Treatment of endometrial polyps

Objective: To determine the effectiveness of different treatments for abnor mal uterine bleeding in women with known endometrial polyps. Methods: We retrospectively assessed the effectiveness of polypectomy and o ther treatments of women with abnormal uterine bleeding who had benign poly ps detected by sonohysterography. Women with endometrial polyps diagnosed b y sonohysterography between January 1997 and July 1998 were sent questionna ires on pretreatment and posttreatment uterine bleeding and satisfaction wi th their treatments. Charts were reviewed to validate questionnaire respons es and determine treatments administered. Results: Seventy-eight women had endometrial polyps by sonohysterography, a nd 60 of them (77%) responded to the questionnaire. Two with endometrial ad enocarcinoma were excluded. The average age of the remaining 58 was 49 year s; 37 (64%) were premenopausal and 21 (36%) postmenopausal. The average tim e from treatment to follow-up was 13 months (range 5-24 months). Participan ts were grouped according to the following treatments: polypectomy, polypec tomy plus endometrial ablation, polypectomy plus hysteroscopic myomectomy, hysterectomy, D&C, and nonsurgical treatment. The most frequent treatment w as polypectomy (n = 26). Polypectomy, polypectomy plus endometrial ablation , polypectomy plus myomectomy, and hysterectomy each resulted in at least a twofold decrease in the number of bleeding days per month and led to high satisfaction rates. Conclusion: Our results showed that simple polypectomy and more invasive su rgical procedures led to subjective improvement in symptoms of menorrhagia and metrorrhagia and a high satisfaction rate in women with endometrial pol yps. (Obstet Gynecol 2000;96:886-9. (C) 2000 by The American College of Obs tetricians and Gynecologists.).