References:

Nijkang, N., Anderson, L., & Manconi, F. (2019). Endometrial polyps: Pathogenesis, sequelae and treatment. Retrieved on 18, March
2023 from: https://journals.sagepub.com/doi/full/10.1177/2050312119848247
 Legend:
PATHOPHYSIOLOGY --------- Signs and Symptoms
Disease Process
Abnormal Uterine Bleeding Endometrial Polyps
Symptoms Manifested by patient
Treatment Management and Diagnostics
Current Medications and treatment undertaken
Complications

PREDISPOSING FACTORS: PRECIPITATING FACTORS:

 Women within the reproductive age  Episodes of the abnormal menstrual cycle:
(48years old) frequency, regularity, duration, and volume
 Family history of endometrial polyps of blood flow
 Perimenopausal  Physical Stress
 Sex: Female  Prolonged Birth control: Hormonal IUD
 Hyperandrogenism (PCOS, congenital  Sudden weight loss
adrenal hyperplasia)  Obesity
 Medication: Tamoxifen, Antipsychotic drug  Uterine trauma
 Estrogen secreting ovarian tumors  Intake of medications such as
 Endometrial hyperplasia antiepileptics, antipsychotics,
 Smoking phenothiazones, metocloperamide,
 Vitamin D Deficiency morphine, dextroamphetamine, alpha-
 Liver or kidney disease methylodopa, verampil and cimetidine

Hormonal imbalances

Inadequate secretion of Estrogen Stimulation that

estradiol and progesterone causes excess estrogen

Upregulation of estrogen receptors

Decrease production of Decreased vasoconstriction

progesterone receptors of the spiral vessels in the
within the tissues endometrium Activation of signaling pathways
(PI3K/Akt, MAPK, Wnt/beta-catenin)
 Abnormal proliferation Overexpression of
of endometrial glands growth factors (EGF,
Unopposed and prolonged Increased vascular fragility
and stroma VEGF, IGF) and cytokines
estrogenic stimulation within and decreased vascular (IL-6, TNF-alpha)
the endometrium tone

Celecoxib
Dysregulation of cell cycle and apoptosis 200 mg PO
pathways (p53, Bcl-2, caspases) BID

Excessive proliferation Inadequate structural inflammation in

and uncontrolled support within the
Formation of Polyp the
differentiation of cells endometrium endometrium
without shedding

Formation of Upregulation of
hyperchoic foci matrix
Recruitment Vascularization metalloproteinases
of angiogenic and continued
Thick proliferative (MMPs) and other
factors (VEGF, growth
Endometrium enzymes
PDGF, FGF)
Unstable endometrial lining

Degradation of extracellular matrix

(ECM) and basement membrane
Transvaginal ultrasonography

Invasive and potential

for malignancy
Complete Blood Count
 ENDOMETRIAL POLYPS

With diagnostic, treatment and interventions Without diagnostic,

treatment and interventions

Nursing Management:
Diagnostic Tests: Medical Surgical:  Assess the patient's vital signs and monitor for
-Electrolyte management: -Polypectomy signs of hypovolemia and anemia.
 Provide emotional support and education to the
panels with curettage patient about the condition, including the
-Urinalysis Nonhormonal importance of compliance with treatment and
follow-up appointments. Iron Infertility Hemorrhage
-Abdominal Treatment
-Antibiotics
 Administer medications as prescribed, such as deficiency
Ultrasound nonsteroidal anti-inflammatory drugs (NSAIDs) or
anemia
-Potassium hormonal therapies, to control bleeding and
reduce pain.
Chloride  Encourage the patient to rest and limit physical
-Proton-pump activity during periods of heavy bleeding to Tissue Hypoxia
conserve energy.
inhibitors  Provide adequate hydration and nutrition, Vulnerable to
including iron-rich foods or supplements, to susceptible
prevent or treat anemia.
 Monitor for signs of infection, such as fever, chills,
infections due to
or foul-smelling discharge, and report to the weaken immune
Restoration of reduction of abnormal healthcare provider if present. system Shock
 Instruct the patient to avoid intercourse, tampons,
normal hormone proliferation of endometrial tissue or douching during periods of heavy bleeding to
balance reduce the risk of infection.
 Educate the patient about the importance of

reduction in abnormal
regular gynecologic examinations and follow-up Infections can
Resumption of normal appointments to monitor the condition and detect
uterine bleeding arise and cause
menstrual cycle any changes or complications.
 Monitor for signs of excessive bleeding or clotting, severe
such as passing large clots or soaking through
pads quickly, and report to the healthcare provider
symptoms
if present.

Improvement in quality of Death

Reduction of inflammation
and risk for infection life and reduction of
potential for malignancy.

Bad Prognosis
Good prognosis