Pathologic Evidence of Polyp Versus Office Hysteroscopy

A Retrospective Chart Review

Justin To, Mark D. Levie, Shira Marder, Scott Chudnoff

Research output: Contribution to journalArticle

Abstract

Objective: The goal of this research was to determine the incidence of pathologic evidence of endometrial polyps on Pipelle biopsy without visual evidence of endometrial polyps during office hysteroscopy. Materials and Methods: This study was a retrospective chart review. The setting was an urban, academic medical center outpatient facility. The initial patient cohort was obtained by searching internal office billing records for patients who underwent office hysteroscopic polypectomy between 2010 and 2015. All patients who had pathologic evidence of endometrial polyps on endometrial Pipelle biopsies, who then underwent office hysteroscopy, were included. Data regarding patient variables, imaging, and hysteroscopy findings were collected and analyzed. Results: Reviews were conducted for 1246 patient charts. Inclusion criteria were met by 152 patients; they were found to have Pipelle biopsy evidence of endometrial polyps. Initial endometrial biopsy indications were: postmenopausal bleeding (50%, n = 76); abnormal uterine bleeding (39.5%, n = 60); abnormal Papanicolaou smear (7.9%, n = 12); and abnormal ultrasound results (2.6%, n = 4). Surprisingly, 44 of the 152 patients (28.9%) had polyps noted on Pipelle biopsies but had no polyps visualized during office hysteroscopy. Of these 44 patients, 24 (54.5%) had only thin or atrophic endometrium noted. Repeat biopsy pathology still showed polyps in 16 of these 44 patients although no polyps were visualized. Of these 16 patients, 11 had no abnormal hysteroscopic findings. Conclusions: Despite pathologic evidence of an endometrial polyp, it is important to counsel a patient preoperatively that a polyp might not be visualized during hysteroscopic evaluation.

Original languageEnglish (US)
Pages (from-to)133-137
Number of pages5
JournalJournal of Gynecologic Surgery
Volume33
Issue number4
DOIs
StatePublished - Aug 1 2017

Fingerprint

Hysteroscopy
Polyps
Biopsy
Papanicolaou Test
Uterine Hemorrhage
Endometrium
Outpatients

Keywords

  • endometrial polyp
  • office hysteroscopy
  • Pipelle biopsy

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology

Cite this

Pathologic Evidence of Polyp Versus Office Hysteroscopy : A Retrospective Chart Review. / To, Justin; Levie, Mark D.; Marder, Shira; Chudnoff, Scott.

In: Journal of Gynecologic Surgery, Vol. 33, No. 4, 01.08.2017, p. 133-137.

Research output: Contribution to journalArticle

To, Justin ; Levie, Mark D. ; Marder, Shira ; Chudnoff, Scott. / Pathologic Evidence of Polyp Versus Office Hysteroscopy : A Retrospective Chart Review. In: Journal of Gynecologic Surgery. 2017 ; Vol. 33, No. 4. pp. 133-137.
@article{a7f8eff1563345b28665e9e05c6768a6,
title = "Pathologic Evidence of Polyp Versus Office Hysteroscopy: A Retrospective Chart Review",
abstract = "Objective: The goal of this research was to determine the incidence of pathologic evidence of endometrial polyps on Pipelle biopsy without visual evidence of endometrial polyps during office hysteroscopy. Materials and Methods: This study was a retrospective chart review. The setting was an urban, academic medical center outpatient facility. The initial patient cohort was obtained by searching internal office billing records for patients who underwent office hysteroscopic polypectomy between 2010 and 2015. All patients who had pathologic evidence of endometrial polyps on endometrial Pipelle™ biopsies, who then underwent office hysteroscopy, were included. Data regarding patient variables, imaging, and hysteroscopy findings were collected and analyzed. Results: Reviews were conducted for 1246 patient charts. Inclusion criteria were met by 152 patients; they were found to have Pipelle biopsy evidence of endometrial polyps. Initial endometrial biopsy indications were: postmenopausal bleeding (50{\%}, n = 76); abnormal uterine bleeding (39.5{\%}, n = 60); abnormal Papanicolaou smear (7.9{\%}, n = 12); and abnormal ultrasound results (2.6{\%}, n = 4). Surprisingly, 44 of the 152 patients (28.9{\%}) had polyps noted on Pipelle biopsies but had no polyps visualized during office hysteroscopy. Of these 44 patients, 24 (54.5{\%}) had only thin or atrophic endometrium noted. Repeat biopsy pathology still showed polyps in 16 of these 44 patients although no polyps were visualized. Of these 16 patients, 11 had no abnormal hysteroscopic findings. Conclusions: Despite pathologic evidence of an endometrial polyp, it is important to counsel a patient preoperatively that a polyp might not be visualized during hysteroscopic evaluation.",
keywords = "endometrial polyp, office hysteroscopy, Pipelle biopsy",
author = "Justin To and Levie, {Mark D.} and Shira Marder and Scott Chudnoff",
year = "2017",
month = "8",
day = "1",
doi = "10.1089/gyn.2017.0020",
language = "English (US)",
volume = "33",
pages = "133--137",
journal = "Journal of Gynecologic Surgery",
issn = "1042-4067",
publisher = "Mary Ann Liebert Inc.",
number = "4",

}

TY - JOUR

T1 - Pathologic Evidence of Polyp Versus Office Hysteroscopy

T2 - A Retrospective Chart Review

AU - To, Justin

AU - Levie, Mark D.

AU - Marder, Shira

AU - Chudnoff, Scott

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Objective: The goal of this research was to determine the incidence of pathologic evidence of endometrial polyps on Pipelle biopsy without visual evidence of endometrial polyps during office hysteroscopy. Materials and Methods: This study was a retrospective chart review. The setting was an urban, academic medical center outpatient facility. The initial patient cohort was obtained by searching internal office billing records for patients who underwent office hysteroscopic polypectomy between 2010 and 2015. All patients who had pathologic evidence of endometrial polyps on endometrial Pipelle™ biopsies, who then underwent office hysteroscopy, were included. Data regarding patient variables, imaging, and hysteroscopy findings were collected and analyzed. Results: Reviews were conducted for 1246 patient charts. Inclusion criteria were met by 152 patients; they were found to have Pipelle biopsy evidence of endometrial polyps. Initial endometrial biopsy indications were: postmenopausal bleeding (50%, n = 76); abnormal uterine bleeding (39.5%, n = 60); abnormal Papanicolaou smear (7.9%, n = 12); and abnormal ultrasound results (2.6%, n = 4). Surprisingly, 44 of the 152 patients (28.9%) had polyps noted on Pipelle biopsies but had no polyps visualized during office hysteroscopy. Of these 44 patients, 24 (54.5%) had only thin or atrophic endometrium noted. Repeat biopsy pathology still showed polyps in 16 of these 44 patients although no polyps were visualized. Of these 16 patients, 11 had no abnormal hysteroscopic findings. Conclusions: Despite pathologic evidence of an endometrial polyp, it is important to counsel a patient preoperatively that a polyp might not be visualized during hysteroscopic evaluation.

AB - Objective: The goal of this research was to determine the incidence of pathologic evidence of endometrial polyps on Pipelle biopsy without visual evidence of endometrial polyps during office hysteroscopy. Materials and Methods: This study was a retrospective chart review. The setting was an urban, academic medical center outpatient facility. The initial patient cohort was obtained by searching internal office billing records for patients who underwent office hysteroscopic polypectomy between 2010 and 2015. All patients who had pathologic evidence of endometrial polyps on endometrial Pipelle™ biopsies, who then underwent office hysteroscopy, were included. Data regarding patient variables, imaging, and hysteroscopy findings were collected and analyzed. Results: Reviews were conducted for 1246 patient charts. Inclusion criteria were met by 152 patients; they were found to have Pipelle biopsy evidence of endometrial polyps. Initial endometrial biopsy indications were: postmenopausal bleeding (50%, n = 76); abnormal uterine bleeding (39.5%, n = 60); abnormal Papanicolaou smear (7.9%, n = 12); and abnormal ultrasound results (2.6%, n = 4). Surprisingly, 44 of the 152 patients (28.9%) had polyps noted on Pipelle biopsies but had no polyps visualized during office hysteroscopy. Of these 44 patients, 24 (54.5%) had only thin or atrophic endometrium noted. Repeat biopsy pathology still showed polyps in 16 of these 44 patients although no polyps were visualized. Of these 16 patients, 11 had no abnormal hysteroscopic findings. Conclusions: Despite pathologic evidence of an endometrial polyp, it is important to counsel a patient preoperatively that a polyp might not be visualized during hysteroscopic evaluation.

KW - endometrial polyp

KW - office hysteroscopy

KW - Pipelle biopsy

UR - http://www.scopus.com/inward/record.url?scp=85026807579&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85026807579&partnerID=8YFLogxK

U2 - 10.1089/gyn.2017.0020

DO - 10.1089/gyn.2017.0020

M3 - Article

VL - 33

SP - 133

EP - 137

JO - Journal of Gynecologic Surgery

JF - Journal of Gynecologic Surgery

SN - 1042-4067

IS - 4

ER -