Endometriosis is closely associated with endometrial polyps; The effectiveness of hysteroscopy

Sohn, Byong Cheol; Kim, Mi Ran; Hwang, Kyung Joo; Kim, Young Ah; Ryou, Jong Man; Oh, Kie Suk

Abstract

OBJECTIVE
To evaluate the effectiveness of hysteroscopy and the incidence of endometrial polyps in women with endometriosis.
METHODS
A total of 99 patients determined to be with infertility by laparoscopic procedure from March 1999 to February 2000 were prospectively analyzed at Ajou University Hospital, Suwon, Korea. The study group was 63 patients with endometriosis and the control group consisted of 36 patients without endometriosis. The presence of endometriosis was documented laparoscopically and scored according to The American Fertility Society Classification. We confirmed the presence of endometrial polyps by pathologic examination after polypectomy. We compared the results of the operation to that of the hysterosalpingogram(HSG) and transvaginal sonogram(TVS) before the procedure.
RESULTS
Among the 99 patients with infertility, endometrial polyps were found in 40 of 63 women(63.5%) with endometriosis but in only 10 of 36 women(38.5%) without endometriosis. The greater the degree of endometriosis was accompanied by increased incidence of endometrial polyps, and in particular, women with stage three endomeriosis or higher all showed the presence of endometrial polyps. The sensitivity and specificity of the HSG detecting the presence of an endometrial polyp is 55.3%, 87.2%, and that of the TVS is 78.9%, 95.7%. DISCUSSION: The presence of endometrial polyps is significantly associated with the presence of endometriosis, and therefore hysteroscopy should be performed in patients with endometriosis who have not been confirmed with endometrial pathology by HSG or TVS.