Is resectoscopic treatment of atypical endometrial polyps a safe option?

Objective: This study was undertaken to evaluate the long-term efficacy and prognosis of hysteroscopic resection and coagulation of the polyp base of endometrial polyps with focal atypia in postmenopausal women.

Study Design: In this observational noncomparative study, conservative treatment was offered to 16 patients, with high anesthesiologic risk, who had endometrial polyps with focal atypia and a surrounding atrophic endometrium. To confirm the focality of the lesion, the polyps were analyzed separately from their bases. Patients with atypia in the polyp base were excluded.

Results: After 5 years of follow-up, 13 patients are disease free, 2 underwent vaginal hysterectomy and annessiectomy due to other causes, and 1 died for cardiac disorders.

Conclusion: Adenomatous polyps with atypia can be treated resectoscopically if the treatment is associated with an accurate histologic examination of the polyp base and its eventual involvement and the features of the remaining uterine mucosa. A thorough follow-up is recommended. Studies on wider casuistries of patients are needed.