Uterine polyps treatment has come a long way in the last 10 years. Gone are the days of requiring a hysterectomy as treatment for polyps, or even a D&C but it does depend on where they are located as to the form of treatment. It is through the use of the hysteroscope that allows the gynaecologist to take a look inside the uterus and decide what the best course of action would be.
What are Uterine Polyps?
Polyps are an overgrowth of cells in the uterine lining (endometrium). They are like small bumps or tiny mushroom like growths from the uterine wall. Most are small and less than 1/2 ” wide. They are mostly benign but due to the fact they form from an abnormal cell growth so they have the potential to be precancerous or cancerous. They need to be assessed and biopsy taken. The uterine lining grows and shrinks during the monthly cycle. If the woman isn’t pregnant, the lining sheds causing the menstrual flow. After the period, the lining grows again. The polyp is an area that grows too much, which can lead to an increased surface area and so lead to excessive menstrual bleeding.
How Do They Differ From Fibroids?
Fibroids are made from the thick muscle layer of the uterus, typically the uterine walls and are not made of the uterine lining (endometrium) at all. They are much deeper within the uterine layers.
Sometimes there are no symptoms of polyps, some have light bleeding or spotting, whereas others may have irregular menstrual bleeding, bleeding between menstrual periods, excessive menstrual bleeding, vaginal bleeding after the onset of the menopause and they can play a part in problems with infertility.
The stalks of the polyps are usually short, but occasionally they can be long enough to project through the cervix or they have the potential to block the opening to the Fallopian Tubes. If they are found and the patient has suffered miscarriage, they will be removed as a precaution.
Causes of Polyps
Frequently there is no real cause found for the polyps but there may be hormonal factors. They can be oestrogen sensitive and grow as a response to circulating oestrogen.
There are risk factors that will predispose to production of polyps :
- Being perimenopausal/post menopausal
- Having high blood pressure (hypertension)
- Being obese
- Taking Tamoxifen ( a drug therapy used for breast cancer)
The treatment of choice if uterine polyps are suspected, is a hysteroscopy.
The hysteroscope is passed into the uterine cavity through the cervix and the inside of the uterine cavity is inspected. The polypectomy is performed by the polyps being removed simply using scissors and the removed polyps sent for histological examination to ensure there is no cancer present. This is particularly important if the woman is perimenopausal or post menopausal as bleeding after this time must be investigated, even if it settles quickly.
If the histology is normal, there is nothing further that is required. The woman may experience a small amount of light bleeding for a few days but will quickly settle.
Polyps can recur but not necessarily causing problems and usually theyre treated on a case by case basis in a woman of child-bearing age.
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