Uterine Polyps are growths attached to the inner wall of the uterus that extend into the uterine cavity. They result from an overgrowth of cells in the endometrium, the lining of the uterus. Polyps are usually benign (non-cancerous), but they can sometimes be associated with abnormal uterine bleeding and may contribute to infertility. The exact cause is not well understood, but hormonal factors, particularly estrogen, seem to play a role.
Clinical Evaluation
Patient History: Review of symptoms, including abnormal bleeding, menstrual irregularities, and reproductive history.
Physical Examination: A pelvic exam to check for abnormalities.
Diagnostic Tests
Transvaginal Ultrasound: An imaging test where a probe is inserted into the vagina to create images of the uterus and detect polyps.
Hysteroscopy: A procedure in which a thin, lighted telescope (hysteroscope) is inserted through the vagina and cervix into the uterus to directly view and possibly remove polyps.
Endometrial Biopsy: A sample of the uterine lining is taken and examined under a microscope to check for cancerous or precancerous cells.
Saline Infusion Sonography (SIS): A special ultrasound where saline is injected into the uterus to provide clearer images of the uterine cavity.
Irregular menstrual bleeding, such as frequent, unpredictable periods of variable length and heaviness.
Bleeding between menstrual periods.
Excessively heavy menstrual periods (menorrhagia).
Vaginal bleeding after menopause.
Infertility or difficulty conceiving.
Pelvic pain or discomfort (rare).
Treatment for uterine polyps depends on the size of the polyps, the symptoms they cause, and whether they may be precancerous or cancerous.
Watchful Waiting: Small polyps that cause no symptoms may resolve on their own and may not require treatment.
Medications: Hormonal medications, such as progestins or gonadotropin-releasing hormone agonists, may reduce symptoms temporarily but do not eliminate polyps.
Hysteroscopic Polypectomy: The most common procedure for removing polyps, involving the use of a hysteroscope to excise the polyps.
Dilation and Curettage (D&C): A procedure where the cervix is dilated, and the uterine lining is scraped to remove polyps and tissue for examination.
Surgical Removal: In rare cases where polyps are suspected to be cancerous, more extensive surgical procedures may be necessary.
Follow-up Care: Regular monitoring to check for recurrence of polyps, particularly if they were associated with abnormal cells or symptoms.