Effectiveness of Hysteroscopic Techniques for Endometrial Polyp Removal: The Italian Multicenter Trial

Luerti, Massimo; Vitagliano, Amerigo; Sardo, Attilio Di Spiezio; Angioni, Stefano; Garuti, Giancarlo; Angelis, C. De; Zoppo, Serena Del; Dealberti, Davide; Nappi, Luigi; Perrini, Gaetano; Bettocchi, Stefano; Casadio, Paolo; Marchino, Gian Luigi; Busato, Enrico; Calzolari, Stefano; Castellacci, E.; Leone, Francesco; Benassi, G; Mangino, Francesco Paolo; Scrimin, Federica; Giarrè, Giovanna; Cela, Vito; Florio, Pasquale

doi:10.1016/j.jmig.2018.12.002

Cited by 34 publications

(22 citation statements)

References 41 publications

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“…EPs are localized, sessile or pedunculated projections of endometrial mucosa, resulting from the hyperplastic overgrowths of glands and stroma around a vascular core [ 27 , 28 ]. EPs are common findings in both reproductive age and post-menopausal women.…”

Section: Introductionmentioning

confidence: 99%

Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

et al. 2021

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Background: Chronic endometritis (CE) and endometrial polyps (EPs) are common conditions in reproductive age women. CE is an infectious disorder of the endometrium characterized by signs of chronic inflammation at hysteroscopic and histological analyses. EPs are abnormal endometrial growths containing glands, stroma and blood vessels projecting from the lining of the uterus. During the last years, different authors have investigated the correlation between CE and EPs, with controversial results. The aim of this study was to summarize available evidence on the potential correlation between CE and EPs. Design: Systematic literature review and meta-analysis. Methods: Observational-studies were identified by searching electronic databases from their inception to September 2021. Only studies on pre-menopausal women were included. Statistical analysis was performed using MedCalc 16.4.3 (Ostend, Belgium) and Review Manager version 5.3 (Nordic Cochrane Centre, Cochrane Collaboration). The summary measures were reported as pooled proportion or odds ratio (OR) with 95% confidence interval (CI). The primary outcome was to evaluate the prevalence of CE in women with EPs. The secondary outcome was to determine the prevalence of CD-138-positive EPs among EPs. Tertiary outcomes were to compare the prevalence of CE in women with EPs versus women with a non-polypoid endometrium and to compare the prevalence of CE in women with a single EP versus women with multiple EPs. Results: Eight observational studies (n = 3225 patients) were included in quantitative synthesis. Pooled prevalence of CE among women with EPs was 51.35% (95% CI, 27.24–75.13%). Pooled proportion of CD-138-positive EPs among EPs was 70.73% (95% CI, 55.73–83.68%). Women with EPs showed higher prevalence of CE compared to women without EPs (OR 3.07, 95% CI 1.59–5.95). Women with ≥3 EPs had higher prevalence of CE then women with a single EP (OR 3.43, 95% CI 1.83–6.46). Conclusions: In pre-menopausal women, CE and EPs may have a dependent relationship and may represent two consequent steps of a common pathological process.

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Section: Introductionmentioning

confidence: 99%

Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

et al. 2021

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“…To some extent, polypectomy may even be considered as overtreatment for this cohort, and may be considered a therapeutic approach with high healthcare costs that also carries with it the risks associated with anesthesia and surgery [3]. A multicenter, prospective observational trial reported a rate of 2.27% for surgical complications in patients treated with hysteroscopic polypectomy [8].…”

Section: Discussionmentioning

confidence: 99%

A prospective, open-label, single-arm study to evaluate the efficacy of dydrogesterone in the treatment of endometrial polyps

Chen

Zhang

Wang

et al. 2020

Gynecological Endocrinology

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“…Random endometrial biopsies are advocated to improve the sensitivity and specificity of the diagnostic method [ Figure 2 ]. [ 35 36 37 ]…”

Section: E Ndometrial S Ampling With H Ysteroscopy Using 5 F R mentioning

confidence: 99%

A mini-review of office hysteroscopic techniques for endometrial tissue sampling in postmenopausal bleeding

Haimovich

Tanvir

2021

J Mid-life Health

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Postmenopausal bleeding (PMB) is a common cause for a gynecological visit. Endometrial cancer risk varies from 3% to 25% in women with PMB. There is a significant concern of malignancy of the endometrium and the endocervical canal by a physician in postmenopausal women, and hence, most prefer operating room hysteroscopies with dilation and curettage (D & C) compared to in-office procedures. With increased availablility of miniaturized instruments such as mini- resectoscope and tissue removal systems, there is high likelihood of blind D & C being replaced by hysteroscopic- guided targetted biopsy or visual D & C. The cost-effectiveness of office hysteroscopy is also well demonstrated. In December 2020, an electronic search was performed of PubMed, MEDLINE, and Cochrane Library to look for articles on office hysteroscopic biopsy techniques in postmenopausal women from 2010 to 2020. Relevant studies were included where various office hysteroscopic techniques are used for endometrial sampling in PMB. Studies with 5 Fr scissors, biopsy forceps, crocodile forceps, cup forceps, bipolar electrode, in-office tissue removal system (morcellator), flexible hysteroscope, and mini-resectoscope were included. Standard reference was used as an adequate endometrial sample for histology. The objective of this review is to explore the current evidence on different office hysteroscopic techniques available for endometrial tissue sampling in PMB. Research Question: What are the different available in - office hysteroscopy techniques for obtaining endometrial biopsy? Clinical Importance: Understanding the adequacy of an endometrial tissue sample obtained by different in - office hysteroscopy techniques and their accuracy by histology.

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Effectiveness of Hysteroscopic Techniques for Endometrial Polyp Removal: The Italian Multicenter Trial

Cited by 34 publications

References 41 publications

Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

A prospective, open-label, single-arm study to evaluate the efficacy of dydrogesterone in the treatment of endometrial polyps

A mini-review of office hysteroscopic techniques for endometrial tissue sampling in postmenopausal bleeding

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