Post hysteroscopic progesterone hormone therapy in the treatment of endometrial polyps

Abstract

Objective:To find out the clinical effects of post hysteroscopic progesterone hormone therapy in the treatment of endometrial polyps in terms of clinical outcome and the expression of endometrial Vascular Endothelial Growth Factor (VEGF).Methods:Ninety-eight patients who were confirmed as endometrial polyp in the hospital from April 2014 and December 2016 were selected and divided into treatment group and a control group using random number table, 49 in each group. Patients in both groups were given hysteroscopic operation. Patients in the treatment group were treated by progesterone hormone drugs after hysteroscopic operation, while patients in the control group were not given progesterone hormone. The changes of menstrual blood volume, menstrual cycle and expression of VEGF were compared between the two groups after treatment, and the recurrence condition, thickness of endometrium and hemoglobin were followed up one year after treatment.Results:The pictorial blood loss assessment chart (PBAC) scores of patients in the two groups had no significant difference before treatment (P>0.05); but the score of the treatment group was much lower than that of the control group. The improvement rate of menstrual cycle of the treatment group was much higher than that of the control group, and the difference had statistical significance (P<0.05). Compared to before treatment, the serum VEGF level of the patients in both groups had a remarkable decline in the 1st, 3rd and 6th month after treatment, and the difference had statistical significance (P<0.05). The difference of the serum VEGF level between the two groups in the 1st and 3rd month after treatment had no statistical significance (P>0.05). The serum VEGF level of the treatment group was notably lower than that of the control group six months after treatment, and the difference had statistical significance (P<0.05). The follow-up results demonstrated that the treatment group had smaller thickness of endometrium and higher level of hemoglobin compared to the control group, and the recurrence rate of the treatment group was lower than that of the control group (P<0.05).Conclusion:Post hysteroscopic progesterone hormone therapy has favorable clinical effect in treating endometrial polyps as it can effectively prevent the recurrence of endometrial polyps, relieve the level of hemoglobin and reduce endometrial thickness.

Chronic endometritis increases the recurrence of endometrial polyps in premenopausal women after hysteroscopic polypectomy

“…In this study, the overall recurrence rate of EPs in premenopausal women was 14.2% at 12 months after hysteroscopic polypectomy, which is consistent with rates reported in previous studies [14,[20][21][22]. Although, after subgroup analysis according to CE, the recurrence rate of EPs in premenopausal women increased to 26.6%, and CE played a harmful role in the recurrence of EPs.…”

Endometrial polyps: Pathogenesis, sequelae and treatment

“…Post hysteroscopic progesterone hormone therapy was reported to have encouraging clinical effects in the treatment of endometrial polyps as it is shown to have effectively prevented the recurrence of endometrial polyps, and both a reduction of haemoglobin levels and endometrial thickness. 93 Progesterone appeared to be a valid therapeutic alternative for the management of endometrial polyps. 94…”

Analysis of risk factors and model establishment of recurrence after endometrial polypectomy

“…Paradisi et al found that recurrence after endometrial hysteroscopic polypectomy was related to non-atypical concurrent hyperplasia and had nothing to do with appearance, age, parity, weight, or other demographic characteristics (17). The use of progesterone after endometrial polypectomy could significantly reduce the recurrence rate of polyps, which has been confirmed in some previous studies (18,19). After identifying the independent risk factors of endometrial polyp recurrence, we constructed a nomogram for predicting polyp recurrence using logistic regression analysis and verified the calibration curve.…”