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.
Highlights
Endometrial polyp, one of the common gynecological diseases, has an incidence of 5.7% in China.[1]
This study mainly investigated the clinical effect of post hysteroscopic progesterone hormone therapy in the treatment of endometrial polyps, deeply studied whether the combined therapy could effectively control the recurrence of endometrial polyp, identify the changes of the serum level of Vascular Endothelial Growth Factor (VEGF) before and after treatment, and explored the possible mechanism of the formation of endometrial polyp, which provides a reliable and effective evidence for the clinical treatment of endometrial polyps
Outcome measure: The improvement of menstrual blood volume and menstrual cycle of the two groups was observed after treatment (menstrual blood volume was evaluated using pictorial blood loss assessment chart (PBAC))
Summary
Endometrial polyp, one of the common gynecological diseases, has an incidence of 5.7% in China.[1] It was reported that endometrial polyp was induced by local hyperplasia of endometrium, and its common clinical manifestations included single or multiple smooth mass with pedicles in different. TCRP4 has little damages to endometrium and can effectively relieve menstrual disorder.[5] But TCRP alone cannot thoroughly resect endometrial polyp and is unable to effectively inhibit the supply of blood to endometrial polyp, leading to higher recurrence rate.[6] Previous studies have suggested that short-acting or slowly released progesterone hormone in combination with hysteroscopic resection was significantly effective in preventing postoperative recurrence of endometrial polyp.[7,8,9]
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