High number of endometrial polyps is a strong predictor of recurrence: findings of a prospective cohort study in reproductive-age women

Fang Gu, Zhang H, Huanxiao Zhang, Ruan S, Si‐Min Ruan, Simin Ruan, Jiamin Li, Li J, Xinyan Liu, Liu X, Xu Y, Yanwen Xu, Zhou C, Canquan Zhou
Fertility and sterility · 2018 · vol. 109(3) , pp. 493–500 · doi:10.1016/j.fertnstert.2017.11.029 · PMID:29525689 · W2794417465
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A prospective study found that a high number of endometrial polyps in reproductive-age women is a strong predictor of polyp recurrence.

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Abstract

ObjectiveTo compare the incidence of recurrence between a cohort with a high number (≥6) of endometrial polyps (EPs) and a single-EP cohort among reproductive-age patients after polypectomy.DesignProspective observational cohort study.SettingSingle university center.Patient(s)Premenopausal women who underwent hysteroscopic endometrial polypectomy were recruited.Intervention(s)Patients underwent a transvaginal ultrasound scan every 3 months after polypectomy to detect EP recurrence. Kaplan-Meier and Cox regression models were used to compare the risk of recurrence between the two cohorts and analyze the potential risk factors for EP recurrence.Main outcome measure(s)EP recurrence rate.Result(s)The study enrolled 101 cases with a high number of EP and 81 cases with a single EP. All baseline parameters were similar except that the high number of EP cohort had a slightly lower mean age than the single EP cohort (33.5 [range 30.0-39.0] vs. 36.0 [30.5-43.0] years). The risk of recurrence in the high number of EP cohort was 4.08 (95% confidence interval [CI] 1.89-8.81) times higher than that in the single-EP cohort 1 year after polypectomy, with a recurrence rate of 45.5% versus 13.4%, respectively. A high number of EPs, endometriosis, and previous polypectomy history were independently associated with polyp recurrence.Conclusion(s)The high number of EP cohort was much more prone to recurrence than the single-EP cohort. A high number of EPs, endometriosis, and previous polypectomy history were independent risk factors for recurrence. A high number of EPs is suggested to be a distinct subgroup with different pathogenesis, which warrants frequent monitoring and prevention.

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MeSH descriptors

Polyps Reproductive Health Uterine Diseases Academic Medical Centers Adult Age Factors China China Female Humans Hysteroscopy Incidence Polyps Polyps Polyps Polyps Prospective Studies Recurrence Risk Factors Time Factors

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