Polyps In Women Research Articles

Analysis of risk factors for the development of hyperproliferative endometrial processes in women of reproductive age

Based on clinical and statistical analysis, a study of the leading etiopathogenetic factors in the development of hyperplastic processes of the endometrium in patients of reproductive age was carried out.The aim of the study: to study the risk factors for hyperplasia and endometrial polyps in women of early reproductive age.Materials and methods. Clinical and statistical analysis of 120 patients of active reproductive age with verified atypical hyperproliferative pathology of the endometrium (hyperplasia and endometrial polyps) was included in the main group. The main group was divided into subgroups: Subgroup I - 45 women with endometrial hyperplasia, Subgroup II - 45 patients with endometrial polyps and Subgroup III - 30 patients with combined endometrial pathology (hyperplasia and endometrial polyps).Results of reseаrсh. The leading risk factors for the development of hyperplastic endometrial processes in women of the examined groups have been identified: aggravated heredity, high frequency of medical abortions, miscarriages and a history of abnormal births. There is a high incidence of gynecological and extragenital diseases, surgical interventions on the uterus and appendages in the examined contingent of women, which contributes to the development of endometrial pathology. It is established that the most common clinical manifestations of endometrial hyperproliferative processes are pain and hemorrhagic syndromes.Conclusions. Risk factors for hyperproliferative pathology of the endometrium in women of reproductive age are the following: burdened heredity (60.8%), concomitant extragenital pathology (57.4%), menstrual disorders (86.7%), impaired reproductive function; burdened gynecological anamnesis: chronic inflammatory processes of the uterus and appendages (45.8%), artificial (74.2%) and spontaneous (22.5%) abortions; intrauterine surgical interventions (26.7%).

The prevalence of endometrial polyp in women with tubal factor infertility is higher than male factor infertility: Is PID one of the causes of endometrial polyp?

Previous studies have shown an association between chronic endometritis and endometrial polyps, and only one study in infertile women reported an association between tubal obstruction and polyps. This study aimed to compare the prevalence of endometrial polyps in two groups of women with tubal factor infertility and male factor infertility to assess if is there any association between tubal factor infertility and endometrial polyps. This case-control study was performed on infertile women. The case group included women with tubal factor infertility and the control group included all women with male factor infertility. In all patients, vaginal ultrasound was performed between days 8 and 12 of the menstrual cycle to diagnose endometrial polyp, its size, and number. Demographic and obstetrics variables were recorded. Patients underwent hysteroscopy and polypectomy and the diagnosis of the polyp was confirmed by pathology report. In the present study, 245 people participated in two groups. There was a statistically significant difference between the two groups in terms of demographic and obstetric characteristics like type of infertility, duration of infertility, and gravidity. The prevalence of polyps in the tubal factor group was higher than in the male factor group (63 [60%] vs. 12 [9.8%]), and this difference was statistically significant (p=0.0001). In addition, the prevalence of chronic endometritis in the tubal factor group was higher than in the male factor group (19 [18.8%] vs. 4 [3.3%]), and this difference was statistically significant (p=0.001). In the present study, a strong association was observed between endometrial polyps and tubal obstruction, and considering that the most common cause of tubal obstruction is pelvic and genital infections, after confirmation with more studies, it may be possible to consider antibiotic treatment in these patients, especially in patients with recurrent polyps.

Pathogenesis mechanisms of endometrial polyps in women of reproductive age: a literature review

Endometrial polyp (EP) is a frequent incidental finding during hysteroscopy in asymptomatic patients. To date, the pathogenesis of EPs has not been fully disclosed, which challenges the primary and secondary prevention of EPs and their targeted therapy. It determined the focus of our work. We searched for scientific publications in Cochrane Library, ScienceDirect, PubMed (MEDLINE), eLIBRARY using the keywords "polyps", "endometrial polyps", "pathogenesis", "reproductive age", "recidive" for 20122022. Analysis of the literature data allowed us to conclude that ES pathogenesis most likely involves several mechanisms, both estrogen-mediated (hyperestrogenism, including related to impaired progesterone reception and deficiency) and non-hormonal (inflammatory, immune, genetic factors, neoangiogenesis). Hormonal and non-hormonal factors disturb normal cyclic changes of the endometrium during the menstrual cycle, alter the balance and dynamics of proliferation and apoptosis, and initiate neoangiogenesis that serves as a resolving mechanism of polyposis formation, persistence of ES, and their recurrence after surgical removal. The objective of our study was to analyze and summarize the scientific data available on the mechanisms of ES pathogenesis in women of reproductive age.

Can endometrial thickness at baseline or maximum stimulated levels during IVF predict the presence of endometrial polyps in women with two failed embryo transfers?

To evaluate whether different measurements of endometrial thickness pre-IVF cycle and during the IVF cycles as measured by transvaginal ultrasound are associated with the absence or presence of endometrial polyps. A retrospective cohort study was conducted in a university-affiliated fertility center. Patients were women who underwent two embryo transfer cycles and failed to conceive. hysteroscopic evaluation and resection of any masses. There was no difference on comparing the groups with and without polyps in the mean endometrial thicknesses at baseline scans pre-treatment or during IVF cycle. For women who failed two embryo transfer cycles, at any given endometrial thickness the probability of the presence of a polyp was 30-40%. ROC curves failed to detect an actionable relationship with different endometrial thicknesses and the relationship with an endometrial polyp, with most areas under the curve being just above 0.5. However, once the maximum stimulated endometrial thickness was ≥ 13mm, there was a 70% chance of a polyp being noted at hysteroscopy. This was a statistical difference in the probability of a polyp being present as compared to the lesser thicknesses (p = 0.05). Baseline or maximum stimulated endometrial thickness at IVF fails to predict with accuracy the presence of a polyp. However, if the maximum stimulated thickness was at least 13mm, there was a higher probability of a uterine polyp being present. Such a cutoff would nevertheless miss most polyps. At any baseline thickness on CD 2-5, a polyp has a 30-40% probability of being present in women who failed two embryo transfers. ROC curves suggest that at baseline, or maximum stimulated endometrial thickness, the ability to predict a polyp is no better than flipping a coin. As such, endometrial cavity evaluation for polyps is legitimate in women with two embryo transfers irrelevant of the baseline or stimulated thickness.

Prognostic value of levels of specific autoantibodies in patients of reproductive age with endometrial polyps

The problem of endometrial polyps in women of reproductive age is one of the urgent problems of modern gynecology. The detection rate of PE according to the data of domestic and foreign scientists reaches 25–35%, and therefore they occupy a leading place in the structure of intrauterine pathology.The aim. To study the levels of specific autoantibodies (to double-stranded DNA; to TrM‑03 antigens and collagen) and to assess their prognostic value for the risk of PE formation and recurrence in patients of reproductive age.Materials and methods. Examination of 86 patients aged 18 to 45 years (average age was 34.1 ± 6.3 years), admitted for hysteroscopy, hysteroresection of PE. Study of the relative content of specific autoantibodies to double-stranded DNA; to TrM‑03 antigens and collagen in blood serum was carried out by the method of enzyme-linked immunosorbent assay using specialized reagent kits (ELI-P-Complex).Results. In the course of this study, it was found that in the overwhelming majority of cases (65.1%) PEs were manifested by various types of AMC. All patients with PE were diagnosed with a significant decrease in the level of autoantibodies to double-stranded DNA, which is a marker of apoptosis processes, as well as a statistically significant decrease in the levels of autoantibodies to platelet antigens TrM‑03. The profile of deviations in the level of autoantibodies to TrM‑03 from the reference range in the area of negative values correlated with an increase in the average level of autoantibodies to collagen.Conclusions. Determination of the levels of auto-ATs to double-stranded DNA in serum can be used as a marker for predicting the recurrent course of PE. Determination of the levels of auto-ATs to platelet antigens TrM‑03 and to collagen in blood serum can be used as markers for the development of AMC by the type of BMC or a combination of BMC and BMC in patients with endometrial polyps.

A study on the correlation between occupational radiation exposure and risk of chronic metoblis disease

Objective: To study the correlation between occupational radiation exposure and chronic metabolic diseases. Methods: The status of chronic metabolic diseases of medical workers were compared in 5 hospitals in Hangzhou. As representatives of chronic metabolic diseases, diabetes and metabolic syndrome (MS) were compared in association with duration of radiation exposure. Results: Long-term ionizing radiation (IR) exposure was led to increased blood pressure, fasting blood glucose (FBG) , dyslipidemia, gallbladder disease, and MS. The years of radiation exposure was associated with lens opacity, gallstone and MS in men and gallbladder polyps in women. Radiation working more than 10 years is one of the independent risk factors for increased FBG and MS. Moreover, the risk of FBG increase in the group of radiation working more than 10 years was 3.052 times of that the non-exposed group, and the risk of MS occurrence was 4.132 times that of the non-exposed group. Conclusion: Long-term exposure to IR increases the risk of chronic metabolic diseases.

Long-term Use of Hormone Replacement Therapy is Associated With a Lower Risk of Developing High-risk Serrated Polyps in Women.

Hormone replacement therapy (HRT) and parity have been suggested protective factors against the development of colorectal polyps. However, there are a limited number of studies that have examined the relationship of these factors with high-risk adenomatous polyps (HRAP) or high-risk serrated polyps (HRSP), which may have different causes and therefore implications for screening programs. Data from a cross-sectional study of 1384 women undergoing screening-related colonoscopy between 2008 and 2016 were analyzed. Modified Poisson regression models with robust error variance were used to determine the relative risk of developing adenomatous polyps, serrated polyps, HRAPs, and HRSPs associated with pregnancy, menopausal status, and the use of HRT (duration and type). Women that used HRT for ≥6 years were at a significantly lower risk of developing a HRSP [risk ratios (RR): 0.53; 95% confidence interval (CI): 0.29-0.97]. Irrespective of the duration of use, the use of HRT that included progesterone alone or with estrogen was associated with a significantly lower risk of developing a HRSP (RR: 0.54; 95% CI: 0.30-0.95). The use HRT with progesterone for ≥6 years was associated with a nonsignificant lower risk of developing a HRSP (RR: 0.42; 95% CI: 0.17-1.04). None of the reproductive factors assessed or HRT were associated with the development of adenomatous polyps or HRAPs. The results of this study suggests that the long-term use of HRT, and therapies that include progesterone are associated with a lower risk of developing HRSPs. These results could have implications for targeted screening for serrated polyps among women.

Genetic Obesity Variants and Risk of Conventional Adenomas and Serrated Polyps.

Higher body mass index (BMI) is associated with increased risk of colorectal cancer. How genetically predicted BMI may be associated with colorectal cancer precursors is unknown. Our objective was to quantify the association of genetically predicted and measured BMI with risk of colorectal cancer precursors. We evaluated the association of genetically predicted and measured BMI with risk of conventional adenomas, serrated polyps, and synchronous polyps among 27,426 participants who had undergone at least one lower gastrointestinal endoscopy in the Nurses' Health Study, Nurses' Health Study II, and Health Professionals Follow-up Study. Genetic risk score was derived from 97 BMI-related single nucleotide polymorphisms. Multivariable logistic regression evaluated each polyp subtype compared to non-polyps. For conventional adenomas, the OR per 2-kg/m2 increase was 1.03 (95% CI, 1.01-1.04) for measured BMI and 0.98 (95% CI, 0.88-1.10) for genetically predicted BMI; for serrated polyps, the OR was 1.06 (95% CI, 1.04-1.08) and 1.04 (95% CI, 0.90-1.20), respectively; for synchronous polyps, the OR was 1.10 (95% CI, 1.07-1.13) and 1.09 (95% CI, 0.89-1.34), respectively. Genetically predicted BMI was associated with synchronous polyps in women (OR = 1.37, 95% CI: 1.05-1.79). Genetically predicted BMI was not associated with colorectal cancer precursor lesions. The confidence intervals were wide and encompassed those for measured BMI, indicating that null findings may be due to insufficient power.

Prevention of recurrence of endometrial polyps in women of reproductive age

The objective: the optimization of management of women in reproductive age after removal of endometrial polyps based on the study of the antioxidant status of the organism.Materials and methods. We examined 150 women in reproductive age with endometrial polyps, 65 (43.3%) patients of them were diagnosed with glandular polyp, 85 (56.7%) – with glandular fibrous polyps. 110 patients after polypectomy were divided into three clinical groups: the first group (32 (29.1%) women) did not receive anti-relapse therapy, the second group (36 (32.7%) persons) used dydrogesterone, the third group (42 (38.2%) women) – received complex drug anti-recurrence therapy (thioctic acid preparation, ascorbic acid, α-tocopherol acetate, indole-3-carbinol). In all women, the antioxidant indicators in blood and the presence of recurrent polyps were determined in 12 months after the treatment. Results. Before polypectomy in patients with endometrial polyps, a decrease of indicators of antiradical activity by 28.52%, restored forms of non-protein SH-groups – by 16.46%, protein SH-groups – by 25.31%, ascorbic acid – by 27.04%, α-tocopherol – by 21.62%, the value of the integral indicator of antioxidant protection – by 31.01% were found compared to the persons in the control group, as well as an increase in the concentration of malonic dealdehyde by 37.23%, non-protein SS groups – by 43.48%, protein SS-groups - by 29.43% and oxidized forms of ascorbic acid – by 29.68%.In 12 months after polypectomy, recurrence of the pathology was in 21.9% of patients of the first group, in 16.7% – of the second group, and no recurrence was detected in women in the third group.Conclusions. In patients with endometrial polyps there are a decrease in level of components of antioxidant protection in the organism and the expressed intensification of processes of free radical and peroxide oxidation of lipids. The use of a comprehensive approach that combines the polypectomy with the use of antioxidant drugs in the postoperative period, in such patients allows to prevent a recurrence of the pathology.

Frequency and Spectrum of Non-Malignant Lesions in Abdominal Hysterectomy Specimens

Objective: To determine the histological spectrum of non-malignant lesions in abdominal hysterectomy specimens from women of reproductive age group. Study Design and Setting: This was a descriptive cross-sectional study carried out at a private hospital in Karachi from December 2018 to December 2019. Methodology: The uterine specimens of patients (n=262) between the ages of 24 to 55 years were collected. Hysterectomies done due to any benign uterine disease were included in the study. Hysterectomies due to malignant causes were excluded. Pathological diagnosis was done on light microscopy using routine hematoxylin and eosin staining technique. Data collected during the study period included patient's age, clinical history/diagnosis and histological diagnosis. On receiving the hysterectomy specimens as per protocol, specimens were immediately put in 10% formalin, appropriately labeled for patient’s name, gender, age and procedure. In histopathology lab, grossing of the specimens was done using standard protocols. Frequency and variables were analyzed by using descriptive statistics of SPSS-version 22. Results: Total n=262 hysterectomies were received. Mean age of all the patients was 34.7 years ±7.8. Non-malignant uterine pathologies on histopathology included 124(47.7%) leiomyomas, 52(20%) adenomyosis, 32(12.3%) endometrial polyps, 16(6.2%) endometrial hyperplasia, 6(2.3%) endometritis, 3(1.2%) disordered proliferative endometrium and 1(0.4%) endometrial stromal nodule. Rest of the cases showed normal phases of endometrial cycle. Only two cases (0.76%) out of 262 received as clinically benign uterine disease, were diagnosed as malignant on histopathology. Conclusion: Leiomyoma is the most common uterine pathology diagnosed in clinical setting as well as encountered at histopathological examination followed by Adenomyosis and endometrial polyps in women of reproductive age group in Pakistan.

Clinical analysis of the MyoSure hysteroscopic tissue removal system of endometrial polyps in women with an intact hymen

BackgroundTo investigate the clinical efficacy of the MyoSure hysteroscopic tissue removal system in the treatment of endometrial and cervical polyps in women with an intact hymen.MethodsRetrospective analysis was performed on the clinical data of 32 patients treated with the MyoSure hysteroscopic tissue removal system for endometrial and cervical polyps.ResultsAll the patients successfully completed the procedure. No intraoperative complications, such as cervical trauma, uterine perforation or TURP syndrome, were reported. The surgical time ranged from 5 to 35 min, with an average time of 19.3 min, and the intraoperative blood loss ranged from 2 to 50 ml with an average blood loss of 10.8 ml. After surgery, all patients were shown to have intact hymens. No residual polyp tissues were observed under the microscope, and abnormal uterine bleeding was relieved.ConclusionsThe MyoSure hysteroscopic tissue removal system can be a safe and effective treatment for endometrial and cervical polyps in women with an intact hymen.

CLINICAL AND MORPHOLOGICAL PARALLELS IN THE DIAGNOSIS OF ENDOMETRIAL POLYPS IN THE AGE ASPECT

The aim of research: To study the pathomorphological and endoscopic features of endometrial polyps in women of reproductive, premenopausal and postmenopausal age and conduct a comparative analysis.Materials and methods. To carry out the planned study, 116 women with endometrial polyps were included, who were treated at the Women’s Medical Center of Clinical Hospital “Feofania”. Depending on the pathomorphological type of endometrial polyposis, four groups of patients were formed, Group 1 - 34 women with glandular endometrial polyp, group 2 - 32 patients with glandular-fibrous endometrial polyp, group 3 included 34 women with endometrial fibrous polyp, and the fourth group - 16 patients with endometrial adenomatous polyps. Diagnostic search was carried out by ultrasound followed by hysterectectoscopy and histological examination.Results and discussion. Glandular and glandular-fibrous polyps of the endometrium showed predominantly in women of reproductive 15 (39.4%) age and 10 (31.1%) patients of premenopausal age, against the background of simple endometrial hyperplasia without atypia, in 21 (61.7%) women and in 13 (38.2%) cases against the background of unchanged endometrium. Fibrous polyps are characteristic of postmenopausal women in 21 (45.6%) cases, while on the background of atrophic endometrium in 22 (64.7%) patients, in 7 (20.5%) patients on the background of simple endometrial hyperplasia without atypia, in 5 ( 14.7%) cases against the background of unchanged endometrium. Adenomatous polyps of the endometrium were found in 16 (13.7%) patients of them reproductive 5 (13.1%) and 6 (18.7%) cases of premenopausal age, against the background of complex endometrial hyperplasia without atypia in 5 (31.2%) patients, in 4 (25.1%) women on the background of simple endometrial hyperplasia with atypia, as well as in 3 (18.8%) patients on the background of complex adenomatous endometrial hyperplasia with atypia, and in 1 (6.25%) case on the background atrophic endometrium.Conclusions. Glandular and glandular fibrous polyps of the endometrium are characteristic mainly for women of reproductive and premenopausal age, fibrous polyps of the endometrium are mainly manifested in patients of postmenopausal age. Adenomatous polyps of the endometrium are observed in all age groups. A study of the pathomorphological and endoscopic features of endometrial polyps in women of different age categories in the background endometrium and polyp tissue makes it clear that in most cases they have different pathomorphological characteristics (93,3%), it makes sense to use hysteroscopy with targeted sampling with separate marking of histological material with the definition of further tactics for managing patients for results of pathomorphological findings.

Comparison of diagnostic accuracy of saline infusion sonohysterography, transvaginal sonography, and hysteroscopy in evaluating the endometrial polyps in women with abnormal uterine bleeding: a systematic review and meta-analysis.

IntroductionIn women with abnormal uterine bleeding (AUB), endometrial polyps are a frequent finding, and the risk of a focal (pre)malignancy in a polyp is up to 6%. Because of this reported risk, the detection of polyps in these women is important.AimTo evaluate and compare the diagnostic accuracy of saline infusion sonohysterography, transvaginal sonography, and hysteroscopy in detecting endometrial polyps in women with AUB.Material and methodsThe searches were conducted by two independent researchers to find the relevant studies published from 1/1/2009 until the end of 30/06/2019. We searched for published literature in English language in MEDLINE, EMBASETM, The Cochrane Library, and Trip database. For literature published in other languages, we searched national databases (Magiran and SID), KoreaMed, and LILACS. The risk of bias of every article was evaluated by using QUADAS-2.ResultsAfter selection and quality assessment, 11 studies were included. Based on the random effect model the total prevalence of endometrial polyps in women with abnormal uterine bleeding was 38%. The sensitivity and specificity of saline infusion sonohysterography in diagnosis of endometrial polyps were 0.87 and 0.86, respectively. The sensitivity and specificity of transvaginal ultrasonography were 0.62 and 0.73 and the sensitivity and specificity of hysteroscopy were 0.92 and 0.85, respectively.ConclusionsAlthough that sonohysterography is a safe and relatively cheap method, which allows ruling out or confirming endometrial polyps, it cannot be replaced with hysteroscopy due to the fact that hysteroscopy combined with biopsy is the gold standard for ruling out malignancies in an endometrial polyp.

Resolution of Abnormal Uterine Bleeding After Hysteroscopic Morcellation of Endometrial Polyps

Abstract Objective: The aim of this research was to assess symptom resolution and reintervention rates following hysteroscopic morcellation of benign polyps in women with abnormal uterine bleeding ...

OP07.03: Performance of simultaneous endometrial aspiration and sonohysterography in the diagnosis of endometrial polyps in women with postmenopausal bleeding

OP07.03: Performance of simultaneous endometrial aspiration and sonohysterography in the diagnosis of endometrial polyps in women with postmenopausal bleeding

Fertility outcome after saline sonography guided removal of intrauterine polyps in women with unexplained infertility

ObjectiveTo assess the effect of removal of unsuspected polyps as delineated on saline sonography on the clinical pregnancy rate in women with unexplained infertility.MethodologyA prospective case control study was being conducted from 1st October 2016 to 30th September 2018 at Aziz Medical Centre, Karachi. Women diagnosed with unexplained infertility and unsuspected polyps revealed on saline sonography were included as cases (Group A). They were offered removal of polyps under ultrasound guidance and general anesthesia. Saline sonography was repeated at the time to ensure complete removal (Izhar’s Modification). Those with unsuspected polyps on saline sonography, but who refused the intervention, were classified as controls (Group B). Both groups were followed for one year. The primary outcome measure was women who had clinical pregnancy i.e. fetal heartbeat present on transvaginal scan during the follow up period.ResultsDuring the study period, out of 92 cases, 37 (40.2%) conceived and out of 92 controls, 10 (10.9%) conceived, which proved that polypectomy increased the chances of conception four-fold (p <0.001). The mean time to conception was also significantly lower for cases than controls (9.26 ± 3.928 months vs. 11.33 ± 2.07 months, p <0.001). The cumulative pregnancy rate was significantly higher in the polypectomy group (log-rank test, p <0.001). The duration of infertility (p = 0.007), position of polyp (p = 0.049) and polypectomy (p <0.001) influenced pregnancy rate.ConclusionsOur study shows the beneficial effect of removal of polyps. Women are four times more likely to conceive spontaneously after polypectomy.

Diagnostic accuracy of saline contrast sonohysterography in detecting endometrial polyps in women with postmenopausal bleeding: systematic review and meta-analysis.

In women with postmenopausal bleeding, endometrial polyps are a frequent finding and the risk of a focal (pre)malignancy in a polyp is up to 6%. Because of this reported risk, the detection of polyps in these women, preferably by a minimally invasive method, is important. The aim of this systematic review was to assess the accuracy of saline contrast sonohysterography (SCSH) for diagnosis of endometrial polyps in women with postmenopausal bleeding. In August 2018, an electronic search was performed of MEDLINE, EMBASE and Web of Science databases to identify all diagnostic studies in which SCSH was used to detect endometrial polyps in postmenopausal women. Studies were included if SCSH was performed to detect endometrial polyps in women with postmenopausal bleeding and if detection of a polyp on hysteroscopy or diagnosis on histopathology was used as a reference standard. Two reviewers assessed methodological quality using the quality assessment of diagnostic accuracy studies (QUADAS-2) tool. Two separate analyses were performed for each reference standard. Pooled sensitivity and specificity were calculated using the hierarchical summary receiver-operating characteristics (HSROC) model and HSROC curves were plotted. After selection and quality assessment, five studies were included. Using 'polyps diagnosed with histopathology' as the reference standard, the pooled sensitivity of SCSH was 86.5% (95% CI, 63.6-100%) and the pooled specificity was 91.1% (95% CI, 63.2-100%). Using 'polyps seen on hysteroscopy' as the reference standard, the pooled sensitivity of SCSH was 85.1% (95% CI, 66.9-100%) and the pooled specificity was 84.5% (95% CI, 68.1-100%). Excluding the one study that included women in whom the SCSH examination was reported to be suboptimal, the pooled sensitivity increased to 90.7% (95% CI, 72.8-100%) using hysteroscopy as the reference standard. The sensitivity of hysteroscopy to detect polyps, as reported in two studies, was 81-98%. Provided that the SCSH examination is of optimal quality, it can be considered as a method to stratify women with postmenopausal bleeding for further diagnostic workup and treatment with hysteroscopy. In women without suspicion of a polypoid lesion on SCSH, and with a benign endometrial sample, expectant management should be considered. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Prevalence of hyperplasia and cancer in endometrial polyps in women with postmenopausal bleeding: A systematic review and meta-analysis.

There is wide variation in reporting the prevalence of hyperplasia and cancer in endometrial polyps in women with postmenopausal bleeding. Most studies reported heterogenous populations of pre- and postmenopausal women both symptomatic and asymptomatic, making data interpretation difficult. The aim of this work is to quantify the prevalence of hyperplasia and cancer in polyps in women with postmenopausal bleeding aiming to produce data that help inform clinical practice as whether it is safer to remove all polyps, or some women could be offered expectant management. The search terms used were Medical Subject Headings terms, text words, truncations and word variations of the words or phrases ‘endometrial polyp’ or ‘uterine polyp’ or ‘womb polyp’ and ‘postmenopause’ or ‘menopause’. Search was limited to human studies and English language articles. Studies reporting separate analysis for women with postmenopausal bleeding were included. The included articles were assessed for risk of bias using the ‘Quality in Prognosis Studies’ tool. The prevalence was estimated with a random effect model using ‘DerSimonian and Laird’ method. The pooled estimate of prevalence of hyperplasia and cancer was 9% (95% confidence interval: 6.5%–11.5%). An I2 statistic of 77.2% suggests likely substantial heterogeneity. However, adjustment for small study effects had no influence on the pooled prevalence estimate suggesting no evidence for publication bias. Sensitivity analyses showed that no study exerted a big influence on the pooled estimate. The prevalence of hyperplasia and cancer in endometrial polyps in women with postmenopausal bleeding is high enough to warrant removal for accurate histopathological diagnosis.

Is there a relationship between serum kisspeptin levels and endometrial polyps in women with premenopausal status

Aim: Endometrial polyps are frequently associated with abnormal uterine bleeding. The kispeptin family is one of the peptides that play a role in reproductive functions and whose expression varies in various uterine pathologies. The aim of the study was to determine the relationship between serum Kisspeptin levels and endometrial polyps in women with premenopausal status.Material and Methods: The blood was collected prior to endometrial sampling from women admitted to the hospital due to abnormal uterine bleeding. According to the pathology results, patients were identified as polyp group (n=38) (endometrial polyps) and control group (n=50) (normal endometrial findings). Kisspeptin-54 levels were determined by ELISA method from serum obtained from venous blood. Results: There were no difference was found between the patients’ age, body mass index, gravida, para, abortus and the number of living children were compared (p>0.05). There was no statistically significant difference between the groups in terms of follicle stimulating hormone, luteinizing hormone and thyroid stimulating hormone values (p>0.05). Plasma kisspeptin (1.84±0.93 ng/dL and 1.32±0.47 ng/dL, p= 0.008) and estradiol (90.34±13.02 pg/mL and 81.75±12.36 pg/mL, p=0.002) levels were significantly higher in the polyp group than in the control group. After the Receiver Operating Characteristic (ROC) analysis the area under the curve (AUC) was 1.26 (p= 0.08), (95% CI, 0.550-0.782). The sensitivity value was 0.684 (0.512-0.819), the specificity was 0.620 (0.471-0.750).Conclusion: The serum Kisspeptin-54 and estradiol levels were found higher in patients with endometrial polyps.Keywords: Abnormal uterine bleeding; endometrial polyps; kisspeptin.

A clinical case of large fibroepithelial polyp of breast nipple

Introduction: Polyp of breast nipple is a rare benign tumor which is pedunculated. The typical polypoid appearance makes the clinical diagnosis apparent. The breast nipple polyp in woman are generally small in size. Giant size fibroepithelial polyp are very rare. Case Report: This is case report of a large size fibroepithelial polyp arising from nipple of left breast in 40-year-old woman. This polyp was more than 10 cm size in length having a long pedicle. This polyp with its pedicle was excised from nipple. The histopathological diagnosis was consistent with fibroepithelial polyp. Conclusion: The large size fibroepithelial polyp of nipple breast is very rare.