OC21.01: Prospective evaluation of expectant management as a primary approach for asymptomatic endometrial polyps

To evaluate expectant management and natural history of sonographically benign endometrial polyps (EP) in asymptomatic women. Between January 2016 and January 2022, 326 asymptomatic ≥ 18-year-old women were consecutively diagnosed with sonographically benign EP in our ultrasound unit and accepted to participate in the study. Clinical and ultrasound reassessments were performed 3 and 9 months after the diagnosis, and then annually up to 6 years, EP spontaneous and complete regression, hysteroscopic excision or hysterectomy for other indication. Patients were reevaluated at any time when abnormal uterine bleeding (AUB) occurred. Three patients were lost to follow-up. After the exclusion of the patients using hormonal therapy or tamoxifen, data from 298 women collected until January 2024 were analysed. 62 premenopausal and 236 postmenopausal women were expectantly managed for an average period of 17 months (range: 3 – 72 months). Their clinical and ultrasound evolution is presented in table 1. Expectant management is a safe option for asymptomatic, sonographically benign EPs. Based on our data, the growth rate of EPs does not differ before and after menopause, while their complete spontaneous regression and the appearance of AUB are more common in premenopausal patients, although without a statistically significant difference. A longer average follow-up is needed to confirm our results. Postmenopausal N = 236