POLYPOUS TRANSFORMATION OF ENDOMETRIUM: FEATURES OF DIAGNOSIS IN WOMEN WITH INFERTILITY
DOI:
https://doi.org/10.11603/24116-4944.2018.2.9266Keywords:
infertility, endometrium polyps, fibro-vascular nucleus, ultrasonography, hyperplastic processes of endometriumAbstract
The aim of the study – to find out the incidence of divergence in the diagnosis of endometrial polyps in women of reproductive age.
Materials and Methods. 43 patients of reproductive age with endometrial polyps were examined: ultrasonographic examination of the uterus, biopsy or endometrium scaling. The age of the patients ranged from 23 to 43 years.
Results and Discussion. The first clinical group was 33 patients with infertility. The second clinical group includes 10 women without reproductive disorders. Sonographically, the following types of polyps are singled out: glandular – 15 cases, glandular-fibrotic – 26 and fibrotic – two cases. With the prevalence of the glandular component, the accuracy of the diagnosis reached 89 %, and with a stromal prevalence of 100 %. Glandular polyps were diagnosed in 82 % of cases. Pathomorphologically, in the first clinical group, glandular-fibrotic polyps prevailed (21 cases). The polyp with a predominant fibrous component was the most. In the second group, the glandular component of the polyp prevailed. At primary infertility glandular polyps are characteristic, at secondary – glandular-fibrotic with prevalence of a stromal component. Polyps with a prevalence of the glandular component predominated in women of the second group – seven cases, and with the prevalence of the stromal component – in women of the first clinical group – 13 cases. Fibrotic polyps were found only in women of the first clinical group. In most cases (74.6 %) there were signs of chronic inflammation.
Conclusions. The most complicated for ultrasound are fibrotic polyps in combination with endometrium hyperplasia, which are perceived as uterine fibromyoma. The presence of inclusions of increased echogenicity in the glandular and glandular fibrotic polyps of the endometrium is the reason for the decrease in the level of their diagnosis. Endometrial polyps are characterized by inflammatory lymphocytic infiltration of the stroma, indicating in favor of chronic endometritis. In women with infertility, there are glandular and glandular-fibrotic polyps with the prevalence of the fibrotic component, the common feature of which is the distinct fibro-vascular nucleus.
References
Kindrativ, E.O., Mykhailiuk, I.O., Snizhko, T.B., & Holovchak, I.S. (2014). Analiz zhinochoho bezpliddia za danymy Prykarpatskoho tsentru reproduktsii liudyny z 2004 do 2013 roku [Analysis of female infertility according to the data of the Precarpathian Center for Human Reproduction from 2004 till 2013]. Zdorovye zhenshchiny – Women's Health, (6), 22-25 [in Ukrainian].
Dankovych, N.A., & Vorobey-Vikhovskaya, V.N. (2013). Prichiny i formy besplodiya. Sovremennye vozmozhnosti diagnostiki i lecheniya [Causes and forms of infertility. Modern diagnostic and treatment options]. Zdorovye zhenshchiny – Women's Health, (3), 192-197 [in Russian].
Vdovichenko,Yu.P., & Kolesnik, A.V. (2011) Patologiya endometriya kak prichina zhenskogo besplodiya [Endometrial pathology as the cause of female infertility]. Zdorovye zhenshchiny – Women's Health, (7), 206-207 [in Russian].
Chornenka, H.M., Korda, I.V., & Bodnar, Ya.Ya. (2017). Osoblyvosti ekstrahenitalnoi somatychnoi patolohii ta strukturnoi transformatsii endometriia v zhinok reproduktyvnoho viku iz pervynnym i vtorynnym nepliddiam [Features of extragenital somatic pathology and structural transformation of endometrium in women of reproductive age with primary and secondary infertility]. Aktualni pytannia pediatrii, akusherstva ta hinekolohii – Actual Questions of Pediatrics, Obstetrics and Gynecology, (2), 88-92. DOI 10.11603/24116-4944.2017.2.8044 [in Ukrainian].
Ozerskaya, I.A., Belousov, M.A., Shcheglova, E.A., & Ageyeva, M.I. (2002). Ekhograficheskye i morfologicheskie korrelyatsii giperplasticheskikh protsessov endometriya [Echographic and morphological correlations of endometrial hyperplastic processes]. Ultrazvukovaya i funktsionalnaya diagnostika – Ultrasonic and Functional Diagnostics, (1), 45-50 [in Russian].
Babacan, A., Gun, I., Kizilaslan, C., Ozden, O., Muhcu, M., Mungen, M., & Atay, V. (2014). Comparison of transvaginal ultrasonography and hysteroscopy in the diagnosis of uterine pathologies. Int. J. Clin. Exp. Med., (7), 3, 764-769. PMID: 24753775.
Bortszvadze, Sh.N., Dzhibladze, T.A., & Ishchenko, A.I. (2012). Znacheniye ofisnoy gisteroskopii v diagnostike matochnogo faktora besplodiya i lecheniya takikh bolnykh [The importance of office hysteroscopy in the diagnosis of uterine factor infertility and the treatment of such patients]. Rossiyskiy vestnik akushera-ginekologa – Russian Bulletin of the Obstetrician-Gynecologist, (2), 5, 53-56 [in Russian].
Kumari, M., & Gupta, A.S. (2015) A prospective comparative study to evaluate the efficacy of ultrasonography and hysteroscopy and their correlation with the histopathology of endometrium in a case of abnormal uterine bleeding. Int. J. Reprod. Contracept. Obstet. Gynecol., (4), 6, 1926-1935. DOI:http://dx.doi.org/10.18203/2320-1770.ijcog20.
Hnatko, O.P., & Skuriatina, N.H. (2015). Polipy endometriia i nepliddia v zhinok piznoho reproduktyvnoho viku [Endometrial polips and infertility in women of late reproductive age]. Aktualni pytannia pediatrii, akusherstva ta hinekolohii – Actual Questions of Pediatrics, Obstetrics and Gynecology, (2), 84-87 [in Ukrainian].
Pavlovskaya, M.A., & Gugikova, L.V. (2013). Sovremennye predstavleniya ob etiopatogeneze giperplasticheskikh protsessov endometriya v reproduktivnom vozraste [Modern ideas about the etiopathogenesis of endometrial hyperplastic processes in the reproductive age]. Meditsinskie aspekty zdorovya zhenshchiny – Medical Aspects of Women's Health, (3), 67, 28-34 [in Russian].
German, D.G. (2016). Polipy endometriya v reproduktivnom vozraste: shtrikhi k klinicheskomu portretu [Endometrial polyps in reproductive age: strokes to a clinical portrait]. Reproduktivnaya endokrinologiya – Reproductive Endocrinology, (3), 39-43 [in Russian].
Kim, K.R., Peng, R., Ro, J.Y., & Robboy, S.J. (2004). A diagnostically useful histopathologic feature of endometrial polyp: the long axis of endometrial glands arranged parallel to surface epithelium. Am. J. Surg. Pathol., (28), 1057-1062. DOI: 10.1097/01.pas.0000128659.73944.f3.
Vdovychenko, Yu.P., & Kolesnyk, H.V. (2011). Osoblyvosti patohenezu khronichnoho endometrytu u patsiientok z bezplidnistiu [Features of the pathogenesis of chronic endometritis in patients with infertility]. Pediatriia, akusherstvo ta hinekolohiia – Pediatrics, Obstetrics and Gynecology, (73), 6, 101-104 [in Ukrainian].
Lieng, M., Istre, O., & Qvigstad, E. (2010) Treatment of endometrial polyps: a systematic review. Acta Obstet. Gynecol. Scand., (89), 992-1002. doi.org/10.3109/00016349.2010.493196.
Kondrikov, N.I. (1991). Strukturno-funktsionalnye osnovy giperplasticheskikh izmeneniy endometriya zhenshchin [Structural and functional basis of hyperplastic changes in women's endometrium]. Doctor’s Extended abstract. Moscow [in Russian].
Downloads
Published
Issue
Section
License
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
