Clinical Study of Endometrial Polyp and Role of Diagnostic Hysteroscopy and Blind Avulsion of Polyp

Kanthi, Janu Mangala; Remadevi, Chithra; Sumathy, S; Sharma, Deepti; Sreedhar, Sarala; Jose, Amrutha

doi:10.7860/jcdr/2016/18173.7983

Cited by 18 publications

(16 citation statements)

References 11 publications

(2 reference statements)

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“…21 In this study, endometrial polyp was least common (1%) among neoplastic and related lesions which is much lower as compared to 10% in study by Aslam et al but similar to 1.3% in the study by Baral et al 15,22 Polyp manifested as AUB in 45.6% of study population in the study of Kanthi et al which is surprisingly high in comparison to our findings and are probably due jlmc.edu.np to difference in patient selection. 23 Premalignant lesions were discovered in nine (9%) cases which were lesser than 18.3% in a study by Baral et al 15 Complex hyperplasia with atypia was the most common (4 %) form of endometrial hyperplasia which was higher than 1.3% in studies by Takreem et al and in Tabata et al 24,25 The frequency of endometrial carcinoma in our study was 5% of total endometrial biopsies and it was higher compared to a study done in Nepal by Dhakal et al (2%,N=32) and Aslam et al (1%). 26,22 In contrast to present study, in a study of 1837 patients aged over 26 years in Japan, 2.8% patients were found to have malignant disease, of which, 2.6% of patients had endometrial carcinoma and 0.2% had other malignancies.…”

Section: Discussionmentioning

confidence: 99%

Histopathological Study of Endometrial Biopsy Specimens for Abnormal Uterine Bleeding

Tiwari¹,

Kaur²,

Jain³

et al. 2016

J Lumbini Med Coll

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Introduction: Endometrial specimen for abnormal uterine bleeding (AUB) is the one of the commonest specimens received in histopathology laboratory. Histopathological characteristics of endometrial tissues, as assessed by light microscopy, remains the diagnostic standard for the management of AUB. The objective of study is to find out the histopathological pattern of endometrium in AUB in the light of clinical details. Methods: This was a prospective observational study carried out in the department of Pathology, Lumbini Medical College Teaching Hospital for a period of two years from June 2014 to May 2016. Formalin fixed endometrial specimens were processed, paraffin embedded, sectioned at 3-4 µm, stained with hematoxylin and eosin, and studied under light microscopy along with their demographics. Data were collected, entered and analyzed using SPSS version 20. Results: The study included 100 cases of endometrial biopsy specimens with clinical diagnosis of AUB. Menstrual disturbances was found in wide age range between 17-75 years with the mean age of 45 (SD=13.36) years. Menorrhagia was the commonest (n=60, 60%) clinical presentation. Most (n=85; 85 %) endometrium had non-neoplastic lesions. Among them, normal endometrial patterns were commonest (n=50, 50 %). Neoplastic lesions (n=15, 15%) were distributed in all menstruation status with majority in postmenopause (n=7, 7%) and included malignant cases (n=5, 5%) among others. Conclusion: Post-menopausal bleeding was common presentation among women with malignant and premalignant disease which was present in 15% of the cases together. Timely evaluation of AUB by histopathology can be life saving with early tissue diagnosis and management.

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Section: Discussionmentioning

confidence: 99%

Histopathological Study of Endometrial Biopsy Specimens for Abnormal Uterine Bleeding

Tiwari¹,

Kaur²,

Jain³

et al. 2016

J Lumbini Med Coll

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“…Spontaneous regression has been reported in 6.3 to 25% of cases [97,104]. Although its etiopathogenesis is still unknown, it is usually presented as a hormone-related condition [103,105,106]. Yet, there is to date sufficient evidence indicating an inflammation-mediated pathogenesis, especially as hormonal imbalances are demonstrated to interfere with the inflammatory state of the endometrium [65,99,106].…”

Section: The Concept Of Impaired Inflammatory State Of the Endometriummentioning

confidence: 99%

Impaired inflammatory state of the endometrium: a multifaceted approach to endometrial inflammation. Current insights and future directions

Drizi¹,

Djokovic²,

Laganà³

et al. 2020

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New insights into the complex and fine-regulated inflammatory mechanisms involved in the endometrium reveal multiple facets to the problem of endometrial inflammation. However, the entity termed chronic endometritis is to date restricted to infectious etiology and managed with antibiotics. Conversely, the concept of impaired inflammatory state of the endometrium (IISE) provides a more global approach to defective endometrial inflammation, considering both infectious and non-infectious etiology. A non-systematic review was done through a search on MEDLINE, EMBASE, Global Health, The Cochrane Library, Health Technology Assessment Database and Web of Science, research registers. Pertinent original and review articles, published in English or French until December 31, 2019, were selected. A compelling body of evidence demonstrates transient, repeated and persistent IISE to be a major factor of most problematic disorders in obstetrics/gynecology, such as endometrial polyps, unexplained infertility, miscarriage, placenta-related pathology and endometrial cancer. When scheduled accordingly, hysteroscopy can play a key role in the IISE assessment. Robust data suggests the pertinence of minimal-effective anti-inflammatory regimens for therapeutic IISE targeting. This review provides a comprehensive update on the multiple facets of inflammation in the endometrial physiology and pathology. Further research is needed to improve classification, diagnosis and treatment of IISE.

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“…In a period of 37.57±28.12 months, 3.9% had recurrence. In a follow-up period of 16.56±18.96 months, 78.9% women did not have any recurrence 8 . According to a Turkish study aimed at sonographic description of the endometrium, there is significant correlation between ultrasound findings and histopathological results.…”

Section: Discussionmentioning

confidence: 84%

“…Polyps manifested as abnormal uterine bleeding in 45.6% (ref. 8 ). There is no relation between symptoms and the size or number of polyps 9 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of ultrasound with hysteroscopic and histological findings for intrauterine assessment

Reznak¹,

Kudela²

2018

BIOMED PAP

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Introduction. Hysteroscopy with biopsy is a common diagnostic and therapeutic method in gynaecology. Its use is preceded by ultrasound examination. The success rate of predicting intrauterine findings based on ultrasound has not been assessed in the Czech Republic for a long time. In the meantime, there have been technological improvements in ultrasound devices. Method. Patients indicated for hysteroscopy underwent ultrasound examination and their medical history was recorded. The percentage agreement between ultrasound and histopathological findings was assessed. The secondary goal was to find an easier way of describing ultrasound findings in gynaecological practice. Results. The study comprised 255 patients. In 15 cases, endometrial carcinoma was confirmed by hysteroscopy and histopathological examination. Of these, malignancies were suspected based on previous ultrasound scans in 11 patients. In 95 cases, intrauterine polyps were detected. The success rate for predicting polyps by ultrasound examination was 65.1%. The agreement between ultrasound and hysteroscopic/histopathological findings was 72%. The secondary goal of making the description of the uterine cavity easier was not fulfilled. The prediction percentages for the criteria were low. The incidence of pathological findings in ultrasound findings labelled as anechogenic was 4.8%, suggesting a high negative predictive value. Conclusion. In spite of the better resolution of new ultrasound devices, their predictive value remains limited. Findings that are suspicious in ultrasound should be confirmed by hysteroscopy with biopsy.

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Clinical Study of Endometrial Polyp and Role of Diagnostic Hysteroscopy and Blind Avulsion of Polyp

Cited by 18 publications

References 11 publications

Histopathological Study of Endometrial Biopsy Specimens for Abnormal Uterine Bleeding

Histopathological Study of Endometrial Biopsy Specimens for Abnormal Uterine Bleeding

Impaired inflammatory state of the endometrium: a multifaceted approach to endometrial inflammation. Current insights and future directions

Comparison of ultrasound with hysteroscopic and histological findings for intrauterine assessment

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