- Clinical and anamnestic features of various forms of endometrial hyperplastic processes in combination with uterine myoma
Clinical and anamnestic features of various forms of endometrial hyperplastic processes in combination with uterine myoma
HEALTH OF WOMAN. 2018.10(136):84–87; doi 10.15574/HW.2018.136.84
Krut Yu. Ya., Zemlyana N. A.
Zaporizhzhya State Medical University
Despite the large number of studies devoted to the study of endometrial hyperplastic processes (EHP), many issues of the pathogenesis, diagnosis, treatment and prevention of this pathology remain unresolved to date.
The objective: determine the clinical and anamnestic features of hyperplastic processes of endometrium according to the data of a retrospective analysis.
Materials and methods. We examined 125 patients with various forms of endometrial hyperplastic processes who were treated at the gynecological department of the «City Clinical Hospital No. 7» in Zaporizhia. Patients were divided into groups depending on the specific form of endometrial hyperplasia. The first group included 34 patients with simple endometrial hyperplasia without atypia (mean age 41.6±1.31 years). The second group consisted of 47 patients with complex endometrial hyperplasia without atypia (mean age 40.9±1.34 years). The third group consisted of 44 patients with endometrial polyps (mean age 41.59±1.34 years). The patients underwent an ultrasound examination with the device «MyLab50» («Esaote», Italy) and video hysteroscopy («Karl Storz», Germany). The morphological study of macropreparations was performed in the pathoanatomical department of the University Hospital of the Ural State Medical University.
Results. Significant differences in age were only in the group of simple hyperplasia, where patients with myoma were 19.5% older (p<0.05). The frequency of arterial hypertension was significantly higher in the simple (14.1%; p<0.05) and complex hyperplasia (7.7%; p<0.05) groups compared with the endometrial polyp group. The frequency of combination of uterine fibroids and EHP was significantly higher with complex endometrial hyperplasia without atypia compared with the group of simple hyperplasia (p<0.05) and endometrial polyps (p<0.05). Adenomyosis was also significantly more frequently observed in patients with complex (p<0.05) compared with the group of simple endometrial hyperplasia. The main reason for going to the doctor for patients with EHP were impaired reproductive function in the form of infertility, which correlates with data from other authors. Infertility was somewhat more frequently observed in patients with complex hyperplasia (40.7%).
Conclusions. Women with simple hyperplasia combined with uterine myoma were significantly older than patients without fibroids. In patients with EHP, uterine fibroid was the most common comorbid pathology, was significantly more common in patients with complex hyperplasia. Among the comorbid somatic pathology in patients with EHP, arterial hypertension was more common, which was significantly more common in groups of simple and complex hyperplasia. The main reason for seeking medical attention in women with EHP and uterine myoma was reproductive function disorders in the form of infertility.
Key words: endometrial hyperplastic processes, simple hyperplasia of the endometrium, complex hyperplasia of the endometrium, uterine myoma.
1. Beniuk VO, Honcharenko VM, Nykoniuk TR. 2016. Suchasni determinanty patohenezu hiperplastychnykh protsesiv endometriia. Zdorove zhenshchіnу 5:137–142.
2. Vovk IB, Gorban NE, Borisyuk OYu. 2016. Giperplaziya endometriya (Klinicheskaya lektsiya). Zdorove zhenschiny 5:10–18.
3. Dankovich NA, Vorobey-Vihovskaya VN. 2013. Prichinyi i formy besplodiya. Sovremennyie vozmozhnosti diagnostiki i lecheniya. Zdorove zhenschiny 3:192–197.
4. Zaporozhan VN, Tatarchuk TF, Dubinina VG, Kosey NV. 2012. Sovremennaya diagnostika i lechenie giperplasticheskih protsessov endometriya. Reproduktivnaya endokrinologiya 1(3):5–12.
5. Kovalenko EP. 2013. Klinicheskie osobennosti techeniya proliferativnyih zabolevaniy endometriya u zhenschin fertilnogo i rannego menopauzalnogo vozrastov. Tavricheskiy mediko-biologicheskiy vestnik 2(62):41–46.
6. Korniienko SM. 2017. Optymizatsiia likuvannia hiperplastychnykh protsesiv endometriia v piznomu reproduktyvnomu periodi za dopomohoiu histeroskopichnoi tekhniky «kholodnoi petli». Ginekologiia 6(14):44–49.
7. Kuznetsova IV. 2010. Vozmozhnosti terapii giperplasticheskih protsessov endometriya. Trudnyiy patsient 8;1–2:18–22.
8. Sidorova I, Unanyan A, Vlasov R. 2011. Giperplasticheskie protsessyi endometriya: osobennosti kliniki i terapii. Vrach 3:58–60.
9. Acmaz G, Aksoy H, Albayrak E et al. 2014. Evaluation of endometrial precancer ous lesions in postmenopausal obese womena high risk group? Asian. Pac. J. Cancer Prev. 15;1:195–198. https://doi.org/10.7314/APJCP.2014.15.1.195
10. Hileeto D, Fadare O, Martel M et al. 2005. Age dependent association of endometrial polyps with increased risk of cancer involvement. World J. Surgical Oncology. 3:8. https://doi.org/10.1186/1477-7819-3-8; PMid:15703068 PMCid:PMC549519
11. Trimble CL, Method M, Leitao M et al. 2012. Management of endometrial precancers. Obstet. Gynecol. 120;5:1160–1175. PMid:23090535 PMCid:PMC3800154