High number of endometrial polyps is a strong predictor of recurrence: findings of a prospective cohort study in reproductive-age women

A high number of endometrial polyps has a higher risk of recurrence than a single polyp in reproductive-age women, suggesting that a high number of polyps might be attributed to a distinct etiology.

Volume 109, Issue 3, Pages 493–500


Fang Gu, M.D., Huanxiao Zhang, M.D., Simin Ruan, M.D., Jiamin Li, M.D., Xinyan Liu, M.D., Yanwen Xu, M.D., Canquan Zhou, M.D.



To compare the incidence of recurrence between a cohort with a high number (≥6) of endometrial polyps (EPs) and a single-EP cohort among reproductive-age patients after polypectomy.


Prospective observational cohort study.


Single university center.


Premenopausal women who underwent hysteroscopic endometrial polypectomy were recruited.


Patients underwent a transvaginal ultrasound scan every 3 months after polypectomy to detect EP recurrence. Kaplan-Meier and Cox regression models were used to compare the risk of recurrence between the two cohorts and analyze the potential risk factors for EP recurrence.

Main Outcome Measure(s)

EP recurrence rate.


The study enrolled 101 cases with a high number of EP and 81 cases with a single EP. All baseline parameters were similar except that the high number of EP cohort had a slightly lower mean age than the single EP cohort (33.5 [range 30.0–39.0] vs. 36.0 [30.5–43.0] years). The risk of recurrence in the high number of EP cohort was 4.08 (95% confidence interval [CI] 1.89–8.81) times higher than that in the single-EP cohort 1 year after polypectomy, with a recurrence rate of 45.5% versus 13.4%, respectively. A high number of EPs, endometriosis, and previous polypectomy history were independently associated with polyp recurrence.


The high number of EP cohort was much more prone to recurrence than the single-EP cohort. A high number of EPs, endometriosis, and previous polypectomy history were independent risk factors for recurrence. A high number of EPs is suggested to be a distinct subgroup with different pathogenesis, which warrants frequent monitoring and prevention.

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