title: The clinical significance of small endometrial polyps.
abstract: OBJECTIVE
  Small endometrial polyps are relatively common in asymptomatic women and may regress spontaneously. In symptomatic women, the finding of a small polyp (<1cm diameter) raises the question of the clinical pertinence and necessity of excision. Sparse data are available on the effectiveness of hysteroscopic excision of small polyps to manage abnormal uterine bleeding. The aim of this study was to assess outcome after hysteroscopic excision of small endometrial polyps in symptomatic patients.
  
  
  METHODS
  This was an observational cohort study enrolling 255 premenopausal women presenting with abnormal uterine bleeding and a small endometrial polyp on office hysteroscopy, undertaken between January 2004 and February 2007. The study group was referred for polypectomy by operative hysteroscopy. The outcome of the procedure was reviewed 6-12 months later by a telephone interview to assess the pattern of uterine bleeding after the procedure and overall satisfaction.
  
  
  RESULTS
  Significant improvement in the magnitude of bleeding was experienced by 70% of participants, but only 30% of them reported return to regular menses. Satisfaction with the procedure was reported by 80%. Younger patients reported a less favorable bleeding pattern and were found to be less satisfied with the outcome of the procedure.
  
  
  CONCLUSIONS
  Symptomatic women with small endometrial polyps can be treated safely and efficiently with hysteroscopic excision. In the younger age group of patients, however, the outcome of the procedure may be less favorable and may necessitate the addition of endometrial ablation to improve outcome and increase patient satisfaction.
authors.affiliation: Division of Obstetrics and Gynecology, Hadassah Hebrew University Medical Centers, Mt. Scopus, Jerusalem, Israel. Electronic address: yhamani@gmail.com.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Hamani
authors.forename: Ido
authors.initials: I
authors.lastname: Eldar
authors.forename: Hen Y
authors.initials: HY
authors.lastname: Sela
authors.forename: Ernst
authors.initials: E
authors.lastname: Voss
authors.forename: Ronit
authors.initials: R
authors.lastname: Haimov-Kochman
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D016015:Logistic Models; D008875:Middle Aged; D064887:Observational Studies as Topic / Q000639:trends; D011127:Polyps / Q000150:complications / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery; D014592:Uterine Hemorrhage / Q000175:diagnosis / Q000473:pathology
keywords: Abnormal uterine bleeding; Endometrial polyps; Hysteroscopy