Clinical features of endometrial polyps in postmenopausal women

The incidence of cancer of the uterine body in recent years is in the first place in the structure of genital cancers. Endometrial polyps (PE) are an actual gynecological problem from the point of view of cancer risk, increased in the postmenopausal period. The aim of the study was to conduct a quantitative analysis of the clinical features of the course of PE in postmenopausal patients. Material and methods. A retrospective cohort study was performed on the basis of the gynecological department of the CHUZ «CB «Russian Railways-Medicine» Omsk». The research cohort consisted of 133 postmenopausal women with PE (mean age-59.23±6.34 years) who underwent hysteroscopic polypectomy. Results. The duration of postmenopause was 9.47±6.66 years. PE was dominant in late postmenopausal women (68.4%). Postmenopausal PE patients had asymptomatic course (69.2%), uterine bleeding (30.8%), recurrent PE (15.8%), concomitant tamoxifen treatment (3.8%). According to the hysteroscopy data, single PE (75.2%) with an average size of 15.7±9.4 mm prevailed. The predominance of glandular-fibrous PE (61.7%) is characteristic of glandular PE (36.8%) and adenomatous PE (1.5%). Signs of malignancy of adenomatous PE and cancer in the surrounding endometrium were found in the symptomatic (n=41) and asymptomatic course of the disease (n=92) (p>0.05). Conclusion. In postmenopausal patients with asymptomatic PE and PE associated with postmenopausal bleeding, the disease occurs against the background of precancerous and endometrial cancer (in the polyp or surrounding endometrium) in 3.76% of cases, which requires histological verification when detecting proliferative endometrial processes in postmenopausal ultrasound, regardless of the size of the polyp and the absence of clinical manifestations.

endometrial polyp, postmenopause, hysteroscopic polypectomy, malignancy, endometrial cancer