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Uterine polyp treatment

Chensi Ouyang, Marina Frimer, Laura Y Hou, Yanhua Wang, Gary L Goldberg, June Y Hou
OBJECTIVES: Uterine serous carcinoma (USC) involving an endometrial polyp and concurrent extrauterine disease is associated with poor prognosis. We examined the clinicopathological profiles of patients with stage 1A USC with and without polyp involvement and the role of polyp size and lymphovascular invasion (LVI) as prognostic indicators for extrauterine disease in patients with early USC. METHODS/MATERIALS: From 2002 to 2014, 242 patients with pure USC were identified...
March 2018: International Journal of Gynecological Cancer
Paulette Mhawech-Fauceglia, Damanzoopinder Samroa
Adenomatoid tumors (AT) arising in the female genital tract are usually incidental findings occurring most often in the fallopian tube and uterine serosa and rarely in the myometrium. In the myometrium, they appear grossly as deep seated, small, firm, ill circumscribed nodules mimicking leiomyoma. Histologically they show a glandular and invasive pattern making well-differentiated/low-grade endometrioid adenocarcinoma a major differential diagnosis. However, this differential is rarely encountered in practice because myometrial AT is usually seen on the hysterectomy specimen, because of their anatomic position in the deep myometrium, and only rarely in endometrial curettings...
February 5, 2018: Applied Immunohistochemistry & Molecular Morphology: AIMM
Kohei Nakamura, Kentaro Nakayama, Kaori Sanuki, Toshiko Minamoto, Tomoka Ishibashi, Emi Sato, Hitomi Yamashita, Masako Ishikawa, Satoru Kyo
This study aimed to describe the long-term outcomes of patients with menorrhagia treated with microwave endometrial ablation (frequency, 2.45 GHz), as well as to identify factors associated with recurrence or re-surgery. This retrospective cohort study was conducted from 2007 to 2015 at Shimane University Hospital in Japan. Patients with severe menorrhagia and a desire to preserve their uterus were included in the study. Clinical factors associated with recurrence of menorrhagia or re-surgery were analyzed with a multivariable logistic regression model...
December 2017: Oncology Letters
Nicoleta Puie, Lavinia Patricia Trică, Georgiana Anca Nagy, Ioana Rusu, Alina Simona Şovrea, Carmen Georgiu
INTRODUCTION: Uterine leiomyosarcoma (ULMS) is a rare tumor, representing 1-2% of all uterine malignancies. It is highly aggressive, with high metastatic rate, especially in lungs, peritoneal cavity, retroperitoneum, bones and liver, usually during the first years after diagnosis. CASE PRESENTATION: A 58-year-old woman, with subtotal hysterectomy and bilateral adnexectomy, followed by radiochemotherapy for spindle-type ULMS nine years ago, presented with gastrointestinal bleeding and severe anemia...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
William T Jaegle, Jason C Barnett, Bridget R Stralka, Nicole P Chappell
Background: Tamoxifen is a medication often used for the treatment and prevention of breast cancer. It is classically associated with several gynecological side effects to include a thickened endometrial stripe, increased uterine polyp formation, and an increased risk of uterine cancer. Rarely tamoxifen use has been associated with proliferation of endometriosis often severe enough to mimic a late-stage gynecologic malignancy. Case: A 62-year-old Gravida 0 postmenopausal female with a medical history of severe obesity, infertility, and preventative tamoxifen use presented for evaluation of gross hematuria...
November 2017: Gynecologic Oncology Reports
Marzieh Shiva, Firouzeh Ahmadi, Arezoo Arabipoor, Mansoureh Oromiehchi, Mohammad Chehrazi
Background: We sought to compare diagnostic values of two-dimensional transvaginal sonography (2D TVS) and office hysteroscopy (OH) for evaluation of endometrial pathologies in cases with repeated implantation failure (RIF) or recurrent pregnancy loss (RPL). MATERIALS AND METHODS: This prospective study was performed at Royan Institute from December 2013 to January 2015. TVS was performed before hysteroscopy as part of the routine diagnostic work-up in 789 patients with RIF or RPL...
January 2018: International Journal of Fertility & Sterility
Ying Cheong, Iain T Cameron, Hilary O D Critchley
Introduction: It is not uncommon for a woman to suffer from abnormal uterine bleeding (AUB) or heavy menstrual bleeding (HMB) at some point during her lifetime. Once pathology is excluded, in practice, management needs to be individualised, taking into account the improvement of the woman's symptoms and quality of life. Sources of data: Peer-reviewed journals, governmental and professional society publications. Areas of agreement: There is now agreement on a structured, universal approach to the diagnosis of AUB, with the aide memoirs PALM (polyps, adenomyosis, leiomyoma, malignancy) and COEIN (coagulopathies, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified)...
September 1, 2017: British Medical Bulletin
Andrew Deutsch, Kirsten J Sasaki, Aarathi Cholkeri-Singh
Resectoscopic surgery is routinely performed to remove endometrial polyps and uterine myomas. A search of Medline, PubMed, and the Cochrane Library was conducted through November 2016 for studies written in English, regardless of sample size or study type. The studies were then filtered by selecting those evaluating resectoscopic surgery. An analysis of peer-reviewed, published literature was performed to examine the clinical application of this treatment modality on patients requiring polypectomy and myomectomy...
November 2017: Journal of Minimally Invasive Gynecology
Osnat Elyashiv, Ron Sagiv, Ram Kerner, Ran Keidar, Joseph Menczer, Tally Levy
STUDY OBJECTIVE: The standard treatment of endometrial cancer (EC) and complex atypical hyperplasia (CAH) is hysterectomy with or without adnexectomy. In the last decade several centers have attempted to perform hysteroscopic resection of malignant and premalignant polyps as an alternative to hysterectomy. In the present study we evaluated the safety of this procedure in regard to residual uterine pathology. DESIGN: Retrospective chart review (Canadian Task Force classification II-2)...
November 2017: Journal of Minimally Invasive Gynecology
Eman Aly Abd El Fattah
Endometriosis is strongly associated with infertility. Endometrial polyps are prevalent in infertile women and they have similar pathological characteristics to endometriosis, suggesting a possible association. Uterine malformations as uterine septum and hypoplastic uterus are also linked to endometriosis. Hysterosalpingogram and transvaginal ultrasonography are used to diagnose endometrial lesions. Hysteroscopy can detect small lesions that might be missed. Recently, 4D ultrasonography is being used, but which is superior has not been established yet...
2017: Obstetrics and Gynecology International
Cristina Laguna Benetti-Pinto, Ana Carolina Japur de Sá Rosa-E-Silva, Daniela Angerame Yela, José Maria Soares Júnior
Abnormal uterine bleeding is a frequent condition in Gynecology. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. In cases of acute and severe bleeding, women may need urgent treatment with volumetric replacement and prescription of hemostatic substances. In some specific cases with more intense and prolonged bleeding, surgical treatment may be necessary. The objective of this chapter is to describe the main evidence on the treatment of women with abnormal uterine bleeding, both acute and chronic...
July 2017: Revista Brasileira de Ginecologia e Obstetrícia
Farhat Deeba, Shaista, Bushra Khan
BACKGROUND: Abnormal uterine bleeding is one of the most common clinical problems in gynaecological practice and is an indicator of various underlying disorders. An endometrial biopsy should be done in all women over 35 years with AUB to rule out endometrial cancer or pre-malignant lesion and to initiate treatment. However, wide range of histological patterns on endometrial biopsy offer a diagnostic challenge to practicing pathologists. The objective of this study was to determine histological patterns of endometrium in postmenopausal women with abnormal uterine bleeding...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
Jahnavi Meena, Rahul Manchanda, Sudhir Kulkarni, Nirmal Bhargava, Priyanka Mahawar
Endometrial polyps are localized overgrowth of endometrial glands and stoma through the uterine cavity. They are associated with postmenopausal bleeding, infertility and menorrhagia and are affected by unbalanced oestrogen therapy or increased frequency of tamoxifen exposure. We report a case of giant endometrial polyp in postmenopausal female without vaginal bleeding and hormone or drug use. A 65-year-old, postmenopausal female P3L2 with hypertension and Diabetes Mellitus (DM) came for routine health check-up...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
M Elsokkary, M Elshourbagy, K Labib, A Mamdouh, Y El-Shahawy, Wael S Nossair, O Abd El Fattah, H Hemeda, S Sallam, Waleed M Khalaf, M Ali, M Elsayed, A Kotb, R Abdelhadi, M Etman, M Abd El Aleem, M Samy, A Salama, M Abdelhaleem, A Abdelshafy
OBJECTIVES: To assess the hysteroscopic value in the management of intrauterine lesion in women with recurrent pregnancy loss. METHODS: This study was done in Ain Shams Maternity Hospital after the approval of the research Ethics Committee, during the period between August 2014 and December 2015 where 200 nonpregnant women with a history of three or more consecutive unexplained first and second trimester miscarriages before 20 weeks were recruited from recurrent miscarriage clinic...
May 2, 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
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