Hysteroscopic observation of the association between endometrial polyps and endometriosis: a retrospective cohort...

This single-centre retrospective study (100 women with endometrial polyps, mean age 41.8 ± 8.2 years) investigated the association between endometrial polyps and endometriosis. Endometriosis was confirmed in 13 % of patients. Multiple polyps were significantly more common in the endometriosis group (69.2 % vs. 42.5 %, P = 0.046). Women with endometriosis had higher CA125 levels (89.3 ± 45.2 vs. 18.6 ± 12.3 U/mL, P < 0.001) and higher rates of dysmenorrhoea (100 % vs. 35.6 %, P < 0.001). Independent predictors of endometriosis were dysmenorrhoea (aOR[95 % CI] = 8.45 [2.34-30.52], P = 0.001), CA125 > 35 U/mL (aOR[95 % CI] = 12.67 [3.82-42.01], P < 0.001), and multiple polyps (aOR[95 % CI] = 3.12 [1.08-9.01,], P = 0.036). CA125 > 35 U/mL showed an area under the curve (AUC) of 0.852 (95 % CI: 0.778-0.926), and the combined model achieved an AUC of 0.938 (95 % CI: 0.885-0.991) with a bootstrap-corrected AUC of 0.925. During a median follow-up of 17.5 months, polyp recurrence was significantly higher in women with EM (45.5 % vs. 17.6 %, P = 0.047). These findings demonstrate that the combination of multiple polyps, dysmenorrhoea, and elevated CA125 levels should raise suspicion for concurrent EM in women with EPs, suggesting potential shared pathophysiological mechanisms with important implications for clinical management, surgical planning, and fertility counselling.