The importance of transvaginal ultrasound in diagnosis of endometrial polyps

C. Vasiliu, S.E. Albu, G. Danileț, O. Vișan, A. Bădănoiu

Rezumat: Endometrial polyps are a common cause of bleeding in pre- or postmenopausal. They are formed by hyperplasia of the endometrial glands and stroma around a shaft vessel. Risk factors involved in their appearance are: obesity, diabetes type II, hypertension, treatment with tamoxifen. Transvaginal ultrasound is a simple and valuable investigation in guiding diagnosis. Our study aims to evaluate the importance of transvaginal ultrasound in the diagnosis of endometrial polyps. It is a retrospective study that includes patients who presented in the Department of Obstetrics and Gynecology of Emergency University Hospital Bucharest with an ultrasound diagnosis of endometrial polyp, during 01.04.2013-31.03. 2015. In the group were included 74 patients with suggestive ultrasound image of endometrial polyp, of witch 67 cases (90.54%) were confirmed histologically. At the unacknowledged 7 cases histopathology revealed: simple endometrial hyperplasia without atypia (5 cases), proliferative endometrium (1 case) and well-differentiated endometrial adenocarcinoma (1 case). In the group of histologically confirmed, endometrial polyp was associated with: simple endometrial hyperplasia without atypia (8 cases), complex endometrial hyperplasia without atypia (4 cases) and carcinoma in situ (1caz). In addition, endometrial polyp was also associated with cervical lesions: inflammatory (2 cases) and neoplastic (1 case). Patients included in the study were aged between 30 and 85 years. The dominant symptom was meno-/ metrorrhagia. The diagnostic methods used in the study were: transvaginal ultrasound, hysteroscopy and D&C biopsy. Endometrial polyps can be diagnosed both in pre- and in postclimax. They may be asymptomatic or causing meno- / metrorrhagia. Transvaginal ultrasound is a simple diagnostic method, a first choice investigation in these patients. In the study group, histopathological confirmation of ultrasound images suggestive of endometrial polyp was 90.54%. For patients with inconclusive ultrasound image sonohisterografy or hysteroscopy are indicated.
Cuvinte cheie: endometrial polyps, transvaginal ultrasound.