GYN

CMECNE

Endometrial Polyps – Do They Always Need To Be Removed?

Learning Objectives and CME/Disclosure Information

This activity is intended for healthcare providers delivering care to women and their families.

After completing this activity, the participant should be better able to:

1. Name the imaging tests for identifying polyps
2. List the factors associated with malignancy

Estimated time to complete activity: 0.25 hours

Faculty:

Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project

Disclosure of Conflicts of Interest

Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.

The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.

Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.

Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.

Method of Participation and Request for Credit

Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Jan 25 2023, participants must read the learning objectives and faculty disclosures and study the educational activity.

If you wish to receive acknowledgment for completing this activity, please complete the test and evaluation. Upon registering and successfully completing the test with a score of 100% and the activity evaluation, your certificate will be made available immediately.

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education

Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.

Read Disclaimer & Fine Print

CLINICAL ACTIONS:

Endometrial polyps are a common cause of menstrual abnormalities and postmenopausal bleeding, with a prevalence of 7.8-35% depending on the population studied.

To diagnose polyps, transvaginal ultrasound is reliable and can be augmented by saline infusion sonohysterography
- Addition of color Doppler is sometimes helpful in identifying a feeding vessel
Consider annual observation if polyp is < 10 mm, as up to 25% of polyps will resolve spontaneously
Hysteroscopy with resection under direct vision is effective and reduces recurrence rate
Blind dilation and curettage or biopsy should not be used for the diagnosis of polyps

SYNOPSIS:

Although uncommon, both endometrial hyperplasia and endometrial cancer can occur in polyps. When symptomatic, premenopausal women present with abnormal uterine bleeding (AUB-P), and postmenopausal women may have postmenopausal bleeding. Prevalence appears to be higher in women seeking fertility treatment but cause and effect have yet to be established. It is important to know when to intervene and when to observe.

KEY POINTS:

Risk of malignancy increases with age and size of the polyp with the highest rates in postmenopausal women with bleeding
- However, asymptomatic polyps in postmenopause are not likely to be malignant
- Observation is an option following discussion of risk/benefit with the patient
Malignancy is unlikely in premenopausal women even if symptomatic
Women on tamoxifen (a SERM) are at increased risk for the development of polyps
Polypectomy in subfertile women appears to improve fertility
- Recurrence rate is 2.5-3.7% up to 9 years after resection

Learn More – Primary Sources:

AAGL Practice Report: Practice Guidelines for the Diagnosis and Treatment of Endometrial Polyps

Surgical Management of Endometrial Polyps in Infertile Women: A Comprehensive Review

Take a post-test and get CME credits

TAKE THE POST TEST

Want to be notified when new guidelines are released? Get ObGFirst!

Learn More »

< Previous

All GYN Posts

Next >

Endometrial Polyps – Do They Always Need To Be Removed?