Uterine polyps are growths that occur due to overgrowth of the endometrium which is the inner lining of the uterus. Therefore, they are also called endometrial polyps.
They are attached to the endometrium by a thin stalk or a broad base. If an endometrial polyp is attached to the uterine surface by a narrow elongated pedicle, then it is known as pedunculated, if they have a large flat base then they are known as sessile.
They grow into the cavity of the uterus and sometimes when large can even protrude through the cervix and rare cases through the vagina.
The polyps may be round or oval, and range in size from a few millimeters to a few centimeters or even larger. There may be one or several polyps present.
Causes of Uterine Polyps
The polyps are usually benign. They occur after the age of 40 and after menopause but can occur in younger women. They usually cause bleeding problems and occasionally get in the way of getting pregnant.
There is no clear reason why the polyps develop. Women who have high estrogen levels tend to make polyps.
Obesity, high blood pressure, HRT (Hormone Replacement Therapy) and tamoxifen tablets can increase the chance of endometrial polyp.
Women who take tamoxifen are advised to do regular sonography of the uterus to check the endometrial lining.
Symptoms Of Uterine Polyps
Women who have polyp will complain of:
- Irregular menstrual periods
- Unusually heavy flow during menstrual periods
- Bleeding or bloodstained discharge through the cycle
- Bleeding after menopause.
- In younger women, it is sometimes implicated in infertility and miscarriage.
- Very occasionally they are discovered on routine ultrasound examination in asymptomatic patients.
Diagnosis and Treatment
The history is important, but an ultrasound of the pelvic organs is the first step test.
Colour-flow Doppler may demonstrate the single feeding vessel typical of endometrial polyps.
Sonohysterography can be done. In this case, a sterile fluid or saline is introduced inside the uterine cavity and this fills the cavity. The growth inside the cavity is then delineated.
Hysteroscopy is not only useful for diagnosis but also treatment as under hysteroscopic vision the diagnosis is confirmed and the polyp can be removed at the same time. The polyp is sent for histological examination. In case the polyp is cancerous then the uterus may have to be removed.
It is common for doctors to recommend the insertion of the LNG-IUS (for women who are not desiring fertility) inside the cavity of the uterus after the polyp removal to prevent further polyp formation.
