Uterine polyp: what it is and how it is treated
An endometrial polyp (a uterine polyp, or a polyp in the womb) is a usually stalked growth that projects into the inside of the uterus. A polyp can appear anywhere within the uterus, and there may be one or several.
A uterine polyp can be the first sign of cancer of the uterus, which is why its presence within the endometrium is not safe. A polyp can also make it harder to conceive and to carry a pregnancy.
Symptoms
What symptoms a uterine polyp causes, and which women it affects:
A uterine polyp may be found by chance at the annual gynecological check-up, or after abnormal bleeding during or between periods. Bleeding after intercourse and a feeling of fullness or pressure downwards can also be symptoms suggesting that there is a polyp in the uterus.
Uterine polyps occur both in young women and in women after the menopause. In a woman who bleeds after the menopause, the presence of a polyp is a particularly concerning sign.
Causes and diagnosis
How a uterine polyp forms and how it is diagnosed:
Biologically, a uterine polyp is due to a group of cells in the uterus growing autonomously, increasing in size and in number. If their genetic material becomes damaged, a cancer may arise.
The presence of a uterine polyp is confirmed by gynecological examination and gynecological ultrasound. On examination the polyp may be visible through the cervix and palpable by the gynecologist. On ultrasound it appears as a thickening inside the uterus. Specialized techniques such as Doppler ultrasound can show whether the polyp has a blood supply and can highlight features suspicious for malignancy. Where the presence of a polyp is not clear, saline is instilled into the uterine cavity so that it shows up better on sonohysterography.
Treatment
Uterine polyp: how it is treated and what the stages are:
Treating a polyp essentially means removing it. The first stage is to locate it with an endoscopic camera, using specialized microsurgical instruments. This operation is called operative hysteroscopy. It is carried out under brief general anesthesia, widely known as sedation. During the operation the cervix is gradually dilated. The uterine cavity is filled with saline and a special camera is introduced. The polyp usually appears as a tongue-like projection or a broad swelling inside. The next stage is to determine its exact position — whether the polyp lies low in the endocervix, in the middle at the isthmus, or higher up inside the endometrial cavity. The polyp is also assessed hysteroscopically, from the appearance of the image, as suspicious or not. It is then removed using microscissors or a diathermy loop. At the end, the polyp is always sent for histological examination to determine its nature: benign or malignant. Removal of the polyp may be followed by curettage of the endometrium to reveal any additional pathology besides the polyp — for example hyperplasia, unopposed hormonal stimulation or malignancy.
After removal of the uterine polyp
Discomfort after the operation is usually short-lived, and a woman can return to her normal routine the next day, or better still after a day's rest. Removal of a polyp may be followed by a small amount of bleeding over the following month, as the endometrium heals. Pain is limited and painkillers for a day are usually enough. Antibiotics may be given as a precaution after removal of a polyp, although this is not usually necessary.
The doctor's advice
Dr. Michael Rotas emphasizes how effective hysteroscopy is as a treatment for removing uterine polyps — safely, directly and with minimal invasiveness.