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Federación Mexicana de Ginecología y Obstetricia, A.C.

2007, Number 06

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Ginecol Obstet Mex 2007; 75 (06)

In-office hysteroscopic polypectomy: eight years analysis

Alanís FJ

Language: Spanish
References: 24
Page: 341-346
PDF size: 148.33 Kb.


ABSTRACT

Objective: To evaluate endometrial polypectomy procedure results through in-office hysteroscopy.
Material and method: Retrospective study based on a 641 patients sample with endometrial polyp, within 5,103 diagnostic hysteroscopies done at hysteroscopy clinic in the Hospital General Dr. Manuel Gea Gonzalez, from November 1998 to December 2005.
Results: Abnormal uterine bleeding cases had higher rate within premenopausic (2,951, 57.8%) than postmenopausal (347, 6.7%) patients. From 641 hysteroscopy identified endometrial polyps, 490 (76.37%) were in premenopausic and 151 (23.35%) in postmenopausal patients; 468 (73%) of them were unique, 374 (58.5%) ‹ 1 cm in diameter, 133 (20.7%) with a diameter from 1 to 4 cm, and 134 (20.9%) › 4 cm in diameter. Diagnostic and therapeutic hysteroscopy, at the same time, was performed in all the cases (no major complications); one patient had epileptic crisis during polypectomy and another one uterine perforation, treated only with uterotonic agents. Endometrial cancer was detected in 35 cases (5.4%), 12 (34.29%) premenopausic and 23 (65.71%) postmenopausal.
Conclusions: Successful systemic resection can be performed in-office in most endometrial polyps’ cases, through hysteroscopic study. This technique allows high rate endometrial polyps detection within studied patients.


REFERENCES

  1. Peterson WF, Novack ER. Endometrial polyps. Obstet Gynecol 1956;8(1):40-49.

  2. Savelli L, De Laco P, Santini D, Rosati F, et al. Histopatologic features and risk factors for benignity, hyperplasia, and cancer in endometrial polyps. Am J Obstet Gynecol 2003;183(4):927-31.

  3. Ben-Arie A, Goldchmit G, Laviv Y, Levy R, et al. The malignant potential of endometrial polyps. Eur J Obstet Gynecol Reprod Biol 2004;115(2):206-10.

  4. Martínez MA, Jou P, Nonell R, Cardona M, et al. Pólipos endometriales: riesgo de malignización y correlación clínicoanatómica. Prog Obstet Ginecol 2004;47(11):506-10.

  5. Perez-Medina T, Martinez O, Folgueira G, Bajo J. Which endometrial polyps should be resected? J Am Assoc Gynecol Laparosc 1999;6(1):71-74.

  6. Wolfe SA, Macules A. Malignant lesions arising from benign endometrial polyps. Obstet Gynecol 1962;20:542-51.

  7. Anastasiadis PG, Koutlaki NG, Skaphida PG, Galazios GC, et al. Endometrial polyps: prevalence, detections, and malignant potential in women with abnormal uterine bleeding. Eur J Gynaecol Oncol 2000;21(2):180-3.

  8. Bakour SH, Khan KS, Gupta JK. The risk of premalignant and malignant pathology in endometrial polyps. Acta Obstet Gynecol Scand 2002;81(2):182-3.

  9. Salm R. The incidence and significance of early carcinomas in endometrial polyps. J Pathol 1972;1085(1):47-53.

  10. Vázquez F, González-Tejero C, Bernardo R, Mayor JM. Estudio histeroscópico de los pólipos endometriales y la necesidad de la resección quirúrgica para su confirmación anatomopatológica. Toko-Gin Pract 2004;63(4):320-3.

  11. Clark TJ, Khan KS, Gupta JK. Current practice for the treatment of benign intrauterine polyps: a national questionnaire survey of consultant gyneacologists in UK. Eur J Obstet Gynecol Reprod Biol 2002;103(1):65-67.

  12. Syrop CH, Sahakian V. Transvaginal sonografic detection of endometrial polyps with fluid contrast augmentation. Obstet Gynecol 1992;79(6):1041-3.

  13. Kurjak A, Kupesic S. Transvaginal color Doppler and pelvic tumor vascularity: lessons learned and future challenges. Ultrasound Obstet Gynecol 1995;6(2):145-59.

  14. Mazur MT, Kurman RJ. Polyps. In: Mazur MT, Kurman RJ, editors. Diagnosis of endometrial biopsies and curettings. 2nd ed. New York: Springer Science+Business Media, Inc, 1995;pp:163-177.

  15. Saidi MH, Sadler RK, Theis VD, Akrigth BD, Farhat SA, et al. Comparison of sonography, sonohisterography and hysteroscopy for evaluation of abnormal uterine bleeding. J Ultrasound Med 1997;16(9):587-91.

  16. Escribano JJ, Bértolo JF, Álvarez E, Alguacil M, et al. Utilidad de la histeroscopia en consulta en el diagnóstico y tratamiento del pólipo cervical. Toko Gin Pract 2004;63(5):414-9.

  17. Bergman L, Beelen ML, Gallee MP, Hollema H, et al. Risk and prognosis of endometrial cancer after tamoxifen for breast cancer. Comprehensive Cancer Centres’ ALERT Group. Assessment of liver and endometrial cancer risk following tamoxifen. Lancet 2000;356(9233):881-7.

  18. Fuentes JA, Zacarías CR, Aragón HJP. Sangrado uterino anormal (y el endocrinólogo). Rev Endocrinol Nutr 2005;13(1):39-46.

  19. Bettocchi S, Selvaggi L, Porreca M, Lovero G. The vaginoscopical technique: a new approach to hysteroscopy. J Am Assoc Gynecol Laparosc 1995;(2 Suppl):76.

  20. Bettocchi S, Selvaggi L. A vaginoscopical approach to reduce the pain of the office hysteroscopy. J Assoc Gynecol Laparosc 1997;4:255-8.

  21. Bettocchi S. Techniques for approaching the uterus: classical and vaginoscopical. In: Van Herendael BJ, Valle R, Bettocchi S, editors. Ambulatory hysteroscopy: diagnosis and treatment. 1st ed. Oxfordshire: Bladon Medical Publishing, 2004;pp:40-41.

  22. Mencaglia L, Perino A, Hamou J. Hysteroscopy in perimenopausal and postmenopausal women with abnormal uterine bleeding. J Reprod Med 1987;32(8):577-82.

  23. DeWaay DJ, Syrop CH, Nygaard IE, Davis WA, et al. Natural history of uterine polyps and leiomyomata. Obstet Gynecol 2002;100(1):3-7.

  24. Loffer, FD. Hysteroscopy with selective endometrial sampling compared with D&C for abnormal uterine bleeding: the value of negative hysteroscopic view. Obstet Gynecol 1989;73(1):16-20.




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