Endometrial polyps recurrence: risk factors, prevention, and management

Endometrial polyps (EPs) are common intrauterine lesions often associated with abnormal uterine bleeding, infertility, and recurrence after treatment. Despite advances in diagnostic and surgical techniques, recurrence remains a clinical challenge. This review provides an overview of pathophysiology, risk factors, diagnostic strategies, and management options for recurrent EPs, emphasizing prevention. A literature search was conducted through PubMed, Scopus, Web of Science, Cochrane Library, and EMBASE, covering studies published up to November 30th, 2025.

Recurrent EPs are influenced by hormonal imbalances, genetic abnormalities, chronic inflammation, oxidative stress, and microbial dysbiosis. Risk factors include age, obesity, metabolic syndrome, incomplete resection, and altered microbiota. Diagnostic techniques include transvaginal ultrasound, hysteroscopy, and biomarker assays. Management options involve medical therapy (e.g., progesterone, LNG-IUS) and hysteroscopic removal. Preventive measures, such as post-polypectomy hormonal treatments, show promise in reducing recurrence.

A multidisciplinary approach combining precise surgery with targeted hormonal and microbiota therapies is essential for minimizing recurrence. Future research should focus on personalized management based on molecular and microbiological profiles.