ENDOMETRIAL POLYPS:

Which Patients Should Be Selected for Hysteroscopic Surgery?

By
Kaida Irma Setyarini
Abstract

Data on all hysteroscopic procedures

registered as surgery of endometrial
polyps between 19972013 Total:
4512hysterosc
opicoperation
s

The most frequently symptoms of endometrial 1934 cases

polyps were: Endometrial
1. Postmenopausal bleeding polyps
2. Metrorrhagia
3. Pain
4. Infertility.
INTRODUCTION
Endometrial polyps the most
common pathology of the
endometrium in asymptomatic,
postmenopausal women

1660 healthy women between 20 and 74 years old were offered

screening for endometrial polyps and polyps were found in
Material and Methods
Selection
From GynOp, we selected 4512 female
patients (Between 1997- January 2013)
Identification of endometrial polyps pre-,
intra- or postoperatively
Multiple and combined surgeries were
excluded from the analysis.
endometrial polyps were present in 43%
of all hysteroscopic operations in the
registry.
The final study population was 1934
women operated with hysteroscopic
Study Population
Biopsy results were registered
for 1640 (85.8%) patients.
The biopsy results were
divided into three groups:
benign, dysplastic, and
malignant
Objective to examine the
patients according to their
menopausal status, divided
into two groups: pre- and
postmenopausal
Next..
Study Population
follow-up survey Biopsy results
preoperative survey
after 2 months
78.1% (n = 1511) had a response Were
responded rate of 71.3% registered for
(n = 1378) 1640 (85.8%)
patients
Results
The premenopausal group (age < 52 years)
consisted of 835 women (43.2% of the study
The 1934 women were divided population) with a mean age of 42 years and a
median age of 43 years.
into two groups according to
age, a premenopausal and a
postmenopausal.

1099 (56.8%) women in the postmenopausal group

(age 52 years

The most common symptom was bleeding and pain

Next Results..

Operation and Complications

The operation time was
indicated for 1835 patients, with
a mean value of 26 minutes and
median value of 21 minutes.
The longest operation lasted
176 minutes.
The nine operations which
exceeded 100 minutes involved
six perioperative complications:
five blunt perforations and three
hysterectomies.
Next Results..
Next Results..

Histopatology
1640 biopsy results were
registered (84.8%)
1. There were 30 malignancies
(1.8%),
2. 41 dysplasia (2.5%)
3. 1569 benign samples (95.7%).

Microscopic appearance of the polyp after resection.

 Body Mass Index at
Dysplasia/Malignancy
Treatment
hysteroscopy
operation younger woman with an endometrial polyp is experiencing
symptoms such as bleeding or pain

Surgical Optional Hysteroscopicpol

intervention Treatment yp extirpation

Postmenopausal women with bleeding Recommended for all women >60 years of age and for
where an endometrial polyp is suspected every woman with postmenopausal bleeding

Dilatation and
Curettage In postmenopausal women with bleeding, 98% of the endometrial
transformations are focal, and in one study population, 87% of
these transformations remained completely or partly
 Hysteroscopic surgery should be undertaken for
women with postmenopausal bleeding and
presence of endometrial polyps.
The results further indicate a low risk of
Conclusions malignancy in premenopausal women <52 years
with endometrial polyps. In those cases, it seems
to be safe to refrain from surgery.
If there are any symptoms of discomfort for a
patient with an endometrial polyp indicates
that the patient will in a better condition one year
after the surgery.