC were associated with the occurrence of endometrial cancer. These findings may provide useful information for gynecologic surveillance and counseling during tamoxifen treatment in premenopausal BC patients.
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Endometrial polyps (EPs) are a frequently encountered gynecologic disease with abnormal uterine bleeding and infertility being the two common presenting problems, and hysteroscopic polypectomy is an effective method to remove them. The postoperative polyp recurrence might result in reappearance of abnormal uterine bleeding or infertility, whereas factors influencing the postoperative recurrence potential have limited data. Endometrial polyp recurrence remains a concern with recurrence rates of 2.5% to 43.6%. As such, it is critical to identify the risk factors and the preventive measures for endometrial recurrence, especially in reproductive-age women desiring future conception, to aid in clinical counselling and decision making. The recurrence of EPs is related to estrogen stimulation and endometrial hyperplasia. The progesterone-containing drugs are currently the most commonly used method to prevent the recurrence of EPs. In this article, authors aim to discuss the high-risk factors of EPs recurrence and the preventive measures for EPs recurrence. The preventive measures will focus on the combined oral contraceptives (COCs) and the levonorgestrel-releasing intrauterine system (LNG-IUS).
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Objective To investigate the influence of LNG-IUS placement on endometrial thickness, recurrence rate and complications of patients with endometrial polyps and moderate anemia after TCRP. Methods 140 patients with endometrial polyps and moderate anemia were chosen from January 2014 to January 2016 and randomly divided into control group (70 patients) with TCRP used alone and observation group (70 patients) with LNG-IUS placement after TCRP; the endometrial thickness, hemoglobin levels and PBAC score before and after treatment, the recurrence rate and the complication incidence of both groups were compared. Results The endometrial thickness after treatment of observation group were significantly less than control group before the treatment (P 0.05). Conclusion LNG-IUS placement in treatment of patients with endometrial polyps and moderate anemia after TCRP can efficiently reduce the endometrial thickness, decrease the uterine bleeding amount, prevent the long-term recurrence and not increase the complications incidence.
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Objective:To investigate the analysis of features and differential diagnosis of ultrasonic image for patient with endometrial lesions.Methods: The imaging data of 80 patients with endometrial lesions were selected as random number table. The relevant ultrasound manifestations and sonographic features of patients were further analyzed, and then these data were compared with the pathological diagnosis by using operation.Results: In the 80 patients with endometrial lesions, 43 cases were endometrial polyps, and in the 43 cases, there were 41 cases were consistent with the pathological diagnosis and the diagnostic accordance rate was 95.35%, while there were 2 cases were not consistent between the two methods. 33 cases of the 80 patients were submucous myoma of uterus, and there were 29 cases of them were consistent with the pathological diagnosis and the diagnostic accordance rate was 87.88%, while there were 4 cases were not inconformity. And 4 cases of the 80 patients were endometrial carcinoma, the result was completely consistent with the pathological diagnosis and the diagnostic accordance rate was 100%. In the 6 misdiagnose cases, the ratios of atypical cases and (or) typical cases were 1:16, 5:36 and 1:8, respectively. All of these endometrial lesions has the distinctive manifestations on the ultrasonoscopy of color Doppler.Conclusion: For the detection of endometrial lesions, transvaginal colar Doppler ultrasonic detection has unique feature of ultrasonogram compared with other detection methods. In the contrast, there is a regular congruent relationship between the ultrasonogram of typical disease and section of pathological specimen by using operation in a certain degree, and the ultrasonogram of typical disease has definite diagnosis value.
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Objective To explore the clinical effect of hysteroscopic eletrosurgery for abnormal uterine bleeding of endometrial polyps.Methods 126 patients with abnormal uterine bleeding of endometrial polyps were selected,and they were selected and randomly divided into control group and research group according to the digital table,63 cases in each group.The control group received traditional curettage surgery, the research group received hysteroscopic eletrosurgery.The intraoperative blood loss,operative time,length of hospital stay,postoperative menstruation recovery time,therapeutic effect and complications were compared between the two groups.Results The intraoperative blood loss and operation time of the research group were significantly lower than those of the control group (t1=7.44,P1<0.01,t2=7.78,P2<0.01).And there were no statistical differences between the two groups in length of hospital stay and postoperative menstruation recovery time(t1=1.82,P1=0.07,t2=1.71,P2=0.09).The total cure rate of the research group was 100.00%,which of the control group was 92.14%,the difference was statistically significant(x2=8.18,P=0.00).The incidence rate of complications of the research group was 3.17%, which of the control group was 17.50%,the difference was statistically significant(x2=11.08,P=0.00).Conclusion Hysteroscopic eletrosurgery for abnormal uterine bleeding of endometrial polyps has remarkable clinical effects and low incidence of complications,and it is worthy of clinical application.
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Objective To explore the diagnostic value of transvaginal ultrasound in endometrial polypoid lesions.Methods Three hundred and forty-four cases with endometrial polypoid lesions diagnosed in Hankou Hospital of Wuhan from April 2012 to December 2016 were selected as the research objects.All patients underwent color Doppler ultrasonography before surgery.The image features were analyzed,and the specificity, sensitivity and accuracy of ultrasound diagnosis of endometrial lesions were analyzed and pathological results served as the gold standard.Results According to the postoperative pathological diagnosis,142 cases were with endometrial polyps,Including 136 cases with simple endometrial polyps and 6 cases with endometrial polyps combined with endometrial carcinoma; 160 cases were diagnosed with endometrial polyps via transvaginal ultrasound,38 cases were misdiagnosed(11.05%,38/344),20 cases were missed diagnosis(5.81%,20/344), using the postoperative pathological results as the gold standard,the sensitivity of transvaginal ultrasonography in the diagnosis of endometrial lesions was 85.92%(122/142),the specificity was 81.19%(164/202),the accuracy was 73.14%(286/344),and the diagnostic accuracy of ultrasonography was consistent with the pathological diagnosis(Kappa>0.75).Conclusion The value of transvaginal ultrasound is to observe the presence of uterine lesions, the identification of benign and malignant lesions still need hysteroscopy examination.
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OBJECTIVE: To describe the endometrial pathologic lesions in premenopausal breast cancer patients with a history of tamoxifen (TMX) use. METHODS: We retrospectively reviewed the medical records of 120 premenopausal breast cancer patients with a history of TMX use that had undergone a gynecological examination. RESULTS: Among 120 patients, 44.2% (n=53) were asymptomatic with an endometrial thickness ≥5 mm, as assessed by transvaginal ultrasonography. Of the patients that reported abnormal uterine bleeding, 5% (n=6) had an endometrial thickness <5 mm and 20% (n=24) had an endometrial thickness ≥5 mm by transvaginal ultrasonography. The final group of patients were asymptomatic, but showed an abnormal endometrial lesion, such as an endometrial polyp, by transvaginal ultrasonography (30.8%, n=37). Of the 56 benign lesions that were histologically reviewed, 50 (41.7%) were endometrial polyps, 3 (2.5%) were submucosal myomas, 2 (1.7%) were endometrial hyperplasias, and 1 (0.8%) was chronic endometritis. There were 64 (53.3%) other non-pathologic conditions, including secreting, proliferative, and atrophic endometrium, or in some cases, there was insufficient material for diagnosis. In our data, only one case was reported as a complex hyperplasia without atypia arising from an endometrial polyp, and one patient was diagnosed with endometrioid adenocarcinoma. CONCLUSION: For premenopausal breast cancer patients with a history of TMX use, the majority of the patients were asymptomatic, and endometrial polyps were the most common endometrial pathology observed. Therefore, we believe that endometrial assessment before starting TMX treatment, and regular endometrial screening throughout TMX treatment, are reasonable suggestions for premenopausal breast cancer patients.
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Female , Humans , Breast Neoplasms , Breast , Carcinoma, Endometrioid , Diagnosis , Endometrial Hyperplasia , Endometritis , Endometrium , Gynecological Examination , Hyperplasia , Hysteroscopy , Mass Screening , Medical Records , Myoma , Pathology , Polyps , Retrospective Studies , Tamoxifen , Ultrasonography , Uterine HemorrhageABSTRACT
Objective:To explore the clinical efficacy of hysteroscopy combined with drospirenone ethinylestradiol in the treatment of endometrial polyps. Methods:A total of patients with endometrial polyps from Feb 2014 to Dec 2015 were randomly divided into 2 groups.The control group was given hysteroscopic surgery. Intravenous infusion of oxytocin and antibiotics after operation was done. The observation group on the basis of the control group received oral administration of drospirenone and ethinylestradiol tablets (1 tablet/d), taking 3 consecutive weeks, and a total of 3 cycles. In the postoperative 4 months follow-up, the curative effect and complications was compared. Results: There was significant difference in menstrual improvement rate in 2 groups (P<0.05) . The recurrence rate in the control group was significantly higher than that in the observation group (P<0.05), but there was no difference in the pregnancy within 6 months after the surgery and adverse reactions (P>0.05) . Conclusion:The endometrial polyps performed hysteroscopic surgery combined with drospirenone ethinyl estradiol can effectively improve menstrual bleeding and cycle,reduce the recurrence of endometrial polyp,and the adverse reaction.
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BACKGROUND: The pathogenesis and etiology of endometrial polyps has not been elucidated. In this study, we aimed to examine the pathogenic mechanisms of endometrial polyp development using immunohistochemistry. We evaluated the expression of galectin-3 and cyclooxgenase-2 (COX-2) during the menstrual cycle in premenopausal women with endometrial polyps or normal endometrium. METHODS: Thirty-one patients with endometrial polyps and 50 healthy control patients were included in this study. The levels of expression of COX-2 and galectin-3 were studied by immunohistochemistry. RESULTS: The percentage of COX-2-positive cells and the intensity of COX-2 staining in the endometrium did not vary during the menstrual cycle either in the control group or in patients with endometrial polyps. However, expression of galectin-3 was significantly lower in endometrial polyps and during the proliferative phase of the endometrium compared with the secretory phase. CONCLUSIONS: Our data suggests that the pathogenesis of endometrial polyps does not involve expression of COX-2 or galectin-3.
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Female , Humans , Cyclooxygenase 2 , Endometrium , Galectin 3 , Immunohistochemistry , Menstrual Cycle , PolypsABSTRACT
Objective: To observe the efficiency of the therapy of hormone treatment aftertranscerviacal resection of endometrial polyps (TCRP). Methods: Eighty-six cases of endometrial polyps were analyzed retrospectively. They were divided into the control group (39 cases), which with simple TCRP, and the observation group (47 cases), which treated with hormone after TCRP. The clinical efficiency was compared between 2 groups. Results:The operation time of control group is 16-45 min, average (29.8±7.2) min; the intraoperative blood loss was 10-65ml, average(41.8±11.6) ml. The operation time of observation group was 18–55 min, average (33.2±8.8) min;the intraoperative blood loss was from 13–69 ml, average(43.2±13.1)ml. The differences of operation time and intraoperative blood loss between the two groups were not significant. The recurrence rate of observation group (6.38%) was much lower than control group(30.77%)(x2=8.802, P<0.05). 1 month, 3 months, 6 month and 1 year after therapy, the menstrual blood volume were (53.6±17.8)ml, (41.3±13.5)ml, (33.8±9.6)ml and (20.8±6.4)ml, respectively, which were much lower than the control group (t=12.564, t=12.691, t=14.494, t=23.72; P<0.05). 1 month, 3 months, 6 month and 1 year after therapy, the endometrial thickness were (8.2±1.0)mm, (7.1±0.9)mm, (4.2±0.8)mm and (3.5±0.7)mm, respectively, which were much lower than the control group (t=1.324, t=3.774, t=11.996, t=10.508; P<0.05). Conclusion: The menstrual blood volume, the endometrial thickness and the recurrence of endometrial polyps can be effectively reduced with the hormone therapy after TCRP.
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To evaluate the clinical effect of LNG-IUD on preventing recurrence after hysteroscopic resection of endometrial polyps . [ Methods] Electrical excision of endometrial polyps with the help of hysteroscopy was performed for 120 patients, who were randomly divided into trial group ( levonorgestrel-releasing intrauterine system after surgery ) and control group ( without any treatment after surgery), with 60 patients in each group.After follow-up of 4 years, the recurrence of endometrial polyps was observed in the two groups . [ Results] The recurrence rate of trial group was 1.6%,and that of control group was 15.0%.There was significant difference in recurrence between the two groups ( P<0. 05 ) . [ Conclusion] The hysteroscopy can be used for more definite diagnosis and treatment of endome-trial polyps .And there has been a significantly positive effect of LNG-IUD proved on preventing recurrence after hysteroscopic resection of endometrial polyps .
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Objective: To observe the accuracy rate, false negative rate of B ultrasound examination in the diagnosis of endometrial polyps and discuss the diagnosis value. Methods:Selected 80 cases of patients with endometrial polyps treated in the hospital from 2013 January-2013 year in June as the research object and they were confirmed by pathological examination, mean age (43.9±11.2) years old, they were examined by B ultrasound examination before and after menstruation, then analyze sensitivity, specific degrees of B Ultrasound performance combining with pathological examination and the survey of satisfaction for patients. Results:the patients before and after the menstrual endometrium showed different degrees of thickening, ranging from 1.2-2.4 cm, the probe showed ligulate, papillary substance not uniform, single, multiple echo;after analysis 73 cases were diagnosed as endometrial polyp, the correct diagnostic rate was 91.2%and the false negative rate was 8.8%. 76 cases (95%) were satisfactory for the simplicity, low cost, accurate diagnosis. Conclusion:B ultrasound examination in the diagnosis of endometrial polyps has high correct rate and is noninvasive, safe, and is easily accepted by patients, so it has important clinical value.
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Objective To analyze the MRI features of senile endometrial polyp and compared MRI features with pathological find-ings,to improve the ability for the diagnosis.Methods The study included 58 cases with senile endometrial polyp proved by diag-nostic curettage or hysterectomy.MRI and pathological findings were analyzed retrospectively.Results Among 58 cases,there were 46 cases with and 12 cases without uterine cavity enlargement.Lesion combined solid portions with cryptomere cystics areas filled in uterine cavity in 35 cases,and MRI showed hypointensity on T1 WI,mixed intensity with hypointensity separation lines on T2 WI, and marked heterogeneous enhancement.The signal of uterine cavity was heterogeneous in 23 cases with hypointensity or isointensi-ty on T1 WI,hyperintensity or isointensity on T2 WI,and no obviously enhancement.Conclusion MRI combined with clinical fea-tures can improve the diagnostic accuracy of senile endometrial polyp.
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Objetivo: revisar la literatura disponible acerca de la fisiopatología en el desarrollo de lospólipos endometriales (EP).Metodología: se realizó una búsqueda bibliográfica en la base de datos Medline y en el buscadorPubmed, usando la palabra clave endometrial polyps, identificando aquella información relevanterelacionada con su fisiopatología, publicada entre los años 2000 2011, de artículos publicadostanto en castellano como en inglés.Resultados: se pueden resumir los fenómenos asociados con la aparición de los pólipos endometrialesen factores hormonales, inflamatorios, proliferativos y genéticos. Con respecto a la influenciahormonal se ha demostrado un aumento de los receptores de estrógenos y progestágenos, y unasobreexpresión de la aromatasa en el endometrio de los pólipos endometriales. Con respecto a losfactores inflamatorios y proliferativos, la presencia de pólipos se asocia con el aumento de la concentraciónde mastocitos activados, aumento de los niveles de cicloxigenasa 2 y el incremento de otras sustancias inhibidoras de la apoptosis, tales como, el Bcl2y el Ki67. Además, se han relacionado anormalidades genéticasen diversos cromosomas, junto con reacomodamientosproducidos por proteínas de alta movilidad, conla presencia de los EP.Conclusiones: aunque la etiología de los pólipos endometrialessigue siendo desconocida, se puede pensar quepara su aparición se requiere de un proceso proliferativoestimulado por algunos factores hormonales asociados aun fenómeno inflamatorio.
Objective: To make a review of the available literatureabout the pathophysiology of endometrialpolyps (EP) development.Methods: A search was conducted using Medlinedatabase and the browser Pubmed in orderto retrieve relevant information related to thepathophysiology of endometrial polyps, usingas search terms endometrial polyps, including publicationsfrom 2000 through 2011.Results: The factors associated with the endometrialpolyps can be summarized within hormonal,inflammatory, proliferative and geneticfactors. Related to the hormonal influence, ithas been demonstrated by an increase in estrogensand progestagen receptors, and overexpressionof aromatase in endometrial tissue ofEP. Related with inflammatory and proliferativefactors EP are associated with the increase ofmastocytes activated concentration, increase ofcycloxigenase2 levels and increase of other inhibitingapoptosis substances such as Bcl 2 andKi 67. Furthermore, EP has been associated withgenetic abnormalities in various chromosomes,together with rearrangement produced by highmobility proteins.Conclusions: In spite of the EP etiology beingunknown, it could be established that for it tooccur requires a proliferative process stimulatedby hormonal factors associated with an inflammatoryprocess.
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Humans , Apoptosis , Hormones , Mast Cells , Polyps , Stromal CellsABSTRACT
Se presenta la experiencia quirúrgica en 160 pacientes con diagnóstico ecográfico de pólipo endometrial. Se evalúan las características epidemiológicas, clínicas y la correlación histológica. La edad promedio fue de 50 años, se analizaron las variables diferenciándolas en premenopáusicas o post menopáusicas, y presencia de síntomas. En todos los subgrupos la incidencia fue igualmente alta para los pólipos endometriales, seguida en frecuencia por los leiomiomas, hiperplasia endometrial y endometrio proliferativo, entre otros. Se encontraron 3 casos de adenocarcinoma endometrial, todos en el subgrupo de las pacientes postmenopáusicas sintomáticas. El procedimiento fue bien tolerado, y sin complicaciones. Destacamos a la histeroscopia como el estándar dorado por su alta sensibilidad y especificidad en el diagnóstico de pólipo endometrial.
The surgical experience in 160 patients with echographic diagnostic of endometrial polyps, are analyzed. Clinical and pathological characteristics are evaluated. The patient average age was 50 years old; variables were analyzed differentiating them in pre menopausal or post menopausal, according to the presence of symptoms. In all sub-groups the incidence was equally high for the endometrial polyps, followed in frequency by leiomyomas, endometrial hyperplasia and endometria proliferative among others. Three cases of endometrial adenocarcinoma were found, all in the sub-group of the symptomatic post menopausal patients. The procedure was well tolerated, without complications. We emphasized the hysteroscopy procedure as the gold standard by its high sensitivity and specificity in the endometrial polyp diagnosis.
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Humans , Female , Adult , Middle Aged , Polyps/surgery , Polyps/pathology , Uterine Diseases/surgery , Uterine Diseases/pathology , Hysteroscopy/methods , Obstetrics and Gynecology Department, Hospital , Retrospective Studies , Endometrial Neoplasms/surgery , Endometrial Neoplasms/pathology , Premenopause , Postmenopause , Age Distribution , HyperplasiaABSTRACT
OBJECTIVE: To determine the incidence of benign, hyperplastic, and malignant endometrial polyps and whether particular clinical parameters are associated with malignancy in the polyps. METHODS: Four hundred and forty nine patients who were suspected as endometrial polyps by hysteroscopy underwent hysteroscopic guided removal over 12 months period were retrieved. The medical records and histopathological findings were reviewed. Statistical analysis was performed. RESULTS: Histologically, among 360 (80.1%) polypoid lesions, 353 polyps (75.1%) were benign; 16 polyps (3.5%) had simple or complex hyperplasia, only 1 polyp (0.2%) had hyperplasia with atypia (considered as premalignant lesions), and 6 polyps (1.3%) were cancerous. Non polypoid lesions were found in 89 (19.9%) cases. Older age, postmenopausal status were associated with pre-malignant or malignant changes significantly, but presence of abnormal uterine bleeding, multiplicity, larger sizes (>1.5cm) were not a predictor of malignancy in the polyp. CONCLUSIONS: Age and menopausal status may increase the risk of premalignant and malignant polyps. Although the risk of malignancy is low, we should pay attention to postmenopausal women with endometrial polyps regardless of the symptoms, and we prefer hysteroscopic resection for the exact diagnosis.