Hysteroscopic evaluation of endometrial polyps.

Polycystic ovary syndrome and increased polyp numbers as risk factors for malignant transformation of endometrial polyps in premenopausal women.

Aims and backgroundHysteroscopic polypectomy is the gold standard to treat endometrial polyps and obtain specimens for histological evaluation. There is continuing debate as to when to offer hyster...

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Suspecting malignancy in endometrial polyps: value of hysteroscopy.

The aim of this study was to evaluate the effects of the number, location, dimension and histopathological diagnosis of endometrial polyps on laboratory and clinical findings. Seventy three women with endometrial polyps who underwent hysteroscopic polyp resection at Gynecology Clinic of Bakirkoy Dr. Sadi Konuk Education and Research Hospital were evaluated retrospectively from January 2008 to July 2009. Sociodemographic characteristics, symptomatology and menopausal status of the patients were documented. Polypectomy was performed by bipolar resectoscope in all cases under general anesthesia in operating room. Hemoglobin levels were measured just before and after 3 months later operation. The number, location, dimension, histopathological diagnosis of endometrial polyps and clinical symptoms were recorded. The histopathological diagnosis were benign endometrial polyp in 70 (%95,8) cases, complex endometrial hyperplasia with atypia in two cases (%2,73) and endometrial carcinoma in one case (%1,36). Ninety percent of the patients in the menopausal group and %84,9 of the patient in the reproductive age group were symptomatic. In addition, %88,6 of polyp in the reproductive-age and %85 of polyp in the menopausal group were single. The polyp number, dimension and location were not statistically correlated with symptomatology (P=0,346, P=0,350 and P=0,742, respectively) and histopathological diagnosis (P=0,825, P=0,751 and P=0,099, respectively). Polyp location, number and dimension do not correlate with histopathological diagnosis and symtomatology. The hemoglobin levels were significantly lower in cases with symptoms.

Endometriyal poliplerde sayi, çap ve lokalizasyonun; laboratuvar, klinik ve histopatolojik bulgularla ilişkisi The effects of the number, location, dimension and histopathological diagnosis of endometrial polyps on laboratory and clinical findings

Key content
• Hysteroscopic endometrial polyp removal appears to be superior to the current practice of blind avulsion.
• Outpatient treatment is safe, cost effective and well tolerated, even in older or nulliparous women.
• New technologies facilitate office hysteroscopy.
• Benign endometrial polyps can regress and rarely progress to malignancy.


Learning objectives
• To learn how to diagnose and treat endometrial polyps in pre and postmenopausal women.
• To be able to compare the performance of diagnostic modalities.
• To understand the role of outpatient vaginoscopy and hysteroscopy.


Ethical issues
• Given the cost effectiveness and acceptability of office ambulatory diagnostic and interventional hysteroscopy, is it ethical not to offer such a service?

The management of endometrial polyps in the 21st century

The objective of this study is to evaluate the differences between benign and malignant endometrial polyps at hysteroscopy. In our collected experience of 1793 diagnostic hysteroscopies performed from December 1989 to December 1993, we found 3 malignant polyps in 151 cases of hysteroscopically diagnosed endometrial polyps. The differences in appearance of the malignant polyps are mainly represented by surface irregularities such as necrosis, vascular irregularities and whitish thickened areas. We conclude that when these patterns are present it is better to perform a targeted biopsy to confirm the hysteroscopic diagnosis. This approach allows selection of patients that can be treated by hysteroscopic polypectomy from those who require more radical treatment.

Hysteroscopic appearance of benign and malignant endometrial polyps. What are the differences

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Hysteroscopic appearance of benign and malignant endometrial polyps. What are the differences