Aims: To estimate the recurrence rate of patients with endometrial polyps and to evaluate whether the recurrence can be correlated with the histopathologic features of the polyp. Methods: Two hundred and eighty-two women with endometrial polyps in both pre- or postmenopausal period and suffering from abnormal uterine bleeding or not were treated by resectoscopic surgery in a tertiary university hospital and were subsequently followed to check for polyp recurrence. Results: Polyp recurrence rate after hysteroscopic surgery and correlation between recurrence and main demographic, hysteroscopic and histopathologic characteristics were analyzed. During mean ± SD follow-up period of 26.3 ± 19.7 months, the overall recurrence rate was high (13.3%) and did not vary (p = NS) with age, parity, weight or other demographic characteristics of the patients or with the hysteroscopic appearance. On the contrary, the histopathologic features showed significant differences between patients with and without polyp recurrence. Recurrence rate was higher (p < 0.001) in women with histopathologically hyperplastic polyps without atypia and lower (p < 0.001) in women with benign polyps. Conclusion: The study shows that after resectoscopic polypectomy, the recurrence rate of endometrial polyps is high (13.3%). Moreover, the hyperplastic polyps without atypia recur more frequently than benign ones.

Keywords:
Endometrial polyps, Recurrence, Resectoscopic polypectomy, Hysteroscopy
1.
Salim S, Won H, Nesbitt-Hawes E, Campbell N, Abbott J: Diagnosis and management of endometrial polyps: a critical review of the literature. J Minim Invasive Gynecol 2011;18:569-581.
2.
AAGL Advancing Minimally Invasive Gynecology Worldwide: AAGL Practice report: practice guidelines for the diagnosis and management of endometrial polyps. J Minim Invasive Gynecol 2012;19:3-10.
3.
Clark TJ, Khan KS, Gupta JK: Current practise for the treatment of benign intrauterine polyps: a national questionnaire survey of consultant gynaecologists in UK. Eur J Obstet Gynecol Reprod Biol 2002;103:65-67.
4.
Goldstein SR, Monteagudo A, Popiolek D, Mayberry P, Timor-Tritsch I: Evaluation of endometrial polyps. Am J Obstet Gynecol 2002;186:669-674.
5.
Tjarks M, Van Voorhis BJ: Treatment of endometrial polyps. Obstet Gynecol 2000;96:886-889.
6.
Sherman MD, Mazur MT, Kurman RJ: Benign diseases of the endometrium; in Kurman RJ (ed): Balustein's Pathology of the Female Genital Tract, ed 5. New York, Springer, 2002, pp 421-457.
7.
Savelli L, De Jaco P, Santini S, Rosati F, Ghi T, Pignotti E, Bovicelli L: Histopathologic features and risk factors for benignity, hyperplasia, and cancer in endometrial polyps. Am J Obstet Gynecol 2003;188:927-931.
8.
Shushan A, Revel A, Rojansky N: How often are endometrial polyps malignant? Gynecol Obstet Invest 2004;58:212-215.
9.
Lieng M, Istre O, Qvigstad E: Treatment of endometrial polyps: a systematic review. Acta Obstet Gynecol Scand 2010;89:992-1002.
10.
Golan A, Cohen-Sahar B, Keidar R, Condrea A, Ginath S, Sagiv R: Endometrial polyps: symptomatology, menopausal status and malignancy. Gynecol Obstet Invest 2010;70:107-112.
11.
Cravello L, Stolla V, Bretelle F, Roger V, Blanc B: Hysteroscopic resection of endometrial polyps: a study of 195 cases. Eur J Obstet Gynecol Reprod Biol 2000;93:131-134.
12.
Van Dongen H, Emanuel MH, Wolterbeek R, Trimbos JB, Jensen FW: Hysteroscopic morcellator for removal of intrauterine polyps amd myomas: a randomized controlled pilot study among residents in training. J Minim Invasive Gynecol 2008;15:466-471.
13.
Gebauer G, Hafner A, Siebzehnrübl E, Lang N: Role of hysteroscopy in detection and extraction of endometrial polyps: results of a prospective study. Am J Obstet Gynecol 2001;184:59-63.
14.
Preutthipan S, Herabutya Y: Hysteroscopic polypectomy in 240 premenopausal and postmenopausal women. Fertil Steril 2005;83:705-709.
15.
Henriquez DD, van Dongen H, Wolterbeek R, Jansen FW: Polypectomy in premenopausal women with abnormal uterine bleeding: effectiveness of hysteroscopic removal. J Minim Invasive Gynecol 2007;14:59-63.
16.
Gao W, Zhang L, Li W, Li J, Wang W, Zhao W, Feng L: Three-year follow-up results of polypectomy with endometrial ablation in the management of endometrial polyps associated with tamoxifen in Chinese women. Eur J Obstet Gynecol Reprod Biol 2012;161:62-65.
17.
Hartman A, Wolfman W, Nayot D, Hartman M: Endometrial thickness in 1,500 asymptomatic postmenopausal women not on hormone replacement therapy. Gynecol Obstet Invest 2013;75:191-195.
18.
Parsons AK, Lense JJ: Sonohysterography for endometrial abnormalities: preliminary results. J Clin Ultrasound 1993;21:87-95.
19.
Corbacioglu Esmer A, Akbayir O, Goksedef BP, Gunduz N, Kisacik S, Dagdeviren H, Guraslan B, Ark C: Is there an appropriate cutoff age for sampling the endometrium in premenopausal bleeding? Gynecol Obstet Invest 2014;77:40-44.
20.
Orvieto R, Bar-Hava I, Dicker D, Bar J, Ben-Rafael Z, Neri A: Endometrial polyps during menopause: characterization and significance. Acta Obstet Gynecol Scand 1999;78:883-886.
21.
Ferrazzi E, Zupi E, Leone FP, Savelli L, Omodei U, Moscarini M, Barbieri M, Cammareri G, Capobianco G, Ciccinelli E, Coccia ME, Donarini G, Fiore S, Litta P, Sideri M, Solima E, Spazzini D, Testa AC, Vignali M: How often are endometrial polyps malignant in asymptomatic postmenopausal women? A multicenter study. Am J Obstet Gynecol 2009;200:235.e1-e6.
22.
Tallini G, Vanni R, Manfioletti G, Kazmierczak B, Faa G, Pauwels P, Bullerdiek J, Giancotti V, Van Den Berghe H, Dal Cin P: HMGI-C and HMGI(Y) immunoreactivity correlates with cytogenetic abnormalities in lipomas, pulmonary chondroid amartomas, endometrial polyps, and uterine leiomyomas and is compatible with rearrangement of the HMGI-C and HMGI(Y) genes. Lab Invest 2000;80:359-369.
© 2014 S. Karger AG, Basel
2014
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.