Effectiveness of different methods for polypectomy in the menopause: a retrospective study

• Published in: Climacteric : the journal of the International Menopause Society Vol. 23; no. 4; pp. 325 - 329
• Main Authors: Molnár, S., Farkas, Z., Jakab, A., Lampé, R., Török, P.
• Format: Journal Article
• Language: English
• Published: Boca Raton Taylor & Francis 03-07-2020; Taylor & Francis Ltd
• Subjects: abnormal uterine bleeding; curettage; Endometrial polyp; Histology; Hyperplasia; hysteroscopy; Menopause; Polyps; recurrence; resectoscope
• ISSN: 1369-7137; 1473-0804
• DOI: 10.1080/13697137.2020.1732915

Introduction: Most endometrial polyps represent focal hyperplasia of the endometrium. Endometrial polyps can be diagnosed by ultrasound, hysterocontrast sonography, hysterosalpingography, endometrial biopsy, and uterine curettage, but diagnostic hysteroscopy is considered the gold-standard method, with the greatest sensitivity and specificity and also with the opportunity for treatment at the same time.
Study design: A retrospective study was conducted on 424 patients between 2006 and 2018. The polyps were verified during diagnostic hysteroscopy and were removed by resectoscopy or curettage. All samples underwent histological examination. The effectivity of the type of resection and the recurrence rate were evaluated.
Results: The average age of the patients was 60.2 ± 9.3 years. Polyps were excised in 62.97% by resectoscopic polypectomy and in 37.03% by curettage. Malignancy was confirmed in 4.24% of cases. Histological verification of polyps was 79.4% in the resectoscopy group and 69.04% in the curettage group; the difference was significant (p < 0.01). The recurrence rate was 20.47% after resectoscopy and 27.12% following curettage.
Conclusion: Hysteroscopy remains the best option and the gold-standard method among diagnostic procedures of endometrial pathology. In this study, there was a significant difference in matching hysteroscopic and histological findings in the two methods of polypectomy. The recurrence rate is also lower following resectoscopy.