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Purpose <p>Abnormal uterine bleeding (AUB) significantly affects women’s quality of life and is often linked to conditions like hormonal imbalances, structural anomalies, and endometrial polyps. Endometrial polyps, common in premenopausal women, frequently cause AUB. Exploring their histopathological, clinical, and ultrasonographic features is vital for better management of AUB. The aim of the current study was to examine the relationship between the histopathological features of endometrial polyps, the clinical characteristics of AUB, and ultrasonographic findings to deepen our understanding of the underlying mechanisms of AUB.</p> Methods <p>This retrospective, cross-sectional study analyzed 313 women with AUB and histologically confirmed endometrial polyps at Shahid Sayyad Shirazi Medical Training Center in Gorgan, Iran, from December 2021 to December 2023. Demographic, clinical, ultrasonographic, and histopathological data were collected and statistically analyzed.</p> Results <p>In our study, significant associations were found between age and clinical, histopathological, and ultrasonographic findings in women with abnormal uterine bleeding (<i>p</i> &lt; 0.001). Younger and middle-aged women presented mostly with menometrorrhagia, proliferative and secretory patterns, while elderly patients had higher rates of hyperplasia. Polyp sizes and endometrial thickness (ET) also varied significantly by age, menstrual pattern, and clinical presentation, with larger polyps and thicker ET correlating with specific bleeding patterns. Notably, ET was a predictive factor for polyp size. Ultrasonographic features correlated significantly with histopathology (<i>p</i> &lt; 0.001); abnormal vascularity was disproportionately observed in carcinomas, and notably 60% of malignancies occurred with endometrial thickness &lt; 7&#xa0;mm.</p> Conclusion <p>This study highlights that menometrorrhagia is the most common bleeding pattern in women with AUB, while atrophic and carcinomatous patterns are more frequent in older women. Age and specific symptoms, such as pain, correlate with larger polyps and increased endometrial thickness, indicating targeted diagnostic and treatment strategies are needed for diverse demographic groups to improve AUB management.</p>

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Histopathological, Clinical, and Radiological Assessment of Endometrial Polyps in Women with Abnormal Uterine Bleeding: A Study from Iran (2021–2023)

  • 期刊论文

  • 发表日期：

    2026年2月5日

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  • Mahboobeh Azadehrah,
  • Haleh Hedayat Mofidi,
  • Gholamreza Roshandel,
  • Malihe Azadehrah

摘要

Purpose

Abnormal uterine bleeding (AUB) significantly affects women’s quality of life and is often linked to conditions like hormonal imbalances, structural anomalies, and endometrial polyps. Endometrial polyps, common in premenopausal women, frequently cause AUB. Exploring their histopathological, clinical, and ultrasonographic features is vital for better management of AUB. The aim of the current study was to examine the relationship between the histopathological features of endometrial polyps, the clinical characteristics of AUB, and ultrasonographic findings to deepen our understanding of the underlying mechanisms of AUB.

Methods

This retrospective, cross-sectional study analyzed 313 women with AUB and histologically confirmed endometrial polyps at Shahid Sayyad Shirazi Medical Training Center in Gorgan, Iran, from December 2021 to December 2023. Demographic, clinical, ultrasonographic, and histopathological data were collected and statistically analyzed.

Results

In our study, significant associations were found between age and clinical, histopathological, and ultrasonographic findings in women with abnormal uterine bleeding (p < 0.001). Younger and middle-aged women presented mostly with menometrorrhagia, proliferative and secretory patterns, while elderly patients had higher rates of hyperplasia. Polyp sizes and endometrial thickness (ET) also varied significantly by age, menstrual pattern, and clinical presentation, with larger polyps and thicker ET correlating with specific bleeding patterns. Notably, ET was a predictive factor for polyp size. Ultrasonographic features correlated significantly with histopathology (p < 0.001); abnormal vascularity was disproportionately observed in carcinomas, and notably 60% of malignancies occurred with endometrial thickness < 7 mm.

Conclusion

This study highlights that menometrorrhagia is the most common bleeding pattern in women with AUB, while atrophic and carcinomatous patterns are more frequent in older women. Age and specific symptoms, such as pain, correlate with larger polyps and increased endometrial thickness, indicating targeted diagnostic and treatment strategies are needed for diverse demographic groups to improve AUB management.