In both pre and postmenopausal women, endometrial polyps lose their apoptotic regulation and overexpress estrogen and progesterone receptors, thus avoiding the usual control mechanisms.
Endometrial polyps are present in approximately one-quarter of symptomatic pre and postmenopausal women.
Half of the premenopausal women present with menorrhagia; other presentations include postmenopausal bleeding, prolapse through the cervical ostium, abnormal vaginal discharge and breakthrough bleeding during hormonal therapy.
Increased incidence of endometrial polyps in women on hormone replacement therapy (HRT) and tamoxifen (8-36%), which acts as a selective receptor modulator and estrogen agonist on the endometrium. The influence on endometrial polyps seems to be through estrogen, on which endometrial polyps depend. However, endometrial polyp formation appears to be related to the type and dosage of the estrogen and progestogen in HRT; in particular, a progestogen with high anti-estrogenic activity may have an important role in preventing the development of endometrial polyps.
Diabetes, hypertension and obesity are independent risk factors for the development of endometrial polyps. Predictors of malignancy or premalignancy in endometrial polyps : a size of >10 mm postmenopausal status abnormal uterine bleeding a polyp diameter A polyp of >18 mm in asymptomatic women increased the risk of malignancy there is a higher incidence of concurrent endometrial hyperplasia with endometrial polyps,13, 14 especially in women on hormone replacement.
Hysteroscopic markers for malignant endometrial polyps include surface irregularities such as necrosis, vascular irregularities and whitish thickened areas, which are indications for obtaining a histological diagnosis.
Fertility and endometrial polyps Large or multiple endometrial polyps can contribute to infertility and increase the risk of miscarriage.Hysteroscopic polypectomy will improve the rate of spontaneous conception regardless of size or number of polyps, which may be due to the normalisation of endometrial implantation fayctors
Treatment of endometrial polyps: The risk of malignant transformation of endometrial polyps is low, but they should be removed when detected, as excision allows for both histological diagnosis and effective treatment of abnormal uterine bleeding patterns and excessive menstrual loss; in addition, endometrial polyps in postmenopausal women are more likely to be malignant when symptomatic
What to do with asymptomatic and incidental finding of endometrial polyps?
Asymptomatic and incidental endometrial polyps should be treatedause for endometrial polyps In both pre and postmenopausal women, endometrial polyps lose their apoptotic regulation and overexpress estrogen and progesterone receptors, thus avoiding the usual control mechanisms.
Endometrial polyps are present in approximately one-quarter of symptomatic pre and postmenopausal women. Half of the premenopausal women present with menorrhagia; other presentations include postmenopausal bleeding, prolapse through the cervical ostium, abnormal vaginal discharge and breakthrough bleeding during hormonal therapy. Increased incidence of endometrial polyps in women on hormone replacement therapy (HRT) and tamoxifen (8-36%), which acts as a selective receptor modulator and estrogen agonist on the endometrium. The influence on endometrial polyps seems to be through estrogen, on which endometrial polyps depend. However, endometrial polyp formation appears to be related to the type and dosage of the estrogen and progestogen in HRT; in particular, a progestogen with high anti-estrogenic activity may have an important role in preventing the development of endometrial polyps. Diabetes, hypertension and obesity were independent risk factors for the development of endometrial polyps. Predictors of malignancy or premalignancy in endometrial polyps : a size of >10 mm postmenopausal status abnormal uterine bleeding a polyp diameter A polyp of >18 mm in asymptomatic women increased the risk of malignancy there is a higher incidence of concurrent endometrial hyperplasia with endometrial polyps,13, 14 especially in women on hormone replacement. Hysteroscopic markers for malignant endometrial polyps include surface irregularities such as necrosis, vascular irregularities and whitish thickened areas, which are indications for obtaining a histological diagnosis. Fertility and endometrial polyps Large or multiple endometrial polyps can contribute to infertility and increase the risk of miscarriage.Hysteroscopic polypectomy will improve the rate of spontaneous conception regardless of size or number of polyps, which may be due to the normalisation of endometrial implantation fayctors Treatment of endometrial polyps: The risk of malignant transformation of endometrial polyps is low, but they should be removed when detected, as excision allows for both histological diagnosis and effective treatment of abnormal uterine bleeding patterns and excessive menstrual loss; in addition, endometrial polyps in postmenopausal women are more likely to be malignant when symptomatic What to do with asymptomatic and incidental finding of endometrial polyps? Asymptomatic and incidental endometrial polyps should be treated. Algorithm for management of endometrial polyps. Whether to avulse blindly or resect hysteroscopically? There is good direct and circumstantial evidence that hysteroscopic resection of endometrial polyps under vision is safe, simple and superior to blind techniques: There is a possibility that malignant cells can be missed if one uses blind technique of avulsion Hysteroscopic resection avoids excessive cervical dilatation, which is when uterine perforation and creation of a false passage usually occur With the blind avulsion technique, recurrence rate of 15% and none with resection technique. Polyps>2 cm require piecemeal removal, a longer operating time and multiple instrument passes through the cervix. In those cases removal under general Anaesthesia is advisable, but small-diameter hysteroscopic morcellators can also be considered.. Algorithm for management of endometrial polyps. Whether to avulse blindly or resect hysteroscopically? There is good direct and circumstantial evidence that hysteroscopic resection of endometrial polyps under vision is safe, simple and superior to blind techniques: There is a possibility that malignant cells can be missed if one uses blind technique of avulsion Hysteroscopic resection avoids excessive cervical dilatation, which is when uterine perforation and creation of a false passage usually occur With the blind avulsion technique, recurrence rate of 15% and none with resection technique. Polyps>2 cm require piecemeal removal, a longer operating time and multiple instrument passes through the cervix. In those cases removal under general Anaesthesia is advisable, but small-diameter hysteroscopic morcellators can also be considered.
Endometrial polyps are present in approximately one-quarter of symptomatic pre and postmenopausal women.
Half of the premenopausal women present with menorrhagia; other presentations include postmenopausal bleeding, prolapse through the cervical ostium, abnormal vaginal discharge and breakthrough bleeding during hormonal therapy.
Increased incidence of endometrial polyps in women on hormone replacement therapy (HRT) and tamoxifen (8-36%), which acts as a selective receptor modulator and estrogen agonist on the endometrium. The influence on endometrial polyps seems to be through estrogen, on which endometrial polyps depend. However, endometrial polyp formation appears to be related to the type and dosage of the estrogen and progestogen in HRT; in particular, a progestogen with high anti-estrogenic activity may have an important role in preventing the development of endometrial polyps.
Diabetes, hypertension and obesity are independent risk factors for the development of endometrial polyps. Predictors of malignancy or premalignancy in endometrial polyps : a size of >10 mm postmenopausal status abnormal uterine bleeding a polyp diameter A polyp of >18 mm in asymptomatic women increased the risk of malignancy there is a higher incidence of concurrent endometrial hyperplasia with endometrial polyps,13, 14 especially in women on hormone replacement.
Hysteroscopic markers for malignant endometrial polyps include surface irregularities such as necrosis, vascular irregularities and whitish thickened areas, which are indications for obtaining a histological diagnosis.
Fertility and endometrial polyps Large or multiple endometrial polyps can contribute to infertility and increase the risk of miscarriage.Hysteroscopic polypectomy will improve the rate of spontaneous conception regardless of size or number of polyps, which may be due to the normalisation of endometrial implantation fayctors
Treatment of endometrial polyps: The risk of malignant transformation of endometrial polyps is low, but they should be removed when detected, as excision allows for both histological diagnosis and effective treatment of abnormal uterine bleeding patterns and excessive menstrual loss; in addition, endometrial polyps in postmenopausal women are more likely to be malignant when symptomatic
What to do with asymptomatic and incidental finding of endometrial polyps?
Asymptomatic and incidental endometrial polyps should be treatedause for endometrial polyps In both pre and postmenopausal women, endometrial polyps lose their apoptotic regulation and overexpress estrogen and progesterone receptors, thus avoiding the usual control mechanisms.
Endometrial polyps are present in approximately one-quarter of symptomatic pre and postmenopausal women. Half of the premenopausal women present with menorrhagia; other presentations include postmenopausal bleeding, prolapse through the cervical ostium, abnormal vaginal discharge and breakthrough bleeding during hormonal therapy. Increased incidence of endometrial polyps in women on hormone replacement therapy (HRT) and tamoxifen (8-36%), which acts as a selective receptor modulator and estrogen agonist on the endometrium. The influence on endometrial polyps seems to be through estrogen, on which endometrial polyps depend. However, endometrial polyp formation appears to be related to the type and dosage of the estrogen and progestogen in HRT; in particular, a progestogen with high anti-estrogenic activity may have an important role in preventing the development of endometrial polyps. Diabetes, hypertension and obesity were independent risk factors for the development of endometrial polyps. Predictors of malignancy or premalignancy in endometrial polyps : a size of >10 mm postmenopausal status abnormal uterine bleeding a polyp diameter A polyp of >18 mm in asymptomatic women increased the risk of malignancy there is a higher incidence of concurrent endometrial hyperplasia with endometrial polyps,13, 14 especially in women on hormone replacement. Hysteroscopic markers for malignant endometrial polyps include surface irregularities such as necrosis, vascular irregularities and whitish thickened areas, which are indications for obtaining a histological diagnosis. Fertility and endometrial polyps Large or multiple endometrial polyps can contribute to infertility and increase the risk of miscarriage.Hysteroscopic polypectomy will improve the rate of spontaneous conception regardless of size or number of polyps, which may be due to the normalisation of endometrial implantation fayctors Treatment of endometrial polyps: The risk of malignant transformation of endometrial polyps is low, but they should be removed when detected, as excision allows for both histological diagnosis and effective treatment of abnormal uterine bleeding patterns and excessive menstrual loss; in addition, endometrial polyps in postmenopausal women are more likely to be malignant when symptomatic What to do with asymptomatic and incidental finding of endometrial polyps? Asymptomatic and incidental endometrial polyps should be treated. Algorithm for management of endometrial polyps. Whether to avulse blindly or resect hysteroscopically? There is good direct and circumstantial evidence that hysteroscopic resection of endometrial polyps under vision is safe, simple and superior to blind techniques: There is a possibility that malignant cells can be missed if one uses blind technique of avulsion Hysteroscopic resection avoids excessive cervical dilatation, which is when uterine perforation and creation of a false passage usually occur With the blind avulsion technique, recurrence rate of 15% and none with resection technique. Polyps>2 cm require piecemeal removal, a longer operating time and multiple instrument passes through the cervix. In those cases removal under general Anaesthesia is advisable, but small-diameter hysteroscopic morcellators can also be considered.. Algorithm for management of endometrial polyps. Whether to avulse blindly or resect hysteroscopically? There is good direct and circumstantial evidence that hysteroscopic resection of endometrial polyps under vision is safe, simple and superior to blind techniques: There is a possibility that malignant cells can be missed if one uses blind technique of avulsion Hysteroscopic resection avoids excessive cervical dilatation, which is when uterine perforation and creation of a false passage usually occur With the blind avulsion technique, recurrence rate of 15% and none with resection technique. Polyps>2 cm require piecemeal removal, a longer operating time and multiple instrument passes through the cervix. In those cases removal under general Anaesthesia is advisable, but small-diameter hysteroscopic morcellators can also be considered.
Premenopausal women are at increased risk for cardiovascular disease
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