Outcomes of endometrial-polyp treatment with hysteroscopy in operating room

Abstract

To assess the results of using a resectoscope in the hysteroscopic resection of endometrial polyps that were previously diagnosed by office hysteroscopy and to demonstrate the necessity of extraction for histological study. A prospective long-term follow-up study (level of evidence II-2). University Hospital. 303 women presenting a hysteroscopic image of an endometrial polyp. Interventions: Office hysteroscopy, hysteroscopic resection of polyps by means of a resectoscope and an anatomopathological study of the polyps. Statistical analysis was performed. 303 diagnosed endometrial polyp formations were resected by means of hysteroscopy during surgery. In all cases, biopsies of the uterine cavity or of the polyp were negative. Resection of the polyps with hysteroscopy in the operating room using a resectoscope proved to be a safe technique. The anatomopathological study of the polyps showed hyperplasia with atypias in 10 cases (3.3%) and endometrial cancer in 9 women (3.0%). Our study data suggest that endometrial polyps should be resected because they may harbor malignant or premalignant lesions. Hysteroscopic surgery is recommended for its simplicity and scant complications.

Treatment of endometrial polyps: a systematic review

“…In this study, hyperplasia was found to be more frequent among women with endometrial polyps compared to women without polyps (7/62, 11.3% vs. 8/186, 4.9%), but no such differences between the two study groups were found for malignancy (2/62, 3.2% vs. 6/162, 3.7%). Two other prospective uncontrolled studies, including 90 and 303 women, respectively, were identified (22, 45). The study samples of the remaining retrospective studies varied between 60 and 1,922 women (median 438 women).…”

“…Of 35 studies retrieved for detailed evaluation (1, 6, 22–54), 20 primary studies including 9,266 women with endometrial polyps reported the prevalence of premalignant and/or malignant endometrial changes and met the criteria for inclusion (1, 22–26, 28, 29, 32–34, 36–38, 40, 41, 44, 45, 49, 51) (Figure 1).…”

The management of endometrial polyps in the 21st century

“… Malignant cells at the base of the polyp can be missed with blind avulsion 30 Hysteroscopic resection avoids excessive cervical dilatation, which is when uterine perforation and creation of a false passage usually occur 31 …”