Endometrial polyps: impact on reproductive function and clinical aspects

Abstract

Endometrial polyps (EP) are among the most common benign intrauterine lesions and may significantly affect female reproductive function. Despite their prevalence, clinical features, impact on fertility, and optimal management strategies remain insufficiently studied, particularly in postmenopausal women.

Aim - to evaluate the influence of EP on reproductive function and to assess their clinical characteristics, localization, and management in women of reproductive and postmenopausal age.

Materials and methods. A prospective comparative clinical study was conducted, involving 114 women aged 20-70 years with histologically confirmed EP. The Control group included 54 healthy women of reproductive age. Diagnostic methods included transvaginal ultrasound (TVUS), sonohysterography, and office hysteroscopy with targeted biopsy. Polypectomy was performed using mechanical or electromechanical resection techniques.

Results. Office hysteroscopy demonstrated high diagnostic and therapeutic efficiency, allowing removal of small EP (<20 mm) in outpatient settings, while larger EP required in-hospital electromechanical resection. Most EP were single (76.8%), small to medium-sized (≤2 cm, 79.3%), and localized mainly on the posterior and lateral uterine walls. Histologically, EP were predominantly glandular-fibrous (59.8%) or glandular (37.8%), with 2.4% being adenomatous (atypical). The majority of postmenopausal EP were asymptomatic (67.1%). No significant intraoperative complications were reported. Organ-preserving surgical techniques were effective and safe, with polypectomy success rates exceeding 96%.

Conclusions. EP in postmenopausal women are often asymptomatic, highlighting the importance of early detection via TVUS and hysteroscopy. Office hysteroscopy enables minimally invasive, effective treatment of small EP, whereas larger EP require electromechanical resection. A combined imaging and histological evaluation optimize patient management, reduces the risk of recurrence, and supports preservation of reproductive and gynecological health.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the patients was obtained for conducting the studies.

The author declares the absence of conflict of interests.