Endometrial polyps (endometrial polyp EP) is the body of the house is composed of glands, stroma and thick wall vessel pedunculated or sessi
Endometrial polyps (endometrial polyp EP) is the body of the house is composed of glands, stroma and thick wall vessel pedunculated or sessile neoplasm, is the most common cause of abnormal uterine bleeding.
The main clinical manifestations of uterine endometrial polyps is vaginal bleeding, menstrual disorders and postmenopausal in premenopausal women is menstrual disorders, menorrhagia, menostaxis, uterine bleeding after curettage or continued abortion; postmenopausal symptoms of abnormal vaginal bleeding, bleeding when little, dripping dirty. Reslova reported that the appearance of abnormal uterine bleeding in premenopausal women, 82% of them caused by endometrial polyps, in postmenopausal women, the proportion is 44%, and about 30% of patients with endometrial polyps showed delayed menopause.
Endometrial polyps is also one of the causes of infertility, Yang Jing, etc., in the intrauterine lesions caused by infertility patients, endometrial polyps accounted for 19%. Endometrial polyps may cause infertility: including the mechanism of endometrial polyps is located at the corner of the uterus and the effects of the combination of sperm and egg in the huge upward; multiple endometrial polyps endometrial effects of local blood supply, interfere with the implantation of the fertilized egg and development; the endometrial polyps associated with infection, change the intrauterine environment, is not conducive to survival the implantation of the fertilized egg and sperm; combined tubal or ovarian inflammation, can cause obstructive or anovulatory infertility. There is an increase in pregnancy rates after removal of endometrial polyps.
Endometrial polyp still has a certain probability of canceration rate, Lieng reviewed 20 studies of 9266 patients with endometrial polyps in the precancerous and cancerous changes in 0.2-23.8% and 0-12.9% respectively, with symptoms of menopause in women after cancer more likely. It is suggested that endometrial polyps should be treated in time.
The diagnosis of uterine endometrial polyps mainly rely on ultrasound and curettage and other means, a prospective study of Gebauer of 83 cases of postmenopausal bleeding or endometrial abnormal ultrasound findings and both patients before and after curettage, hysteroscopy, found 51 cases of endometrial polyp, 22 cases of curettage only found (43%). And after curettage hysteroscopy again only 4 cases of polyp complete curettage, so that simple curettage of missed diagnosis of endometrial polyps, and curettage cannot completely remove endometrial polyps resection under hysteroscopy surgery.
Based on the above reasons, at present, we recommend hysteroscopy for patients with abnormal uterine bleeding, and the sensitivity of hysteroscopy in the diagnosis of endometrial polyps can reach 100%. Hysteroscopic endometrial polypectomy is recommended for the diagnosis of endometrial polyps.
Endometrial polyps resection way before using hysteroscopic monopolar or bipolar TURP, were hospitalized, because the resectoscope is thick, cervical dilatation needs about expansion to Hegar10, and prepare for cervical anesthesia requires high to epidural anesthesia, spinal anesthesia and general anesthesia, patients in hospital for a long time, the high cost.
In recent years, the application of micro instruments and non invasive techniques makes it possible to treat the patients with hysteroscopy and surgery, that is, the treatment of immediate diagnosis and treatment. It is safe and effective to perform the resection of the polyp with a bipolar electrode of 1.7 mm. Into the uterine cavity operation through the hole of the electrode can be integrated 6.5mm uterine cavity endoscopy, the cervical canal expansion requires only Hegar7, can significantly reduce the pain of patients, surgery without anesthesia or only local anesthesia, in the clinic practice. Patients in outpatient hysteroscopy lesions and surgery can be performed from the cumbersome procedures for appointment wait in hospital, which greatly facilitates the patients, significantly reduce the cost of treatment, but also saves medical resources. Although Medicare patients can be reimbursed for some medical expenses through hospitalization, but their own part of the more than the cost of outpatient surgery.
At present, our hospital has carried out this operation, for the province's first, has been operating more than 40 cases, were successfully completed, follow-up treatment effect is good. At the same time to carry out the resection and uterine septum resection, intrauterine adhesions incision with submucous uterine myoma, achieved good curative effect, providing a convenient, safe and effective treatment modality for patients with intrauterine benign diseases.
Case 1: endometrial polyp
Post operative surgery
Case 2: Endometrial adenomatous polyp
Post operative surgery
Case 3: complete uterine septum
Post operative surgery