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Hysteroscopic Treatment of Endometrial Polyps

Diagnostic and operative hysteroscopy for visualisation and complete polyp removal.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Hysteroscopic Treatment of Endometrial Polyps?

Endometrial polyps are sessile or pedunculated outgrowths of endometrial glands, stroma and blood vessels arising from the uterine cavity.

Prevalence ranges from 8% in premenopausal asymptomatic women to 35% in those with abnormal bleeding; up to 50% of postmenopausal women with bleeding harbour polyps.

Most polyps (95%) are benign; the risk of malignancy is 0-13% and is higher in postmenopausal women with bleeding, hypertension, obesity, polyps over 1.5 cm and tamoxifen use.

Symptoms

Premenopausal: heavy menstrual bleeding, intermenstrual spotting, postcoital bleeding
Postmenopausal: any bleeding (mandatory evaluation)
Subfertility (polyps may interfere with implantation, especially when over 1.5 cm or near tubal ostia)
Recurrent miscarriage in some patients
Asymptomatic discovery on ultrasound or hysteroscopy
Mucoid vaginal discharge in larger polyps
Cyclic pelvic pain when polyp prolapses through the cervix

Risk Factors

Reproductive and perimenopausal age (40-50 years peak)
Hypertension and obesity (insulin resistance)
Tamoxifen therapy (up to 30-60% incidence)
Hormone replacement therapy in postmenopause
Anovulatory cycles and polycystic ovary syndrome
Diabetes mellitus
Cervical polyps frequently coexist
Race (higher prevalence in some populations)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Postmenopausal bleeding requires urgent transvaginal ultrasound and hysteroscopy
  • Premenopausal abnormal bleeding unresponsive to medical therapy needs hysteroscopic evaluation
  • Subfertility patients with thickened endometrium or focal lesion on saline infusion sonography benefit from hysteroscopy
  • Polyps over 1.5 cm, multiple polyps or polyps in tamoxifen users should be removed
  • Symptomatic polyps in any age group warrant removal regardless of size
  • Asymptomatic small polyps (under 1 cm) may be observed in premenopausal women without infertility

Treatment Methods

01
Diagnostic workup: transvaginal ultrasound in early proliferative phase, saline infusion sonography improves accuracy, diagnostic hysteroscopy is the gold standard
02
Office hysteroscopy with vaginoscopic approach is preferred for diagnosis without anaesthesia
03
Operative hysteroscopy under regional or general anaesthesia for polyp removal
04
Mechanical resection (cold loop, scissors, morcellator) is the preferred method to preserve specimen for histology
05
Bipolar resectoscope or hysteroscopic morcellator for larger polyps
06
Always send specimen for histopathological analysis to exclude malignancy or hyperplasia
07
Postoperative hormonal therapy (combined contraceptives, levonorgestrel IUD) for patients with recurrent polyps
08
Pregnancy rates after polypectomy in infertility patients improve significantly (65-70% versus 30-40% without treatment)

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.