Medical and social profile and clinical features of patients with endometrial polyps

Introduction. Nowadays, a wide range of environmental, social, behavioral and medical factors influence somatic and reproductive health of women, which leads to the development of specific characteristics of the course of various gynecological diseases, i.e. pathomorphosis in the clinical (narrow) sense. Aim. Analysis of the medical and social profile, and clinical and anamnestic specific characteristics of patients with endometrial polyps (EPs) of different morphological types in the light of the doctrine of pathomorphosis. Materials and methods. To investigate the pathomorphosis of EPs, a retrospective study of 393 patients with EPs was performed: 207 women were treated in 2016–2018 (1st group), and 186 women – in 2006–2008 (2nd group). Results. In patients of the 1st group, changes of the medical and social profile and clinical course of the disease were revealed: a later age of manifestation of atrophic and earlier age of functional and hyperplastic EPs; in women with atrophic EPs, hypertension is more often observed, with functional EPs – disorders of the digestive system and anemia; patients with functional and hyperplastic EPs have a lower number of pregnancies, childbirths and surgical abortions, and with atrophic EPs have a greater number of pregnancies, therapeutic abortions and miscarriages; in the past medical history of patients with atrophic EPs, cervical polyps, endometrial hyperplasia, cervicitis are more often observed, with hyperplastic EPs – endometrial hyperplasia and ovarian cysts, with functional EPs – cervicitis and infertility. The incidence of abnormal uterine bleeding (AUB) decreased significantly, the incidence of asymptomatic course of the disease increased in atrophic EPs, while the incidence of AUB in the form of intermenstrual bleeding and asymptomatic course increased statistically significantly in hyperplastic EPs, and infertility – in functional EPs. Conclusion. Formed over a period of 10 years, the changes in the age of EPs manifestation, somatic and reproductive health of women with EPs, clinical manifestations of EPs of various morphological types can be interpreted as pathomorphosis in the clinical (narrow) sense. These changes must be taken into account when developing diagnostic, therapeutic and reconstructive treatment of this pathology.