Endometrial Polyps: A Review

Abstract

Endometrial polyps are benign lesions that reproduce the endometrium in full or in part, with a low potential for malignant transformation. Although they are hormone dependent and present a cyclic functional reaction similar to that of the adjacent endometrium, most of them consist of an immature, “out of phase” type of endometrium with irregular glands that are poorly responsive to progesterone. During the reproductive period, they are diagnosed in symptomatic patients with abnormal uterine bleeding or infertility. After menopause, although more frequent, most of them are asymptomatic, being associated with abnormal bleeding in one third of cases. The risk factors for cancer of the endometrium are not similarly associated with the risk of malignant transformation of endometrial polyps. The definitive diagnosis of endometrial polyps is made by the histologic examination of a sample that is most efficiently obtained hysteroscopically by a directed biopsy. Their most effective treatment is by a hysteroscopic resection procedure. The polypectomy yields highly satisfactory results during the postmenopausal period, has a lower rate of success in symptomatic women of reproductive age, and improves the fertility rates of infertile women.