Endometrial polyps: Pathogenesis, sequelae and treatment

Nijkang, Njume Peter; Anderson, Lyndal; Markham, Robert; Manconi, Frank

doi:10.1177/2050312119848247

Cited by 117 publications

(139 citation statements)

References 102 publications

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“…Endometrial polyps have an overall malignant potential of less than 5% [2,11]. The incidental finding of endometrial polyps with focal atypical endometrial hyperplasia and squamous metaplasia was discussed with the patient at follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…At the time of the surgery, the only risk factor for endometrial polyps was obesity, and the only symptom was AUB, likely related to the large fibroids. Because the pathology reported focal atypia with a size less than 1.5 cm and a due to a supracervical hysterectomy being performed, the likelihood of this incidental finding having long-term consequences is low [2,5,11].…”

Section: Discussionmentioning

confidence: 99%

“…Both endometrial polyps and uterine leiomyomas are benign structural abnormalities of the uterus that can present with AUB. Endometrial polyps are localized hyperplastic overgrowths of endometrial glands and stroma around a vascular core that form a sessile or pedunculated projection from the surface of the endometrium [2]. Uterine leiomyomas are noncancerous monoclonal tumors arising from the smooth muscle cells and fibroblasts of the myometrium that are described based on their location according to the International Federation of Gynecology and Obstetrics (FIGO) classification system (Intramural, Submucosal, Subserosal, Cervical) [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Endometrial polyps can present with AUB or rarely prolapse. However, many are asymptomatic and are discovered as the result of an evaluation for infertility, a finding of endometrial cells on cervical cytology, or as an incidental finding on endometrial sampling, pelvic imaging, or hysteroscopy [2]. Single or multiple polyps may occur, ranging in diameter from a few millimeters to several centimeters, expressing both estrogen and progesterone receptors.…”

Section: Introductionmentioning

confidence: 99%

“…Single or multiple polyps may occur, ranging in diameter from a few millimeters to several centimeters, expressing both estrogen and progesterone receptors. The prevalence of polyps appears to increase with age and risk factors include tamoxifen use, obesity, postmenopausal hormone therapy, and women with Lynch and Cowden syndromes [2,5]. Treatment, when found in isolation, usually requires polypectomy.…”

Section: Introductionmentioning

confidence: 99%

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Abdominal Supracervical Hysterectomy With Bilateral Salpingo-Oophorectomy as the Surgical Approach for a 22-Week Uterus With Incidental Endometrial Polyp Focal Atypia

Rodriguez

Mehra

Saroop

et al. 2020

Cureus

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A 49-year-old perimenopausal female presented with abnormal uterine bleeding (AUB) and chronic lower abdominal pain with associated urinary urgency. The patient elected to have an abdominal supracervical hysterectomy with bilateral salpingo-oophorectomy for a large, symptomatic fibroid uterus. Preoperative ultrasounds revealed a uterine size of 22 x 20 x 17 cm and a 15.9 x 13 x 9 x 9.2 cm subserosal fibroid occupying the majority of the fundus and body of the uterus. Under general anesthesia, abdominal supracervical hysterectomy and bilateral salpingo-oophorectomy with a midline vertical incision were completed. Pathology reported a uterus with multiple leiomyomata as well as endometrial polyps with focal atypical endometrial hyperplasia and squamous metaplasia. Overall, the uterine corpus with one attached adnexa weighed 3433 g and was 25.8 x 20.3 x 15cm. Choice of surgical approach in a hysterectomy depends upon clinical circumstances, the surgeon's technical expertise, and patient preference. Although minimally invasive hysterectomies via vaginal and laparoscopic approaches are now preferred due to decreased hospitalization stays and postoperative recovering times, individualized treatment plans for patients should be considered depending on uterine size and the possibility of not achieving adequate exposure, which may lead to complications. As this case presents, an abdominal hysterectomy is an important option for certain patients where the use of other approaches could pose significant risk.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Abdominal Supracervical Hysterectomy With Bilateral Salpingo-Oophorectomy as the Surgical Approach for a 22-Week Uterus With Incidental Endometrial Polyp Focal Atypia

Rodriguez

Mehra

Saroop

et al. 2020

Cureus

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Evaluation of endometrial thickness by transvaginal ultrasound and baseline risk factors as a predictor for endometrial abnormalities in postmenopausal women

Yerrisani

Kothari

Collins

et al. 2022

Australas J Ultrason Med

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Introduction/Purpose: To evaluate the endometrial thickness (ET) as a predictor of endometrial abnormalities in postmenopausal women and whether consideration of baseline risk factors increases diagnostic accuracy. Methods: This is a retrospective observational study of postmenopausal women presenting with bleeding or thickened endometrium (≥4 mm) on ultrasound, between 2003 and 2012. Risk factors for endometrial abnormality were analysed using logistic regression. Of 301 women, 220 were symptomatic and 81 were asymptomatic. The median ET was 6 mm (IQR 4-9) for symptomatic women and 9 mm (IQR 6-12) for asymptomatic women. Results: Abnormal pathology was found in 35 symptomatic (15.9%) and 6 asymptomatic women (7.4%). For each 1 mm increase in ET, the odds of an abnormal diagnosis increased by 16.3% (95% CI 9.6-23.5) for symptomatic and 19.9% (95% CI 3.1-39.3) for asymptomatic women. The Youden's index method identified an ET threshold of ≥7.1mm for symptomatic and ≥14.5mm for asymptomatic women. In symptomatic women the sensitivity was 88.6% (95% CI 72.3-96.3) and specificity 69.2% (95% CI 61.9-75.6), while in asymptomatic women the sensitivity was 50.0% (95% CI 13.9-86.1) and specificity was 89.3% (95% CI 79.5-95.0). The addition of age in the symptomatic women model reduced the sensitivity (82.9% (95% CI 65.7-92.8)) but increased the specificity (72.4% (95% CI 65.3-78.6)). Conclusion: ET is a significant predictor of abnormality. In the absence of risk factors, our study suggests that invasive procedures may be withheld until the ET is ≥7.1 mm with bleeding and ≥14.5 mm in asymptomatic women with no bleeding.

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microRNAs in female infertility: An overview

Bahmyari

Jamali

Khatami

et al. 2021

Cell Biochemistry & Function

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Infertility impacts a considerable number of women worldwide, and it affects different aspects of family life and society. Although female infertility is known as a multifactorial disorder, there are strong genetic and epigenetic bases. Studies revealed that miRNAs play critical roles in initiation and development of female infertility related disorders. Early diagnosis and control of these diseases is an essential key for improving disease prognosis and reducing the possibility of infertility and other side effects. Investigating the possible use of miRNAs as biomarkers and therapeutic options is valuable, and it merits attention. Thus, in this article, we reviewed research associated with female diseases and highlighted microRNAs that are related to the polycystic ovary syndrome (up to 30 miRNAs), premature ovarian failure (10 miRNAs), endometriosis (up to 15 miRNAs), uterine fibroids (up to 15 miRNAs), endometrial polyp (3 miRNAs), and pelvic inflammatory (6 miRNAs), which are involved in one or more ovarian or uterine disease‐causing processes.

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Endometrial polyps: Pathogenesis, sequelae and treatment

Cited by 117 publications

References 102 publications

Abdominal Supracervical Hysterectomy With Bilateral Salpingo-Oophorectomy as the Surgical Approach for a 22-Week Uterus With Incidental Endometrial Polyp Focal Atypia

Abdominal Supracervical Hysterectomy With Bilateral Salpingo-Oophorectomy as the Surgical Approach for a 22-Week Uterus With Incidental Endometrial Polyp Focal Atypia

Evaluation of endometrial thickness by transvaginal ultrasound and baseline risk factors as a predictor for endometrial abnormalities in postmenopausal women

microRNAs in female infertility: An overview

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