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Uterine polyp treatment

M Elsokkary, M Elshourbagy, K Labib, M Ali
OBJECTIVES: To assess the hysteroscopic value in the management of intrauterine lesion in women with recurrent pregnancy loss. METHODS: This study done in Ain Shams Maternity Hospital after the approval of the research Ethics Committee, during the period between August 2014 to December 2015 where 200 non-pregnant women with a history of three or more consecutive unexplained first and second trimester miscarriages before 20 weeks were recruited from recurrent miscarriage clinic...
April 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
Se Jeong Jeon, Jae Il Lee, Maria Lee, Hee Seung Kim, Jae Weon Kim, Noh Hyun Park, Yong Sang Song
OBJECTIVE: To describe the endometrial pathologic lesions in premenopausal breast cancer patients with a history of tamoxifen (TMX) use. METHODS: We retrospectively reviewed the medical records of 120 premenopausal breast cancer patients with a history of TMX use that had undergone a gynecological examination. RESULTS: Among 120 patients, 44.2% (n=53) were asymptomatic with an endometrial thickness ≥5 mm, as assessed by transvaginal ultrasonography...
January 2017: Obstetrics & Gynecology Science
Natalie A M Cooper, Lee Middleton, Paul Smith, Elaine Denny, Lynda Stobert, Jane Daniels, T Justin Clark
Uterine polyps can cause abnormal bleeding in women. Conventional practise is to remove them under general anaesthesia but advances in technology have made it possible to perform polypectomy in the office setting. We conducted a patient-preference study to explore women's preferences for treatment setting and to evaluate the effectiveness and treatment experience of women undergoing uterine polypectomy. Three hundred ninety-nine women with abnormal uterine bleeding who were found to have uterine polyps at diagnostic hysteroscopy were recruited...
2016: Gynecological Surgery
M Wong, B Crnobrnja, V Liberale, K Dharmarajah, M Widschwendter, D Jurkovic
STUDY QUESTION: What is the natural history of endometrial polyps in women who are managed expectantly? SUMMARY ANSWER: The growth rates of expectantly managed polyps vary considerably and cannot be accurately predicted. WHAT IS KNOWN ALREADY: The majority of polyps detected on ultrasound are treated surgically, and therefore little is known about their natural history. Some polyps have been reported to regress spontaneously without the need for treatment; however, the factors predictive of regression are unknown...
February 2017: Human Reproduction
Zhongyong Jiang, Wanqing Xu, Gang Dan, Yuan Liu, Jie Xiong
BACKGROUND Endometrial lesions are common in obstetrics and gynecology, including endometrial polyps, uterine adenomyosis, and malignant endometrial adenocarcinoma. Endometrial lesions seriously affect women's health, fertility, quality of life, and life safety. As a pro-apoptosis gene, p53 is considered to be closely related with human tumors. Murine double mimute 2 (MDM2) is an oncogene that can promote tumor occurrence and development. P53 and MDM2 expression and significance in different types of endometrial lesions have not been fully elucidated...
December 7, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
T Justin Clark, Helen Stevenson
The diagnosis and treatment of endometrial polyps will be familiar to most gynaecologists. However, the aetiology and natural history of these focal intrauterine lesions are yet to be elucidated. This lack of clarity is also true with regard to their clinical significance; whilst endometrial polyps are highly prevalent in all types of abnormal uterine bleeding (AUB), they are also commonly found in women without AUB. These controversies will be discussed along with current thoughts on the diagnosis and treatment of endometrial polyps...
April 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
H Krentel, R L De Wilde
BACKGROUND: Uterine adenosarcomas are rare malignant gynaecological tumours. Due to its submucous localization, they can be easily confound with benign tumours like endometrial polyps or submucous myomas. However, the treatment of uterine adenosarcomas requires an oncologic surgical approach. CASE PRESENTATION: In the following case report, we present the minimally invasive treatment of a uterine adenosarcoma by hysteroscopy and laparoscopy in a 37-year-old patient and discuss the special role of hysteroscopy in such cases...
October 21, 2016: World Journal of Surgical Oncology
D Janssens, G Verbeeck, D Wildemeersch
Prevention of progression to invasive carcinoma in patients with a premalignant endometrial lesion using longterm treatment with levonorgestrel (LNG) releasing intrauterine systems (IUS) remains controversial, especially when manifest cellular atypia has been found in the endometrial biopsy specimen. We present a case of a 44-year old premenopausal woman with a premalignant uterine polyp who declined hysterectomy and was followed-up for more than 12 years after the first LNG-IUS was inserted. Endometrial atrophy installed, no pathology was detected and hysterectomy was thereby successfully avoided...
December 28, 2015: Facts, Views & Vision in ObGyn
Onder Celik, Mustafa Acet, Tansu Kucuk, Esra Tustas Haberal, Tuba Acet, Murat Bozkurt, Levent Sahin, Fatma Ferda Verit, Eray Caliskan
Regardless of the anatomical locations, some benign gynecological disorders (BGDs) such as peritoneal endometriosis, ovarian endometrioma, adenomyosis, uterine leiomyomas, endometrial polyps, uterine septum, and hydrosalpinges may lead to implantation failure. Despite progress in medical therapies, surgery remains a mainstay of BGDs treatment. Although our knowledge of endometrial receptivity after BGDs surgery is limited, it has allowed for significant improvement in the treatment of female subfertility. Many researchers studied on pregnancy outcome following BGDs surgery, but they did not investigate the possible impact of surgery on endometrial receptivity...
July 8, 2016: Reproductive Sciences
C Huchon, X Deffieux, G Beucher, P Capmas, X Carcopino, N Costedoat-Chalumeau, A Delabaere, V Gallot, E Iraola, V Lavoue, G Legendre, V Lejeune-Saada, J Leveque, S Nedellec, J Nizard, T Quibel, D Subtil, F Vialard, D Lemery
In intrauterine pregnancies of uncertain viability with a gestational sac without a yolk sac (with a mean of three orthogonal transvaginal ultrasound measurements <25mm), the suspected pregnancy loss should only be confirmed after a follow-up scan at least 14 days later shows no embryo with cardiac activity (Grade C). In intrauterine pregnancies of uncertain viability with an embryo <7mm on transvaginal ultrasound, the suspected pregnancy loss should only be confirmed after a follow-up scan at least 7 days later (Grade C)...
June 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Attilio Di Spiezio Sardo, Costantino Di Carlo, Silvia Minozzi, Marialuigia Spinelli, Vanna Pistotti, Carlo Alviggi, Giuseppe De Placido, Carmine Nappi, Giuseppe Bifulco
BACKGROUND: The scientific community has been re-evaluating the clinical relevance of hysteroscopy in the diagnosis and treatment of uterine factors and its role in the infertility work-up, thanks to its potential capability to improve reproductive outcomes and reduce time to pregnancy. OBJECTIVE AND RATIONALE: The objective of this systematic review and meta-analysis was to assess the efficacy of diagnostic and operative hysteroscopy in improving the live birth rate (LBR) of infertile women, with and without intrauterine abnormalities, at any stage of the infertility work-up...
June 2016: Human Reproduction Update
Andrea Ciavattini, Jacopo DI Giuseppe, Nicolò Clemente, Lorenzo Moriconi, Giovanni Delli Carpini, Nina Montik, Laura Mazzanti
The aim of the present study was to determine the association between the thickness of preperitoneal fat (PFT), utilized as an indicator of visceral fat deposition, and the risk of premalignant and malignant changes of endometrial polyps (EPs) in overweight and obese women. Overweight and obese women who had undergone diagnostic outpatient hysteroscopy and subsequent endometrial polypectomy between January 2010 and May 2013 were analyzed. Each patient underwent a transabdominal ultrasound for the purpose of measuring the thickness of preperitoneal fat...
March 2016: Oncology Letters
Gabriele Centini, Libera Troia, Lucia Lazzeri, Felice Petraglia, Stefano Luisi
Hysteroscopy is an endoscopic surgical procedure that has become an important tool to evaluate intrauterine pathology. It offers a direct visualization of the entire uterine cavity and provides the possibility of performing biopsy of suspected lesions that can be missed by dilatation and curettage (D&C). In most cases, the intrauterine pathologies can be diagnosed and treated at the same setting as office hysteroscopy ("see and treat approach"). For example, endometrial polyps can be diagnosed and removed; similarly, intrauterine adhesions can be liberated in the outpatient setting without the need for an operating theatre...
April 2016: Minerva Ginecologica
Nilima G Sawke, Gopal Krishna Sawke, Hanisha Jain
BACKGROUND: Menorrhagia, by definition, is heavy cyclical blood loss in excess of 80 ml/month of menstrual period lasting longer than 7 days. There are many possible causes of heavy menstrual bleeding which include hormonal imbalance, fibroids, miscarriage or ectopic pregnancy, nonhormonal intrauterine device, adenomyosis, pelvic inflammatory disease, and rarely uterine, ovarian, or cervical cancer. Treatment depends on the causes of the menorrhagia. Hysterectomy is one of the several surgical procedures as definitive treatment...
October 2015: Journal of Mid-life Health
Salvatore Gizzo, Tito Silvio Patrelli, Andrea Dall'asta, Stefania DI Gangi, Giovanna Giordano, Costanza Migliavacca, Michela Monica, Carla Merisio, Giovanni Battista Nardelli, Michela Quaranta, Marco Noventa, Roberto Berretta
The aim of the current study was to diagnose the concomitant presence of adenomyosis (AM) in endometrioid endometrial cancer (EEC) in order to evaluate its value as an oncological prognostic marker. A retrospective analysis of 289 patients diagnosed with EEC who underwent total hysterectomy, bilateral salpingo-oophorectomy and pelvic-lymphadenectomy was conducted. The total cohort included 37 patients in Group A (those with concomitant AM and EEC) and 252 patients in Group B (those affected only by EEC). The following factors were evaluated: Presence or absence of AM, tumor grade, depth of myometrial invasion, tumor size, lymphovascular space involvement, lymph node status, peritoneal cytology, concomitant detection of endometrial atypical-hyperplasia or polypoid endometrial features and tumor stage according to the International Federation of Gynecology and Obstetrics (FIGO) classification...
February 2016: Oncology Letters
Lucy Whitaker, Hilary O D Critchley
Abnormal uterine bleeding (AUB) is a common and debilitating condition with high direct and indirect costs. AUB frequently co-exists with fibroids, but the relationship between the two remains incompletely understood and in many women the identification of fibroids may be incidental to a menstrual bleeding complaint. A structured approach for establishing the cause using the Fédération International de Gynécologie et d'Obstétrique (FIGO) PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy (and hyperplasia), Coagulopathy, Ovulatory disorders, Endometrial, Iatrogenic and Not otherwise classified) classification system will facilitate accurate diagnosis and inform treatment options...
July 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
Sally Dominick, Martha Hickey, Jason Chin, H Irene Su
BACKGROUND: Adjuvant tamoxifen reduces the risk of breast cancer recurrence in women with oestrogen receptor-positive breast cancer. Tamoxifen also increases the risk of postmenopausal bleeding, endometrial polyps, hyperplasia, and endometrial cancer. The levonorgestrel-releasing intrauterine system (LNG-IUS) causes profound endometrial suppression. This systematic review considered the evidence that the LNG-IUS prevents the development of endometrial pathology in women taking tamoxifen as adjuvant endocrine therapy for breast cancer...
2015: Cochrane Database of Systematic Reviews
Tuula Karipohja
The lines of operation in the treatment of gynecologic hemorrhagic disorders have developed towards a more conservative direction: the number of hysterectomies has decreased year by year, mini-invasive hysteroscopies having become more common. Endometrial polyps and submucosal leiomyomas can be treated in hysteroscopy, and destruction of the endometrium (thermoablation) is available along with drug therapies for the treatment of excessive bleedings. Hysteroscopy can be utilized also in elucidating infertility of uterine origin...
2015: Duodecim; Lääketieteellinen Aikakauskirja
Aleksandra Marciniak, Jolanta Nawrocka-Rutkowska, Berenika Wiśniewska, Iwona Szydłowska, Agnieszka Brodowska, Andrzej Starczewski
Nowadays endoscopic techniques are one of the basic diagnostic and operative methods in gynecology. Laparoscopy and hysteroscopy are the most popular of them. Office hysteroscopy is a modern diagnostic and therapeutic method feasible in an outpatient room because no necessity of anesthesia. It is the first-line procedure in the infertility diagnosis and treatment of uterine pathology such as polyps, submucosal fibroids and adhesions. Limitation of this method is the cervical canal atresia. Contraindications to it are: pregnancy, uterine bleeding, active inflammation of pelvic organs, cervical cancer...
October 2015: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Krisztina Z Hanley, Oluwole Fadare, Kevin E Fisher, Kristen A Atkins, Marina B Mosunjac
Uterine papillary serous carcinoma (UPSC) represents 10% of endometrial carcinomas. Significant number of patients initially present with extrauterine disease. The role of adjuvant treatment in low stage, especially polyp-confined UPSC is controversial. This multi-institutional study evaluated the significance of positive pelvic washing (PW) and adjuvant treatment on disease recurrence in a setting of endometrial polyp-confined UPSC. Surgical pathology files from 3 institutions were searched for cases of endometrial polyp-confined UPSC...
May 2016: International Journal of Gynecological Pathology
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