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[Clinical study of hysteroscopic surgery for endometrial polyps]
Li-min Feng1, Wei-juan Wang, Hong-xia Zhang
1Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing 100050, China.
Objective:
To investigate the methods of different types of hysteroscopic surgery for endometrial polyps.
Methods:
A total of 109 cases by different ways by hysteroscopic surgery for endometrial polyp from October 2000 to May 2002 were followed up. The mean age was 45 +/- 9 (26 - 73) years. The mean follow-up was 12 +/- 5 (3 - 22) months. The patients of menstrual disorder were asked for filling in pictorial blood loss assessment chart (PBAC) before and after the surgery.
Results:
By the PBAC there was significant difference between before and after the surgery (P = 0.001). After the surgery, among 84 polyps with menstrual disorder, 14 cases (16.7%) were amenorrhea, 26 cases (31.0%) spotting, other 24 cases reducing the amount. Thirty-four cases that had had anemia recovered in one month after the surgery. In 16 cases dysmenorrhea, 7 cases were recovered, 7 got better, and the other 2 got worse. Of 5 cases of infertility (3 were primary and 2 were secondary), 4 cases got pregnancy after the surgery.
Conclusions:
The polyp patient who had menstrual disorder without desire of fertility should undergo polypectomy with endometrial resection in order to avoid recurrence. The patient who has desire of fertility should undergo polypectomy merely. If she had polyp with polypoid hyperplasia she should undergo polypectomy with endometrial resection of superficial layer. The postmenopausal patient should perform polypectomy merely or polypectomy with endometrial ablation.