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

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Asuka Okamura ◽  
Eriko Yano ◽  
Wataru Isono ◽  
Akira Tsuchiya ◽  
Michiko Honda ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Drug Use ◽  
Spontaneous Regression ◽  
High Body Mass Index ◽  
Abnormal Uterine Bleeding ◽  
Pathological Examination ◽  
Endometrial Polyps ◽  
Waiting Period ◽  
Institutional Review ◽  
Small Polyp

Abstract 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/m2), “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.

scholarly journals Clinical study on 7 cases of polypoid endometriosis. PEM: a mimic of malignancy, the symptoms of adenomyosis, endometrial polyps and infertility can assist in diagnosis

2021 ◽  
Author(s):  
Xiaohua Zheng ◽  
Ying Xu ◽  
xianjing chen ◽  
Qibing Zheng ◽  
Rong Zhao ◽  
...  
Keyword(s):  
Age Of Onset ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
Pelvic Mass ◽  
Abnormal Uterine Bleeding ◽  
Diagnostic Methods ◽  
Pathological Examination ◽  
Rare Type ◽  
Endometrial Polyps ◽  
Polypoid Endometriosis

Abstract Objective: polypoid endometriosis (PEM) is a rare type of endometriosis (EMs), which is easy to be misdiagnosed. The purpose of this paper is to investigate the clinical features and diagnostic methods of PEM. Methods:The clinical data of 7 patients with PEM who were treated at Fujian Provincial Maternity and Children’s Hospital in China within July 2017 to December 2020 period were retrospectively analyzed, and their clinical characteristics, diagnosis, treatment and prognosis were summarized. Results: The age of onset was 31-41 (38.00 ± 1.72) years. There were 5 cases with adenomyosis, 4 cases with endometrial polyps and infertility. The clinical manifestations were diverse. Most of them were pelvic mass, compression symptoms and signs, dysmenorrhea and abnormal uterine bleeding, and three of them were similar to malignant tumors. The gross pathological features were cysts, endogenous or exogenous polypoid masses, which were all composed of endometrioid glands and stromal components, but more diverse than ordinary em. All the 7 patients were confirmed by operation and pathology. Conclusion: PEM is often complicated with adenomyosis, endometrial polyps and infertility. Pathological examination is the gold standard for diagnosis. Imaging examination is easy to be misdiagnosed. Abnormal increase of CA125 can assist in diagnosis.

Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histological Diagnosis ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

scholarly journals EPID-36. ANTIDEPRESSANT DRUG USE IN GLIOBLASTOMA PATIENTS: AN EPIDEMIOLOGICAL VIEW

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii86-ii86
Author(s):  
Dorothee Gramatzki ◽  
James Rogers ◽  
Marian Neidert ◽  
Caroline Hertler ◽  
Emilie Le Rhun ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Drug Use ◽  
Survival Data ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Methylation Status ◽  
Antidepressant Drug ◽  
Antidepressant Drugs ◽  
Population Level ◽  
Disease Course

Abstract PURPOSE Antidepressant drugs have shown anti-tumor activity in preclinical glioblastoma studies. Antidepressant drug use, as well as its association with survival, in glioblastoma patients has not been well characterized on a population level. METHODS Patient characteristics, including the frequency of antidepressant drug use, were assessed in a glioblastoma cohort diagnosed in a 10-year time-frame between 2005 and 2014 in the Canton of Zurich, Switzerland. Cox proportional hazards regression models were applied for multivariate analysis. Kaplan-Meier survival curves were used to estimate overall survival data and the log-rank test was performed for comparisons. RESULTS Four hundred four patients with isocitrate dehydrogenase (IDH) wildtype glioblastoma were included in this study. Sixty-five patients (16.1%) took antidepressant drugs at some point during the disease course. Patients were most commonly prescribed selective serotonin reuptake inhibitors at any time (N=46, 70.8%). Nineteen patients (29.2%) were on antidepressant drugs at the time of their tumor diagnosis. No differences were observed in overall survival between those patients who had taken antidepressants at some point in their disease course and those who had not (p=0.356). These data were confirmed in a multivariate analysis including age, Karnofsky performance status, gender, extent of resection, O6-methylguanine DNA methyltransferase (MGMT) promoter methylation status, and first-line treatment as cofounders (p=0.315). Also, there was no association of use of drugs modulating voltage-dependent potassium channels (citalopram; escitalopram) with survival (p=0.639). CONCLUSIONS This signal-seeking study does not support the hypothesis that antidepressants have antitumor efficacy in glioblastoma on a population level.

scholarly journals Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Mohamed Laban ◽  
Sherif H. Hussain ◽  
Alaa S. Hassanin ◽  
Waleed M. Khalaf ◽  
Mohamed K. Etman ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Premenopausal Women ◽  
Abnormal Uterine Bleeding ◽  
Final Analysis ◽  
Uterine Bleeding ◽  
Endometrial Polyps ◽  
Predictive Values ◽  
Endometrial Volume ◽  
Sensitivity Specificity

The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P=0.223;P=0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

scholarly journals Hysteroscopic evaluation in infertility and abnormal uterine bleeding

2018 ◽  
Vol 7 (2) ◽  
pp. 612
Author(s):  
Navneet Kaur ◽  
Ruby Bhatia ◽  
Paramjit Kaur ◽  
Surinder K. Bhopal
Keyword(s):  
Endometrial Hyperplasia ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Therapeutic Modality ◽  
Secondary Infertility ◽  
Endometrial Polyps ◽  
Submucous Fibroid

Background: Hysteroscopy an endoscopic procedure for visualization of uterine cavity may be extensively used in both primary and secondary infertility and abnormal uterine bleeding for evaluating intrauterine pathology. The objectives of this study were to visualize and identity intrauterine pathology in both primary and secondary infertility and abnormal uterine bleeding (AUB) by hysteroscopic evaluation and to perform hysteroscopic guided therapeutic procedures like endometrial currettage, polypectomy, adhesiolysis.Methods: Hysteroscopic evaluation of uterine cavity for any intrauterine pathology in AUB and Infertility. Adhesiolysis, polypectomy, endometrial biopsy misplaced copper T removal were carried out under hysteroscopic vision.Results: Intrauterine synechia in 20.51%, Submucous fibroid in 5.13%, bicornuate uterus, endometrial hyperplasia and endometrial polyp were seen in 2.56% patient each were detected in infertility group while 81.95% cases with AUB had abnormal intrauterine pathology commonest being endometrial hyperplasia in 33.33% followed by endometrial polyps in 23.81% cases, submucous fibroid and misplaced copper T in 9.52% each and intrauterine synechia in 4.76% patient. Endometrial biopsy and polypectomy was done in 23.80% each with AUB, misplaced copper T removal in 9.52% and adhesiolysis in 4.76% patient with AUB.Conclusions: Hysteroscopy remains gold standard for evaluating intrauterine lesions in abnormal uterine bleeding and infertility. A safe, simple minimally invasive procedure not only diagnostic but therapeutic modality for adhesiolysis, endometrial biopsy/curettage, polypectomy, misplaced copper T removal under direct vision with minimal complication within reach of every Gynaecologist thereby reducing burden of major surgical intervention.

scholarly journals Prevalence and characteristics of endometrial polyps in patients with abnormal uterine bleeding

2008 ◽  
Vol 65 (5) ◽  
pp. 349-352 ◽  
Author(s):  
Biljana Djordjevic ◽  
Jelena Milosevic ◽  
Zorica Stanojevic
Keyword(s):  
Endometrial Carcinoma ◽  
Statistical Significance ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Atypical Hyperplasia ◽  
Endometrial Polyps ◽  
Female Population ◽  
Group A ◽  
Malignant Changes ◽  
Group B

Background/Aim. The prevalence of endometrial polyps (EPs) in the general female population is about 24%. Abnormal uterine bleeding is frequently the presenting symptom of EPs. The aim of this study was to determine the prevalence and characteristics of EPs in patients with abnormal uterine bleeding. Methods. The prevalence and characteristics of EPs were investigated in 961 patients with abnormal uterine bleeding who underwent dilatation and curettage between January and December 2006. Regarding histopathological features of EPs (presence of atypical hyperplasia or endometrial carcinoma), patients were divided into two groups: group A - patients who had EPs and EPs with hyperplasia without atypia (n = 204) and group B - patients who had EPs with atypical hyperplasia and EPs with carcinoma (n = 7). Results. In 211 (21.94%) patients EPs were found with abnormal uterine bleeding. Histopathologically, there were 175 (82.94%) EPs, 29 (13.74%) EPs with hyperplasia without atypia, 5 (2.37%) EPs with atypical hyperplasia, and 2 (0.95%) EPs with endometrial carcinoma. Contrary to the patients with EPs and EPs with hyperplasia without atypia (group A), patients who had EPs with atypical hyperplasia and EPs with carcinoma (group B) were older (p < 0.05), and more commonly postmenopausal (p < 0.05) and with hypertension (p < 0.05), all of statistical significance. Conclusion. The prevalence of endometrial polyps in patients with abnormal uterine bleeding according to our data was 21.95%. Atypical hyperplasia and endometrial carcinoma were rarely confined to a polyp. Older age, postmenopausal period and hypertension may increase the risk of premalignant and malignant changes in endometrial polyps.

scholarly journals Role of hysteroscopy and histopathology in evaluating patients with abnormal uterine bleeding

2017 ◽  
Vol 6 (2) ◽  
pp. 615 ◽  
Author(s):  
Nighat Firdous ◽  
Samar Mukhtar ◽  
Sheikh Bilal ◽  
Salma Kounsar Beigh
Keyword(s):  
Predictive Value ◽  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Common Finding ◽  
Endometrial Polyps ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Definitive Role

Background: Abnormal uterine bleeding is one of the leading causes for seeking gynaecological advice. The aim and objectives of the study was to determine the pattern of hysteroscopic abnormalities and histopathological features of Abnormal Uterine Bleeding and to correlate hysteroscopic findings with histopathological findings.Methods: The present study “Role of Hysteroscopy and Histopathology in Evaluating patients with Abnormal Uterine Bleeding” was an observational study carried out in the Postgraduate Department of Obstetrics and Gynaecology and Postgraduate Department of Pathology of Government Medical college, Srinagar after obtaining clearance from the institutional ethical committee. The period of the study was One and a Half Years from April 2014 to September 2015.Results: The most common abnormality detected by hysteroscopy was Endometrial Hyperplasia (27 cases, 27%) followed by endometrial polyps (21 cases, 21%). Endometrial Hyperplasia was the most common abnormality found in Menorrhagia followed by polyps while polyps were the most common finding in polymenorrhea and endometrial hyperplasia was the most common pathology in postmenopausal bleeding. Hysteroscopy had a sensitivity of 93.2%, specificity of 83.9%, positive predictive value of 82%, Negative Predictive Value of 94% in diagnosing etiology of abnormal uterine bleeding.Conclusions: This study confirms that hysteroscopy has a definitive role in evaluating patients with abnormal uterine bleeding and hysteroscopy and histopathology complement each other in the evaluation of a patient with Abnormal uterine bleeding.

scholarly journals Thyroid function test in abnormal uterine bleeding

2018 ◽  
Vol 12 (2) ◽  
pp. 74-78
Author(s):  
Pramod Kattel
Keyword(s):  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Pap Smear ◽  
Abnormal Uterine Bleeding ◽  
Thyroid Function Test ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Pathological Examination ◽  
Overt Hypothyroidism ◽  
Function Test

Aims: To evaluate and detect the thyroid dysfunction in patients with abnormal uterine bleeding (AUB) from puberty to menopause.Methods: This is an observational descriptive study of 90 patients of abnormal uterine bleeding at Paropakar Maternity and Women’s Hospital, Kathmandu from 17th January 2016 to 16th January 2017. Besides thyroid function test Pap smear, endometrial biopsy and histo-pathological examination of uterus following hysterectomy was done in selected cases.Results: The incidence of AUB was 6.2 % with mean age of 37 years. The most common presenting complaint was menorrhagia (36.7%) followed by metrorrhagia (23.3%). Thyroid dysfunction accounted for 20% of AUB with major share occupied by subclinical hypothyroidism (11%) and least by hyperthyroidism (1%). The most common association of thyroid dysfunction with AUB was overt hypothyroidism (27.3%) with menorrhagia. Non-structural cases of AUB accounted for 30.4% of thyroid dysfunction.Conclusions: This study shows that thyroid dysfunction plays significant role for AUB so it is wise enough to perform TFT on routine basis in order to avoid unnecessary hormonal treatment with Estrogen, Progesterone or their combination and even the hysterectomies.

Frequency and factors predicting the risk for aberrant opioid use in patients receiving outpatient palliative care at a comprehensive cancer center.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 228-228
Author(s):  
Sriram Yennu ◽  
Tonya Edwards ◽  
Joseph Anthony Arthur ◽  
Zhanni Lu ◽  
John M Najera ◽  
...  
Keyword(s):  
At Risk ◽  
Multivariate Analysis ◽  
Drug Use ◽  
Supportive Care ◽  
Cancer Patients ◽  
Financial Distress ◽  
Male Gender ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Edmonton Symptom Assessment Scale

228 Background: Opioid misuse is a growing crisis among patients with chronic pain. Cancer patients at risk of aberrant drug behaviors (ADB) are frequently underdiagnosed in routine cancer care. The aim of this study was to determine the frequency and factors predicting risk for Aberrant Opioid and Drug use among Patients receiving Outpatient Supportive Care Consultation at a Comprehensive Cancer Center Methods: In this retrospective study, 690 consecutive patients referred to a supportive care clinic were reviewed. Patients were eligible if they were ≥18 years, had a diagnosis of cancer, and were on opioids for pain for atleast a week. All patients were assessed with the Edmonton Symptom Assessment Scale (ESAS), SOAPP-14, and CAGE-AID. At risk patients with aberrant opioid behavior (+Risk) was defined as SOAPP-14 score ≥7. Descriptive statistics, spearman correlation coefficient, multivariate analysis were performed. Results: 690/752 consults were eligible. A total of 135(20%)were +risk. 69(11%) were CAGE-AID +.SOAPP-14 scores were positively associated with CAGE-AID p < 0.001; male gender p = 0.007; ESAS pain p = < 0.006; ESAS depression p < 0.001; ESAS anxiety, p < 0.001, and ESAS financial distress p = < 0.001. Multivariate analysis indicated that the odds ratio for +Risk was 2.47 in patients with CAGE-AID+ (p < 0.001), 1.95 for male gender (p = 0.005), 1.11 per point for ESAS anxiety (p = 0.019), and 1.1 per point. for ESAS financial distress (p = 0.02). Conclusions: 20% of cancer patients on opioids presenting to supportive care center are at risk of aberrant drug behavior. Male patients with anxiety, financial distress, and prior alcoholism/illicit drug use are significant predictors of +Risk. Further research to effectively manage these patients is needed.

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