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Abstract: In this case, the patient was 40 years old and was in the stage of pregnancy preparation. She consulted the doctor because the ultrasound indicated uneven endometrial echogenicity during the preconception examination and was afraid of affecting her pregnancy. After combining the patient’s symptoms and perfecting the related examination, we considered the possibility of endometrial polyp, and took surgical treatment after communicating with the patient, and she recovered well 2 days after surgery and was allowed to be discharged from the hospital for recuperation.
Basic information】Female, 40 years old
Disease Type】Endometrial polyp
Hospital】Hunan Provincial Maternal and Child Health Hospital
Date of consultation】June 2022
Treatment plan】Surgical treatment (hysteroscopic endometrial polyp electrosurgery)
Treatment Period】2 days of inpatient treatment, 6 months of outpatient follow-up
Results] Endometrial polyps disappeared and recovery was good
I. Initial consultation
The patient is a 40-year-old female. She was in good spirits and presented a healthy physical appearance when we first saw her. She reported that her pre-pregnancy ultrasound examination showed that the endometrial echogenicity was uneven. She considered that she did not have abdominal pain, abnormal menstruation and other symptoms, but she visited the doctor because she was afraid that it would affect her pregnancy preparation. The ultrasound examination was prescribed after communication with the patient, suggesting myometrial sonographic changes: endometriosis could not be excluded; endometrial echogenicity was not uniform; multifocal cystic mass on the left side of the uterus with a size of about 3.9×2.6×2.8 cm. The preliminary diagnosis was 1. pelvic endometriosis, 2. endometrial polyp? As the patient had a plan to prepare for pregnancy, she decided to undergo hysteroscopy after communication with the patient and was admitted to our hospital.
II. Treatment history
After obtaining the patient’s consent, routine blood, coagulation, liver and kidney function and electrocardiogram were performed, and the results returned no significant abnormalities. After signing the surgical consent form, hysteroscopy was performed under general anesthesia. A polyp-like growth of about 1 cm in diameter was detected in the upper middle part of the uterine cavity and was excised by electrodesection. The postoperative findings supported the diagnosis of endometrial polyp, and the patient was discharged with oral progesterone recommended for recurrence prevention.
III. Treatment results
The patient regained consciousness and conversed fluently 10 minutes after hysteroscopic endometrial polyp electrosurgery and was admitted to the ward. She was discharged with no fever, abdominal pain and other uncomfortable symptoms, good mental status, and normal bowel movement 2 days after surgery. The ultrasound was repeated 2 weeks after discharge, which showed that the endometrial echogenicity was uniform, and the patient had good mental status, normal appetite and no other special discomfort, so the treatment effect was good.
IV. Precautions
I am sincerely happy for the patient because she has a good awareness of medical treatment and is more cooperative with treatment, so she has a good prognosis.
1. taking oral progestin to prevent recurrence half a cycle after menstruation.
2. actively try to conceive in the second month after surgery, and assisted reproduction if necessary.
3. Pay attention to rest, strengthen nutrition, and increase the intake of high-protein foods such as milk, eggs, fish, etc., and avoid eating spicy and stimulating foods.
V. Personal insight
The patient in this case has a strong awareness of health, and she had a checkup during the preparation stage, actively sought medical treatment after finding abnormalities and strictly followed the medical prescription. We call on all women to seek medical treatment promptly if they have abnormal menstruation or abnormalities are found during physical examination, so that early treatment can shorten the treatment time and improve the prognosis to a greater extent.