Endometrial Polyps: Pathophysiology and Clinical Consequences
Summary
The aim of these studies is to study the natural history, the symptoms of, as well as the effect of hysteroscopic resection of endometrial polyps. Furthermore, another aim is to study new diagnostic techniques to differentiate between malignant and benign endometrial polyps.
Description
Study Part 1: New diagnostic methods for the prediction of malignancy in endometrial polyps: A prospective pilot study.
Study of angiogenesis by identification of specific angiogenesis factors in tissue biopsies from the endometrium and by Doppler ultrasound combined with IV contrast. We hope to find specific characteristics with new vessel formation in the endometrial polyp, which can play a role in the prognostic evaluation regarding the risk for cancer development. We will compare women with endometrial polyps and women with endometrial cancer to see if these methods of angiogenesis evaluation may be useful in separating benign polyps from premalignant and malignant polyps.
Study Part 2: The natural history of endometrial polyps. A prospective randomised study of patients with endometrial polyps.
Blood loss during menstruation is documented with the help of a standardized form (PBAC). The patients are randomized to hysteroscopic resection of the endometrial polyp or 6 months of observation. A new registration of blood loss during menstruation is performed by patients in both groups. In the intervention group, a new gynaecological examination 6 months after the resection documents the presence of residual polyp or symptoms. The other group is examined again after 6 months of observation. Symptoms and findings with the second examination are compared with symptoms and findings at the first examination, any changes are documented and the final outcome in the to groups are compared.
Study Part 3: The occurrence and natural history of asymptomatic endometrial polyps in perimenopausal women. A prospective controlled study.
Registration of blood loss during menstruation is documented with the help of a standardized form (PBAC) and gynaecological examination including SIS of 1000 randomly selected women in the age group 45-50. Where endometrial polyps are identified, we document the size and number of polyps and an endometrial biopsy is taken. After including a woman with an endometrial polyp in the study, the next woman without endometrial polyp is recruited to the control group. After one year, blood loss during menstruation is registered again, and all women with endometrial polyps as well as the control group have a new examination including vaginal ultrasound, SIS and endometrial biopsy. Symptoms and findings are compared with symptoms and findings at the first examination and all changes are documented. If the woman has a persistent endometrial polyp when examined at 1 year, she is offered treatment with hysteroscopic polyp resection.
Study Design
Allocation: Randomized, Control: Placebo Control, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Conditions
Endometrial Polyp
Intervention
Hysteroscopic resection of endometrial polyps. (TCRP)
Location
Gynaecologial department, Ullevaal University Hospital
Oslo
Norway
0407
Status
Completed
Source
Ullevaal University Hospital
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT00247923
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Endometrial Stromal Tumors
Neoplasms of the endometrial stroma that sometimes involve the MYOMETRIUM. These tumors contain cells that may closely or remotely resemble the normal stromal cells. Endometrial stromal neoplasms are divided into three categories: (1) benign stromal nodules; (2) low-grade stromal sarcoma, or endolymphatic stromal myosis; and (3) malignant endometrial stromal sarcoma (SARCOMA, ENDOMETRIAL STROMAL).
Endometrial Hyperplasia
Benign proliferation of the ENDOMETRIUM in the UTERUS. Endometrial hyperplasia is classified by its cytology and glandular tissue. There are simple, complex (adenomatous without atypia), and atypical hyperplasia representing also the ascending risk of becoming malignant.
Sarcoma, Endometrial Stromal
A highly malignant subset of neoplasms arising from the endometrial stroma. Tumors in this group infiltrate the stroma with a wide range of atypia cells and numerous mitoses. They are capable of widespread metastases (NEOPLASM METASTASIS).
Intestinal Polyps
Discrete abnormal tissue masses that protrude into the lumen of the INTESTINE. A polyp is attached to the intestinal wall either by a stalk, pedunculus, or by a broad base.
Endometrial Ablation Techniques
Procedures used for the targeted destruction of the mucous membrane lining of the uterine cavity.
Clinical Trials
Clinical Evaluation of the Interlace Medical Hysteroscopic Morcellator
This study assesses the effectiveness of intrauterine fibroid and polyp removal using the Interlace Medical 1st generation hysteroscopic morcellator device based on a retrospective review...
Endometriosis Patients Undergoing Quinagolide Treatment
Dopamine agonists, such as quinagolide, are able to act on the VEGFR-2 blocking antibodies, diminishing Vascular Endothelial Growth Factor effect on angiogenesis in human endometriotic les...
HOME Study: Hysteroscopic Office Myomectomy Evaluation
The purpose of this study is to demonstrate safety and effectiveness of the MyoSure Tissue Removal System when used by community gynecologists in an office setting for the treatment of pat...
Endometrial Injury and IVF-ET Outcome
Implantation of the human embryo is the limiting factor in the success of invitro-fertilization and embryo transfer(IVF-ET).We wanted to find out whether creating a local injury to the end...
Background: Nasal polyps are found in about 5% of asthmatic patients.A close link exists between the upper and lower airways and the concept of the "United Airways" has emerged mainly from...
PubMed Articles
Appropriate interval between endometrial polyp resection and the proceeding IVF start.
PURPOSE: Endometrial polyp is the commenest pathology among the structural uterine abnormalities. In this study we compared the IVF outcomes of patients who underwent hysteroscop...
OBJECTIVES: The goal of this study was to define the diagnostic value of hysteroscopy in evaluating uterine cavity compared to endometrial biopsy in women presenting with postmenopausal bleeding and t...
This study was undertaken to investigate the expression of p53, Ki-67, and CD31 proteins in endometrial polyps of postmenopausal women treated with tamoxifen (TAM). Postmenopausal women with endometri...
High prevalence of endometrial polyps in endometriosis-associated infertility.
In a retrospective study, examination of 431 infertile women (158 cases with endometriosis and 273 without endometriosis) showed a significantly increased frequency of endometrial polyps in patients w...
Exploration of post-menopausal uterine bleeding. Hysteroscopy-histology correlation in 94 cases.
IntroductionPost-menopausal uterine bleeding is the reason for nearly 70% of gynaecological consultations. Because the cause may be a malignant disease, a thorough work-up is necessary to attempt to i...
