Endometrial Micropoliposis, Hysteroscopic Manifestation of Chronic Endometritis

Abstract

Study Objective Identify the relationship between hysteroscopic findings of micropoliposis and the histopathological result of chronic endometritis in a series of cases. Design Between 02/01/17 and 02/15/21, cases diagnosed with endometrial micropoliposis were analyzed through hysteroscopy and histopathology in the gynecological endoscopic surgery service of the Hospital “Lic. Adolfo López Mateos” ISSSTE. Setting Hysteroscopy in gynecological position, 2.7 mm outer diameter lens, 105 ̊ visual field angle, 4.5 mm outer diameter. Saline solution was used to dilate the uterine cavity. The anterior and posterior uterine walls were examined. Patients or Participants 42 patients undergoing hysteroscopy were included in which micropoliposis was reported. Interventions A biopsy was taken of the compatible lesions with micropoliposis by hysteroscopy, reporting inflammatory infiltration with plasma cells was reported in relation to endometritis. Measurements and Main Results The mean age was 28 years, 39 with abnormal uterine bleeding (92%), 1 with infertility (2%) and 2 with a bicornuate uterus with a non-communicating cavity (4%), no patient presented data of vaginal or pelvic infection, cultures: Mycoplasma hominis in 17 (40%), Ureaplasma urealyticum in 15 (35.7%), Chlamydia in 2 (4%), E. Coli in 4 (8%), Gardnerella vaginalis in 2 (4%) and 2 with Müllerian malformations and negative cultures (4%). All patients were treated according to antibiogram with a new culture after 3 months, the infection persisted in 3 patients (7%), having negative cultures with a second antibiotic scheme. All patients had improvement in bleeding, after the management of the Müllerian malformation, micropoliposis persisted 6 months after surgery. Conclusion Chronic endometritis can be manifested as micropoliposis by hysteroscopy, just with abnormal uterine bleeding without data of an active infectious process. Although chronic endometritis has been mentioned as an infertility factor, none of our patients had a desire for pregnancy. In the presence of endometrial micropoliposis by hysteroscopy, chronic endometritis should be suspected, and special cultures against Mycoplasmas and Chlamydia should be performed. Identify the relationship between hysteroscopic findings of micropoliposis and the histopathological result of chronic endometritis in a series of cases. Between 02/01/17 and 02/15/21, cases diagnosed with endometrial micropoliposis were analyzed through hysteroscopy and histopathology in the gynecological endoscopic surgery service of the Hospital “Lic. Adolfo López Mateos” ISSSTE. Hysteroscopy in gynecological position, 2.7 mm outer diameter lens, 105 ̊ visual field angle, 4.5 mm outer diameter. Saline solution was used to dilate the uterine cavity. The anterior and posterior uterine walls were examined. 42 patients undergoing hysteroscopy were included in which micropoliposis was reported. A biopsy was taken of the compatible lesions with micropoliposis by hysteroscopy, reporting inflammatory infiltration with plasma cells was reported in relation to endometritis. The mean age was 28 years, 39 with abnormal uterine bleeding (92%), 1 with infertility (2%) and 2 with a bicornuate uterus with a non-communicating cavity (4%), no patient presented data of vaginal or pelvic infection, cultures: Mycoplasma hominis in 17 (40%), Ureaplasma urealyticum in 15 (35.7%), Chlamydia in 2 (4%), E. Coli in 4 (8%), Gardnerella vaginalis in 2 (4%) and 2 with Müllerian malformations and negative cultures (4%). All patients were treated according to antibiogram with a new culture after 3 months, the infection persisted in 3 patients (7%), having negative cultures with a second antibiotic scheme. All patients had improvement in bleeding, after the management of the Müllerian malformation, micropoliposis persisted 6 months after surgery. Chronic endometritis can be manifested as micropoliposis by hysteroscopy, just with abnormal uterine bleeding without data of an active infectious process. Although chronic endometritis has been mentioned as an infertility factor, none of our patients had a desire for pregnancy. In the presence of endometrial micropoliposis by hysteroscopy, chronic endometritis should be suspected, and special cultures against Mycoplasmas and Chlamydia should be performed.