Endometrial polyps

What is a polyp?

Polyps are very common and you can have them at various stages in your life. Endometrial polyps are like an overgrowth of the lining of the womb. Usually they are benign but sometimes can be precancerous or cancerous. It can arise from the cervix (neck of the womb) or the lining of the womb. Fibroids (Uterine muscle tumours) can sometimes present as polyps.

What are the symptoms of polyps?

Cervical polyp may be asymptomatic as they may be incidentally picked by up by your GP or the nurse at the time of the smear test. Sometimes one can get bleeding or spotting after sex or excessive vaginal discharge.

When polyps are found on the lining of the uterus, you may have heavy bleeding, intermenstrual spotting/ bleeding, vaginal discharge, experience subfertility or miscarriage depending on the type and the size of the polyps.

In post-menopausal women, the polyps can cause post- menopausal bleeding. In this case, you should see a gynaecologist as the chances of precancerous or cancerous changes are higher in this age group.

What investigations are required?

Examination-Cervical polyps are visualised clearly at the time of internal examination. In some cases, you may need a scan to check for the exact origin of the polyps.

Scan– Ultrasound scan is used as the first modality. It provides clear views as to the origin and the number of the polyps.

Hysteroscopy– It is excellent for diagnosis as well as for the treatment options. Most of the polyps can be removed at hysteroscopy either in outpatient or theatre setting.

What are the treatment options?

Not all polyps need removal.

If you have symptoms because of the polyps, or there is any suggestion of sinister changes in the polyp (polyps in menopausal age group), then these polyps will need to be removed and tested.

Cervical polyps-These polyps can be removed easily in the Outpatient Clinic setting without much discomfort. Sometimes, if the polyp is large with a broad base, then you might need either hysteroscopy or removal of the polyp under general anaesthesia.

Endometrial polyps– These can be removed using hysteroscopy either in out- patient setting or under general anaesthesia depending on your preference and the type and size of the polyps.

Fibroids presenting as polyps can also be removed using operative hysteroscope without the need for any major surgery or scarring.

Once removed, the polyps are always sent to the lab for histology.

Uterine polyps, once removed, can recur. It’s possible that you might need to undergo treatment more than once if you experience recurring uterine polyps.