Cargando…

Predictive factors of spontaneously regressed uterine endometrial polyps during the waiting period before hysteroscopic polypectomy

BACKGROUND: The presence of uterine endometrial polyps is associated with not only abnormal uterine bleeding but also infertility, so the use of hysteroscopic polypectomy has been increasing. This operation is considered to increase cost-effectiveness when performed prior to infertility treatments....

Descripción completa

Detalles Bibliográficos
Autores principales: Okamura, Asuka, Yano, Eriko, Isono, Wataru, Tsuchiya, Akira, Honda, Michiko, Saito, Ako, Tsuchiya, Hiroko, Matsuyama, Reiko, Fujimoto, Akihisa, Nishii, Osamu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325800/
https://www.ncbi.nlm.nih.gov/pubmed/34332637
http://dx.doi.org/10.1186/s13256-021-02982-4
_version_ 1783731621721014272
author Okamura, Asuka
Yano, Eriko
Isono, Wataru
Tsuchiya, Akira
Honda, Michiko
Saito, Ako
Tsuchiya, Hiroko
Matsuyama, Reiko
Fujimoto, Akihisa
Nishii, Osamu
author_facet Okamura, Asuka
Yano, Eriko
Isono, Wataru
Tsuchiya, Akira
Honda, Michiko
Saito, Ako
Tsuchiya, Hiroko
Matsuyama, Reiko
Fujimoto, Akihisa
Nishii, Osamu
author_sort Okamura, Asuka
collection PubMed
description BACKGROUND: The presence of uterine endometrial polyps is associated with not only abnormal uterine bleeding but also infertility, so the use of hysteroscopic polypectomy has been increasing. This operation is considered to increase cost-effectiveness when performed prior to infertility treatments. However, there are typical problems to consider, including the possibility of spontaneous regression of the polyp and the duration of complete endometrial wound healing after surgery. Meaningless interventions must be avoided, when possible. Therefore, data acquisition and analysis of various findings obtained from surgery have become important for improving treatment procedures and patient selection. To estimate the spontaneous regression rates and contributions of multiple factors to uterine endometrial polyps during the waiting period (approximately 2–3 months) before hysteroscopic polypectomy, we performed a multivariate analysis of data from the records in our hospital. METHODS: The medical records of 450 cases from September 2014 to April 2021 in our hospital were retrospectively reviewed under the approval of our Institutional Review Board. We included all cases of hysteroscopic polypectomy with postoperative pathological diagnosis. We defined cases as having a “spontaneously regressed polyp” when the target polyp was not detected by postoperative pathological examination. We extracted data on the following ten factors: “Advanced age” (≥ 42 years), “Small polyp” (< 10 mm), “High body mass index” (≥ 25 kg/m(2)), “Nulliparity,” “Single polyp,” “Infertility,” “Hypermenorrhea,” “Abnormal bleeding,” “No symptom,” and “Hormonal drug use.” We also classified cases into five groups according to the size of the polyp (≤ 4.9 mm, 5.0–9.9 mm, 10.0–14.9 mm, 15.0–19.9 mm, and ≥ 20.0 mm) and determined the frequency of spontaneously regressed polyp in each group. RESULTS: After exclusion of cases with insufficient data or other diseases, such as submucosal leiomyoma, 424 cases were analyzed. Among them, 28 spontaneously regressed polyps were identified, and the highest frequency of spontaneously regressed polyp was detected among the cases with polyps measuring 5.0–9.9 mm (16.4%). On multivariate analysis of the ten factors, “Small polyp” and “Hormonal drug use” were found to significantly impact the frequency of spontaneously regressed polyp. CONCLUSIONS: On the basis of the factors identified in this analysis, the indications for observation or medical therapy adapted to small polyps might be expanded.
format Online
Article
Text
id pubmed-8325800
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-83258002021-08-02 Predictive factors of spontaneously regressed uterine endometrial polyps during the waiting period before hysteroscopic polypectomy Okamura, Asuka Yano, Eriko Isono, Wataru Tsuchiya, Akira Honda, Michiko Saito, Ako Tsuchiya, Hiroko Matsuyama, Reiko Fujimoto, Akihisa Nishii, Osamu J Med Case Rep Research Article BACKGROUND: The presence of uterine endometrial polyps is associated with not only abnormal uterine bleeding but also infertility, so the use of hysteroscopic polypectomy has been increasing. This operation is considered to increase cost-effectiveness when performed prior to infertility treatments. However, there are typical problems to consider, including the possibility of spontaneous regression of the polyp and the duration of complete endometrial wound healing after surgery. Meaningless interventions must be avoided, when possible. Therefore, data acquisition and analysis of various findings obtained from surgery have become important for improving treatment procedures and patient selection. To estimate the spontaneous regression rates and contributions of multiple factors to uterine endometrial polyps during the waiting period (approximately 2–3 months) before hysteroscopic polypectomy, we performed a multivariate analysis of data from the records in our hospital. METHODS: The medical records of 450 cases from September 2014 to April 2021 in our hospital were retrospectively reviewed under the approval of our Institutional Review Board. We included all cases of hysteroscopic polypectomy with postoperative pathological diagnosis. We defined cases as having a “spontaneously regressed polyp” when the target polyp was not detected by postoperative pathological examination. We extracted data on the following ten factors: “Advanced age” (≥ 42 years), “Small polyp” (< 10 mm), “High body mass index” (≥ 25 kg/m(2)), “Nulliparity,” “Single polyp,” “Infertility,” “Hypermenorrhea,” “Abnormal bleeding,” “No symptom,” and “Hormonal drug use.” We also classified cases into five groups according to the size of the polyp (≤ 4.9 mm, 5.0–9.9 mm, 10.0–14.9 mm, 15.0–19.9 mm, and ≥ 20.0 mm) and determined the frequency of spontaneously regressed polyp in each group. RESULTS: After exclusion of cases with insufficient data or other diseases, such as submucosal leiomyoma, 424 cases were analyzed. Among them, 28 spontaneously regressed polyps were identified, and the highest frequency of spontaneously regressed polyp was detected among the cases with polyps measuring 5.0–9.9 mm (16.4%). On multivariate analysis of the ten factors, “Small polyp” and “Hormonal drug use” were found to significantly impact the frequency of spontaneously regressed polyp. CONCLUSIONS: On the basis of the factors identified in this analysis, the indications for observation or medical therapy adapted to small polyps might be expanded. BioMed Central 2021-08-01 /pmc/articles/PMC8325800/ /pubmed/34332637 http://dx.doi.org/10.1186/s13256-021-02982-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Okamura, Asuka
Yano, Eriko
Isono, Wataru
Tsuchiya, Akira
Honda, Michiko
Saito, Ako
Tsuchiya, Hiroko
Matsuyama, Reiko
Fujimoto, Akihisa
Nishii, Osamu
Predictive factors of spontaneously regressed uterine endometrial polyps during the waiting period before hysteroscopic polypectomy
title Predictive factors of spontaneously regressed uterine endometrial polyps during the waiting period before hysteroscopic polypectomy
title_full Predictive factors of spontaneously regressed uterine endometrial polyps during the waiting period before hysteroscopic polypectomy
title_fullStr Predictive factors of spontaneously regressed uterine endometrial polyps during the waiting period before hysteroscopic polypectomy
title_full_unstemmed Predictive factors of spontaneously regressed uterine endometrial polyps during the waiting period before hysteroscopic polypectomy
title_short Predictive factors of spontaneously regressed uterine endometrial polyps during the waiting period before hysteroscopic polypectomy
title_sort predictive factors of spontaneously regressed uterine endometrial polyps during the waiting period before hysteroscopic polypectomy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325800/
https://www.ncbi.nlm.nih.gov/pubmed/34332637
http://dx.doi.org/10.1186/s13256-021-02982-4
work_keys_str_mv AT okamuraasuka predictivefactorsofspontaneouslyregresseduterineendometrialpolypsduringthewaitingperiodbeforehysteroscopicpolypectomy
AT yanoeriko predictivefactorsofspontaneouslyregresseduterineendometrialpolypsduringthewaitingperiodbeforehysteroscopicpolypectomy
AT isonowataru predictivefactorsofspontaneouslyregresseduterineendometrialpolypsduringthewaitingperiodbeforehysteroscopicpolypectomy
AT tsuchiyaakira predictivefactorsofspontaneouslyregresseduterineendometrialpolypsduringthewaitingperiodbeforehysteroscopicpolypectomy
AT hondamichiko predictivefactorsofspontaneouslyregresseduterineendometrialpolypsduringthewaitingperiodbeforehysteroscopicpolypectomy
AT saitoako predictivefactorsofspontaneouslyregresseduterineendometrialpolypsduringthewaitingperiodbeforehysteroscopicpolypectomy
AT tsuchiyahiroko predictivefactorsofspontaneouslyregresseduterineendometrialpolypsduringthewaitingperiodbeforehysteroscopicpolypectomy
AT matsuyamareiko predictivefactorsofspontaneouslyregresseduterineendometrialpolypsduringthewaitingperiodbeforehysteroscopicpolypectomy
AT fujimotoakihisa predictivefactorsofspontaneouslyregresseduterineendometrialpolypsduringthewaitingperiodbeforehysteroscopicpolypectomy
AT nishiiosamu predictivefactorsofspontaneouslyregresseduterineendometrialpolypsduringthewaitingperiodbeforehysteroscopicpolypectomy