Analysis Of Vaginal Micro-ecology In Reproductive-age Endometrial Polyps Patients

Part Ⅰ Comparative analysis of vaginal micro-ecology in reproductive age patients with endometrial polyps and healthy womenObjective To analyze the differences of vaginal micro-environment between reproductive age patients with endometrial polyps and healthy women by using vaginal micro-ecological evaluation.Method From January 2017 to December 2019,249 patients with endometrial polyps of reproductive age presenting for further hysteroscopy treatment were consecutively enrolled in the study group at Gynecology Department,Tianjin Medical University General Hospital.All the hospitalized patients enrolled had hysteroscopy confirmed endometrial polyps and vaginal micro-ecology examination before hysteroscopic endometrial polypectomy.Meanwhile,309 healthy women of reproductive age presenting for routine examination at the health management center were selected as the control group.Vaginal micro-ecological indicators were compared to reveal differences between the two groups.Result 1.The incidence of vaginal micro-ecological disorder in endometrial polyps group(20.5%)was significantly higher than that of control group(17.2%);The incidence of vaginitis in endometrial polyps group(30.1%)was significantly higher than that of control group(19.4%,P=0.002).Among which,bacterial vaginosis covered the majority(42/75,56%).2.Except for patients diagnosed with vaginitis,comparative analysis showed that :(1)The p H value(4.434 ± 0.330)in endometrial polyps group was higher than that of control group(3.967 ± 0.337,P<0.001).The incidence of abnormal vaginal p H value(19%)in endometrial polyps group was higher than that of control group(5.2%,P<0.001).(2)The proportion of the Lactobacillus grade Ⅱa to grade Ⅲ in endometrial polyps group(39.7%)were higher than that of control group(30.1%,P=0.042).Conclusion Compared with healthy women,patients with endometrial polyps of reproductive age are more likely to have vaginal micro-ecological abnormalities.Except for patients diagnosed with vaginitis,comparative analysis indicated that elevated vaginal p H was related to the occurrence of endometrial polyps in reproductive age.Lactobacillus remained the dominant role but companied with down regulated counts and up regulated growth of other bacteria in endometrial polyps group.More attention should be paid to the vaginal micro-ecological environment of patients with endometrial polyps since early intervention and correction for asymptomatic or other type of vaginal micro-ecological abnormalities,especially for elevated vaginal p H,increased white blood cells counts,and decreased lactobacilli grade would have positive effect on the reduction of endometrial polyps incidence and recurrence.Part Ⅱ Analysis of vaginal micro-ecological abnormalities and clinical characteristics of endometrial polyps in childbearing age womenObjective To investigate the clinical characteristics of endometrial polyps from vaginal micro-ecology perspective,trying to provide insight to reduce occurrence and relapse of endometrial polyps.Method 249 patients diagnosed with endometrial polyps were divided into either control group(123/249)and vaginal micro-ecological abnormality group(126/249).Clinical characteristics among 2 groups were compared retrospectively.Result 1.Clinical characteristics of endometrial polyps in vaginal micro-ecological abnormality group:(1)The incidence of abnormal uterine bleeding(71.4%)was higher than that of control group(59.3%,P=0.045).Intermenstrual bleeding was the main bleeding pattern.(2)The incidence of infertility(31.7%)was higher than that of control group(20.3%,P=0.040).(3)The incidences of abdominal pain(9.5%)and cervical polyps(23%)were higher than those of control group(3.3%,P=0.044;13%,P=0.040),respectively.2.Hysteroscopy examination revealed that the incidence of multiple polyps(92.1%)and sessile polyps(82.5%)was higher than those of control group(82.9%,P=0.029;71.5%,P=0.039).Some polyps had superficial bleeding and necrosis.Conclusion Vaginal micro-ecological abnormalities may be involved in the occurrence and progression of endometrial polyps.Attention paid to the vaginal micro-ecological environment of reproductive age women,timely treatment for vaginitis and recovered vaginal micro-ecological balance may have positive effect on the reduction of occurrence and relapse of endometrial polyps.