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Treatment of Endometrial Polyps

From the Department of Obstetrics and Gynecology, University of Iowa College of Medicine, Iowa City, Iowa.

Address reprint requests to: Bradley J. Van Voorhis, MD, University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology, 200 Hawkins Drive, Iowa City, IA 52242-1080, E-mail: brad-van-voorhis{at}uiowa.edu

Objective: To determine the effectiveness of different treatments for abnormal uterine bleeding in women with known endometrial polyps.

Methods: We retrospectively assessed the effectiveness of polypectomy and other treatments of women with abnormal uterine bleeding who had benign polyps detected by sonohysterography. Women with endometrial polyps diagnosed by sonohysterography between January 1997 and July 1998 were sent questionnaires on pretreatment and posttreatment uterine bleeding and satisfaction with their treatments. Charts were reviewed to validate questionnaire responses and determine treatments administered.

Results: Seventy-eight women had endometrial polyps by sonohysterography, and 60 of them (77%) responded to the questionnaire. Two with endometrial adenocarcinoma were excluded. The average age of the remaining 58 was 49 years; 37 (64%) were premenopausal and 21 (36%) postmenopausal. The average time from treatment to follow-up was 13 months (range 5–24 months). Participants were grouped according to the following treatments: polypectomy, polypectomy plus endometrial ablation, polypectomy plus hysteroscopic myomectomy, hysterectomy, D&C, and non-surgical treatment. The most frequent treatment was polypectomy (n = 26). Polypectomy, polypectomy plus endometrial ablation, polypectomy plus myomectomy, and hysterectomy each resulted in at least a twofold decrease in the number of bleeding days per month and led to high satisfaction rates.

Conclusion: Our results showed that simple polypectomy and more invasive surgical procedures led to subjective improvement in symptoms of menorrhagia and metrorrhagia and a high satisfaction rate in women with endometrial polyps.

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				D. J. DeWaay, C. H. Syrop, I. E. Nygaard, W. A. Davis, and B. J. Van Voorhis Natural History of Uterine Polyps and Leiomyomata Obstet. Gynecol., July 1, 2002; 100(1): 3 - 7. [Abstract] [Full Text] [PDF]