Modern approaches to the treatment of endometrial polyps considering age-related and morphological-functional aspects

Authors

DOI:

https://doi.org/10.18370/2309-4117.2026.82.46-49

Keywords:

endometrial polyps, morphological structure, late reproductive age, perimenopausal age

Abstract

Objective of the study: to evaluate the effectiveness of treatment of endometrial polyps (EP) in women taking into account age-related and morphological and functional aspects.

Materials and methods. A total of 116 women with EP were under our observation and were divided into two groups. Group I included 54 women of late reproductive age (35–45 years); Group II consisted of 62 patients of perimenopausal age (45–55 years). The diagnosis of EP was verified according to the data of clinical, instrumental, and morphological methods of investigation. For the prevention of EP recurrence, patients with glandular and glandular–fibrous polyps received dienogest at a dose of 2 mg per day for 6 months in a continuous regimen. The effectiveness of the therapy was evaluated on the basis of clinical and instrumental data and the results of pipelle biopsy after 6 months and twice during follow-up at three-month intervals.

Results and discussion. All women underwent hysteroresectoscopy with pathomorphological examination of the obtained material to verify the diagnosis. In women of reproductive age, glandular and glandular-fibrous polyps prevailed (87.0%). In perimenopausal patients, fibrous and glandular-fibrous polyps were dominant (56.4%). Adenomatous polyps were more common in perimenopausal patients – 12.9% and 9.2%, respectively.

Evaluation of the effectiveness of progestogen therapy after 6 months showed that, according to ultrasound examination, EP were not detected in any woman in either group. During further follow-up three and 6 months after treatment, EP were detected by ultrasound examination in three patients (6.3%) of late reproductive age and in one woman (3.3%) of perimenopausal age. The diagnosis was confirmed by repeat hysteroscopic resection and histological examination.

Conclusions. Long-term continuous anti-relapse therapy with dienogest in a group of women of late reproductive and in a group of perimenopausal age demonstrated high efficacy and reduced the recurrence rate of EP to 6.3% and 3.3% of cases, respectively.

Author Biography

O.V. Kravchenko, Bukovinian State Medical University, Chernivtsi

DSc, professor, head of the Department of Obstetrics, Gynecology and Perinatology

References

  1. Van den Bosch T. Benign Disease of the Uterus. Edmonds K, Christoph L, Bourne T, editors. Dewhurst’s Textbook of Obstetrics & Gynaecology. Chichester, UK, John Wiley & Sons, Ltd. 2018:823–34.
  2. Horban NY, Vovk IB, Lysiana TO, Ponomariova IH, Zhulkevych IV. Peculiarities of Uterine Cavity Biocenosis in Patients with Different Types of Endometrial Hyperproliferative Pathology. J Med Life. 2019;12(3):266–70. DOI: 10.25122/jml-2019-0074.
  3. Boichuk AV, Shadrina VS, Vereshchahina TV. Hyperplasia of endometrium – a modern system-pathogenetic view on the problem (literature review). Actual Problems of Pediatrics, Obstetrics and Gynecology. 2019;1:67–72. DOI: 10.11603/24116-4944.2019.1.9906
  4. Shcherbina MO, Polyakova EM, Lutsenko NS. Diagnostic value of transvaginal ultrasound diagnosis of endometrial polyps. Collection of scientific papers of the Association of Obstetricians and Gynecologists of Ukraine. 2020;2 (46):77. DOI: https://doi.org/10.35278/2664-0767.2(46).2020.219476
  5. Gorban NE, Kondratyuk VK, Raksha II. Assessment of echographic indicators in women with hyperproliferative endometrial pathology. Current issues in pediatrics, obstetrics, and gynecology. 2019;2:32–8. DOI: https://doi.org/10.11603/24116-4944.2019.2.10924
  6. Boychuk AV, Vereshchahina TV, Nikitina IM. Estimation of relative risk of development and informativeness of diagnostic metods of hiperproliferative processes of endometrium. Wiadomości Lekarskie (Warsav. Poland: 1960). 2020;73(9):1600–9.
  7. Kornienko SM. Endometrial pathology. Age and reproductive aspects. Current issues in pediatrics, obstetrics, and gynecology. 2022;2:92-96. DOI: 10.11603/24116-4944.2022.2.13457
  8. Namazov A, Gemer O, Ben-Arie A, et al. Endometrial Polyp Size and the Risk of Malignancy in Asymptomatic Postmenopausal Women. JOGC. 2018:41(7):912–5. DOI: 10.1016/j.jogc.2018.07.019
  9. Seto MT, Ip PP, Ngu SF, Cheung AN, Pun TC. Positive predictive value of endometrial polyps in Pipelle aspiration sampling: a histopathological study of 195 cases. Eur J Obstet Gynecol Reprod Biol. 2016 Aug;203:12–15. DOI: 10.1016/j.ejogrb.2016.04.027
  10. Benyuk VO, Perepadia OV, Goncharenko VM, Kalenska OV, Kravchenko YV. Clinical and morphological parallels in the diagnosis of endometrial polyps in terms of age. Collection of scientific papers of the Association of Obstetricians and Gynecologists of Ukraine. 2020;2(46):6–10. DOI: 10.35278/2664-0767.2(46).2020.219458
  11. Tatarchuk TF, Dubossarska YuO, Dubossarska ZM. Endometrial hyperplasia: modern approaches to diagnosis and treatment. Reproductive endocrinology. 2021;2(58):18–27. DOI: 10.18370/2309-4117.2021.58.18-27
  12. Nikitina IM, Mykytin KV, Kalashnik NV, Babar TV, Ikonopistseva NA, Kopytsya TV. Endometrial polyps in women of reproductive age – a modern etiopathogenetic view of the problem (literature review). Current issues in pediatrics, obstetrics, and gynecology. 2020;2:18–27. DOI: 10.18370/2309-4117.2021.58.18-27
  13. Kryvokulsky BD, Zhulkevich IV, Kryvokulsky DB, Shkrobot LV. Study of the influence of age and comorbidity index on the risk of thrombotic complications in patients with endometrial cancer at the preoperative stage. Bulletin of Scientific Research. 2018;2(91):151–153. DOI: 10.11603/2415-8798.2018.2.9212
  14. Vovk IB, Borisyuk OYu, Gorban NE. Sovremennye predstavleniya o giperplazii endometriya. Medical newspaper «Health of Ukraine» Gynecology. Obstetrics. Reproductology. 2016;2(22):70–73.
  15. Hanegem NVan, Prins MM, Bongers MY. The accuracy of endometrial sampling in women with post-menopausal bleeding: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2016;197:147–155. DOI: 10.1016/j.ejogrb.2015.12.008
  16. Franciscis PDe, Riemma G, Schiattarella A. Concordance between the Hysteroscopic Diagnosis of Endometrial Hyperplasia and Histopathological Examination. Diagnostics (Basel). 2019;9(4):142. DOI: 10.3390/diagnostics9040142
  17. Heremans R, Van Den Bosch T, Valentin L, Wynants L, Pascual MA, Fruscio R, et al. Ultrasound features of endometrial pathology in women without abnormal uterine bleeding: results from the International Endometrial Tumor Analysis study (IETA3). Ultrasound Obstet. Gynecol. 2022;60(2):243–255. DOI: 10.1002/uog.24910
  18. de Azevedo JM, de Azevedo LM, Freitas F, Wender MC. Endometrial polyps: when to resect? Arch Gynecol Obstet. 2016 Mar;293(3):639–43. DOI: 10.1007/s00404-015-3854-3
  19. Riemma G, Vitale SG, Manchanda R, Rathore A, Török P, De Angelis C, et al. The role of hysteroscopy in reproductive surgery: Today and tomorrow. J Gynecol Obstet Hum Reprod. 2022 Apr;51(4):102350. DOI: 10.1016/j.jogoh.2022.102350
  20. Moreno I, Cicinelli E, Garcia-Grau I, Gonzalez-Monfort M, Bau D, Vilella F, et al. The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology. Am J Obstet Gynecol. 2018 Jun;218(6):602.e1–602.e16. DOI: 10.1016/j.ajog.2018.02.012
  21. Vovk IB, Kornatska AG, Lysiana TO, Gorban NE, Ponomareva IG. Features of aerobic and anaerobic microflora in women with hyperproliferative diseases of the uterus and endometrium. Women’s Health. 2016;2:102–106.
  22. Sanderson PA, Esnal-Zufiaurre A, Arends MJ, Herrington CS, Collins F, Williams ARW, et al. Improving the Diagnosis of Endometrial Hyperplasia Using Computerized Analysis and Immunohistochemical Biomarkers. Front Reprod Health. 2022 May 12;4:896170. DOI: 10.3389/frph.2022.896170
  23. Ring KL, Mills AM, Modesitt SC. Endometrial Hyperplasia. Obstet Gynecol. 2022;140(6):1061-1075. DOI: 10.1097/AOG.0000000000004989
  24. Detti L, Christiansen ME, Peregrin-Alvarez I. Endometrial Abnormalities: Correlation Between Different Diagnostic Modalities. J Ultrasound Med. 2022 Aug;41(8):1981–1989. DOI: 10.1002/jum.15880
  25. Xu Y, Xie D. Prediction of Factors Associated with Abnormal Uterine Bleeding by Transvaginal Ultrasound Combined with Bleeding Pattern. Comput Math Methods Med. 2022;28:5653250. DOI: 10.1155/2022/5653250

Downloads

Published

2026-04-18

How to Cite

Kravchenko, O. (2026). Modern approaches to the treatment of endometrial polyps considering age-related and morphological-functional aspects. REPRODUCTIVE ENDOCRINOLOGY, (82), 46–49. https://doi.org/10.18370/2309-4117.2026.82.46-49

Issue

No. 82 (2026)

Section

Gynecology

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

    1. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.