Diagnosis and treatment of endometrial polyps

  Endometrial polyps are a common gynecologic condition that most commonly presents clinically as abnormal vaginal bleeding. Endometrial polyps are found accidentally in asymptomatic women on physical examination for other symptoms. Ageing and hormone supplementation therapy are the main reasons for their high incidence. Malignant endometrial polyps are uncommon, but vaginal bleeding with age and after menopause often indicates the possibility of malignancy. With conservative treatment, up to 25% of endometrial polyps can regress, especially those <10 mm in diameter. hysteroscopic polypectomy is the main modality of treatment, and there is no significant difference in outcome depending on the hysteroscopic polyp removal modality. Patients with symptomatic postmenopausal polyps require pathological sampling for evaluation, and removal of endometrial polyps in infertility may improve fertility. Blind curettage is not recommended if endometrial polyp removal can be performed under guided manipulation. The risks associated with hysteroscopic excision of polyps are low. Endometrial polyps are localized endometrial overgrowths that can be single or multiple, ranging from a few millimeters to several centimeters in diameter, and can be either non-tipped or tipped. Polyps are composed of endometrial glands, mesenchyme and blood vessels. Risk factors for its development include age, hypertension, obesity and tamoxifen use. Endometrial polyps can be asymptomatic and when symptoms do occur, they usually include abnormal (including postmenopausal) uterine bleeding and infertility. Malignancy of endometrial polyps is rare, with a typical incidence of 0%-12.9%, depending on the study population.