P07.11: Ultrasound guided IUD implantation

Objective: To determine the prevalence of atypical hyperplasia, and endometrial cancer in asymptomatic postmenopausal women with endometrial polyps on atrophic endometrium, removed by hysteroscopic polypectomy. Methods: Asymptomatic postmenopausal women with standardized sonographic (endometrial thickness ≤4 mm), and/or hysteroscopic (visual diagnosis) diagnosis of endometrial polyp on atrophic endometrium, were retrospectively reviewed from 2000 to 2004. Patients on HRT and/or TMX treatment were excluded. All women underwent transvaginal sonography (TVS) with colorand/or powerDoppler evaluation, sonohysterography in selected cases, and/or diagnostic hysteroscopy (HYS). Hysteroscopic polypectomy was performed by using office operative hysteroscope or by resectoscope. Demographic, sonographic and hysteroscopic data were recorded. Histology of the removed polyp was the main outcome. Results: 637 consecutive patients were analysed among those so far included. Mean age (± sd) was 62 years ±8. Mean years after menopause were 13 ± 13. Mean BMI was 26 ± 5. Mean diameter of endometrial polyp at TVS and/or HYS was 18 ± 15 mm. Typical, atypical hyperplasia, and cancer were 4.9%, 1.6%, and 0.2%, respectively. One polypoid cancer was found. Conclusions: This first ad interim analysis of a larger multicentre study observed one case of endometrial cancer in asymptomatic postmenopausal women with endometrial polyp on atrophic endometrium. This confirmed the reliability of endometrial thickness ≤4 mm and hysteroscopic visual diagnosis for the exclusion of endometrial disease. This retrospective study adds evidence to the feasibility of a conservative management of asymptomatic polyps. Monitoring criteria need to be established.