IMR Press / CEOG / Volume 49 / Issue 10 / DOI: 10.31083/j.ceog4910232
Open Access Review
Endometrial Polyps: Update Overview on Etiology, Diagnosis, Natural History and Treatment
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1 Obstetrics and Gynecology Department, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 10° andar, 05403-000 Cerqueira Cesar, SP, Brazil
2 Unit of Gynecology and Obstetrics, Department of Women and Children's Health, University of Padua, 35122 Padua, Italy
3 Gynecologic Division, Universidade Federal de São Paulo, Escola Paulista de Medicina, 04023-062 São Paulo, SP, Brazil
4 Department of Public Health, University of Naples Federico II, 80138 Naples, Italy
*Correspondence: amerigovitagliano.md@gmail.com (Amerigo Vitagliano)
Academic Editor: Ioannis A. Kalogiannidis
Clin. Exp. Obstet. Gynecol. 2022, 49(10), 232; https://doi.org/10.31083/j.ceog4910232
Submitted: 20 April 2022 | Revised: 28 June 2022 | Accepted: 27 July 2022 | Published: 29 September 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Objectives: To provide an updated literature overview about the pathophysiology, natural history, diagnosis and treatment of endometrial polyps (EPs). Findings in Brief: EPs are focal, sessile or pedunculated projections of endometrial lining, resulting from the hyperplastic overgrowths of endometrial glands and stroma around a vascular core. These are the most common intrauterine diseases, affecting up to 34.9% of the women during their lifetime. EPs may vary in size, location, histopathology, natural history and clinical presentation. Importantly, EPs are common in women suffering with infertility (i.e., up to 32% in patients undergoing in-vitro-fertilization) and are not exempt from risk of malignant transformation (occurring in about 3.1% of patients). For these reasons, EPs represent one of the most significant gynaecological problems worldwide. Trans-vaginal ultrasound has fair diagnostic accuracy for EPs, with sensitivity and specificity of 91% and 90%, respectively. Nevertheless, the current gold standard for EPs diagnosis is hysteroscopy, which allows a direct visualization of EPs size and morphology. Moreover, this technique enables safe EPs excision, with a low risk of incomplete tissue removal (about 1.9% and 4.3% in inpatient and outpatient settings, respectively), and variable recurrence rate based on individual risk factors (ranging between 2.5% and 43.6%). Besides hysteroscopy, other management options for EPs can be considered on a case by case basis. Conclusions: Our review may be helpful for updating clinicians’ knowledge on the management of EPs.

Keywords
endometrial polyps
etiology
diagnosis
infertility
hystopathology
hysteroscopy
natural hystory
polypectomy
endometrial cancer
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