Diagnosis and Management of Endometrial Polyps: A Critical Review of the Literature

This review article summarizes the salient literature on the diagnosis and management of endometrial polyps. Electronic resources including Medline, PubMed, CINAHL The Cochrane Library (including the Cochrane Database of Systematic Reviews), Current Contents, and EM BASE were searched with the MeSH terms including all subheadings and keywords endometrial polyps, abnormal uterine bleeding, polypectomy, polyp management, polyp and diagnosis, and polyp and malignancy. There is a paucity of level I evidence in the literature on the diagnosis and management of this common gynecologic disease. Noninvasive investigations such as transvaginal ultrasonography, with or without the use of 3-dimensional ultrasonography and contrast techniques remain the mainstay of first-line investigation. Hysteroscopic resection is the most effective management for endometrial polyps and allows histologic assessment, whereas blind biopsy or curettage has low diagnostic accuracy and should not be performed. This article will review the cause, epidemiology, clinical presentation, diagnostic investigations, and management of endometrial polyps. Journal of Minimally Invasive Gynecology (2011) 18, 569-581 Crown Copyright (C) 2011 Published by Elsevier Inc. on behalf of AAGL. All rights reserved.