Endometrial polyps. A clinical study of 245 cases

Endometrial polyps (EPs) are among the common cases of abnormal uterine bleeding. Hormonal factors may be involved in the pathogenesis as indicated by endometrial abnormalities in patients treated with tamoxifen. This study was designed to analyse the patient characteristics which may be associated with polyp occurrence and assess the diagnostic and therapeutic difficulties. Group of 245 patients was formed to 152 postmenopausal and 93 premenopausal women with EP diagnosed hysteroscopically and confirmed histologically. Evaluated factors were as follows: 1) patient characteristics: age, body mass, systemic hypertension, diabetes mellitus, nulliparity, late menopause, estrogen replacement therapy, and tamoxifen treatment; 2) clinical features of EPs, and 3) the number of curettage's (D & C) and hysteroscopies. Hypertension associated with obesity appears to be an important factor in combination which may play role in the pathogenesis of EPs like the late menopause which was noted in 30% of examined postmenopausal women. An association between EPs and tamoxifen was found in 8% patients with breast cancer. 2. Postmenopausal uterine bleeding and menstrual disorders were prominent clinical symptoms in 44% post- and in 82% of premenopausal women. The other 56% post- and 18% premenopausal patients were asymptomatic. 3. The multiple EPs were present in 26% of postmenopausal and in 15% premenopausal women. 4. Transvaginal ultrasonography supplemented by sonohysterography in cases with abnormal ultrasonographic findings should be the main diagnostic method. 5 Hysteroscopical polypectomy is regarded as the optimal therapy and the removal of the endometrial basalis in the EP origin area prevents persistence or recurrence of EP.