Uterine polyps are growths of excess tissue that form on the inner wall of the uterus. There can be more than one at a time and can range from a few millimetres in size to several centimetres, they tend to be in the uterus and are rarely cancerous.
They are more regular in woman between 50 and 60, in the obese and those suffering from hypertension.
Polyps can sometimes go harmlessly undiagnosed because they have not caused any symptoms. However when they are symptomatic it will usually involve:
- Heavy menstrual bleeding
- Spotting between periods or after intercourse
- Bleeding after menopause
- Irregular bleeding
Uterine polyps are more difficult to diagnose than cervical polyps because they are not visible on visual inspection. For this reason, the diagnostic process is more extensive, your gynaecologist will decide on the best diagnostic and treatment path for you however some of the options are listed below:
- Transvaginal ultrasound: After an initial consultation to discuss your medical history a transvaginal ultrasound shall be preformed. A slim handheld device called an ultrasound transducer is inserted in the vagina. The transducer emits sound waves that provide images of the inside of the uterus that the technician can view on a monitor.
- Hysteroscopy: this can be used to both diagnose and treat polyps (in combination with another treatment method). The doctor inserts a long thin tube with a lighted telescope (hysteroscope) through the vagina, up into the cervix and womb. This allows for an accurate visual inspection of the uterus.
- Endometrial biopsy: This can be carried out in the gynaecologist’s office. The doctor uses a soft plastic instrument to collect a small tissue from the wall of the womb. The sample is sent to the laboratory for biopsy to check for abnormalities.
- Dilation and Curettage (D&C): this is performed under general aesthetic in an operating theatre. It can both diagnose and treat polyps. Your gynaecologist collects a sample of tissue from the inside of the womb using a long metal instrument called a curette. The tissue will be sent to a lab for biopsy.
The treatment of uterine polyps may not be necessary if they asymptomatic. Some studies even indicate that polyps under 1cm can even spontaneously regress without any treatment – the larger the polyp however, the less likely it is to regress.
Polpys should be treated if they cause heavy bleedings or spotting, if there is a suspicion of precancerous changes or the woman wishes to become pregnant. The treatment options include:
- Hormone Medications: Drugs to regulate hormone imbalances such as gonadotropin-releasing hormone agonists and progestins may be prescribed to relieve symptoms. This is usually only a temporary solution because as soon as you stop taking the medication, the symptoms return.
- D&C: This is the most common procedure and is effective for smaller tumours. The growths are scraped from the wall of the uterus. It is always performed under general anaesthesia.
- Polypectomy: A polypectomy using a hysteroscope for guidance. A special grasping device is inserted through the hysteroscope and used to snag the polyp and remove it. Or instead of a grasping device, polypectomy can be done using an electrical loop to cut the growth out with a low dose of electricity.
- Hysterectomy: If the polyps continue to grow back, or there are signs of cancer, a hysterectomy may be recommended.