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

Abstract

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.

摘要

引言：大多数子宫内膜息肉表现为子宫内膜的局灶性增生。子宫内膜息肉可以通过超声、超声造影、子宫输卵管造影、子宫内膜活检、刮宫术进行诊断, 但诊断性宫腔镜被认为是诊断性子宫内膜息肉的金标准方法, 其灵敏度和特异性最大, 同时也有治疗的机会。

研究设计：一项回顾性研究在2006年至2018年间对424名患者进行了研究。通过诊断性宫腔镜检查中对息肉进行确诊, 并行切除或刮除术。对所有手术标本都进行了组织学检查, 并评价手术方式的疗效及复发率。

结果：平均年龄60.2±9.3岁。息肉切除占62.97%, 刮除占37.03%。恶性肿瘤占4.24%。息肉的组织学鉴别率分别为79.4%（息肉切除）和69.04%（刮除）；差异有统计学意义(p＜0.01)。切除后复发率为20.47%, 刮除后复发率为27.12%。

结论：宫腔镜仍是子宫内膜病理诊断的最佳选择和金标准方法。在本研究中, 两种息肉切除方法在宫腔镜和组织学检查结果的匹配上有显著差异。切除后的复发率也较低。

Keywords:

• Endometrial polyp
• hysteroscopy
• resectoscope
• curettage
• recurrence
• abnormal uterine bleeding

Potential conflict of interest

No potential conflict of interest was reported by the author(s).

Source of funding

Nil.