Uterine polyps are noncancerous tissue overgrowths of endometrium, a tissue in the inner lining of the uterus, that extend into the uterus cavity. These may occur spontaneously or because of high levels of oestrogen hormone, although it is not known what actually causes it. Polyps grow faster during pregnancy and while using oral contraceptives or oestrogen replacement therapy. Although most of the polyps are noncancerous, the polyps that developed in women during or after menopause may turn out to be cancerous. Uterine polyps are more common in women aged between 40 and 50 years however occasionally may be seen in younger women of 20 years or less. Obesity, uncontrolled hypertension and certain drugs used to treat breast cancer may increase the risk of uterine polyps.
Most common symptom of uterine polyp is irregular menstrual periods. Menorrhagia or abnormal heavy menstrual bleeding, prolonged periods, bleeding between periods and bleeding even after menopause or during sexual intercourse are some of the other symptoms of uterine polyps. Infertility may also be an indication of the presence of a uterine polyp.
Uterine polyps are diagnosed based on the medical history and symptoms. Also, other diagnostic tests such as transvaginal ultrasound, sonohysterography, hysteroscopy, biopsy and curettage may be performed.
Smaller polyps that do not cause any problem need not be removed but should be assessed every 6 months to check their progression. However, if uterine polyps cause pelvic pain, heavy menstrual bleeding, or infertility or if there is previous history of miscarriage, then removal of uterine polyps (polypectomy) may be considered. Usually, polypectomy may be performed at your doctor’s office using hysteroscopy during which a long, thin rod with a video camera and light (hysteroscope) is inserted through the vagina and cervical opening. Then the polyp is caught hold and cut with a small scissor.
Larger polyps need to be operated in a hospital set-up under general anaesthesia. In order to remove the uterine polyp, laparoscopy may be performed along with a hysteroscopy. Laparoscopy involves use of laparoscope, a long rigid tube with a video camera and light which is inserted through a small incision made in the belly button. Through the laparoscope, special surgical instruments can be inserted that assist in removal of the polyp.