Patient's question:
Please advise: How to differentiate endometrial polyps from submucosal small fibroids on B-mode ultrasound images? What are the differences in CDFI?Doctor's answer:
Hello: Any mass attached to the uterine cavity wall by a slender stalk can be clinically referred to as an uterine polyp. Therefore, polypoid masses within the uterine cavity may include stalked submucosal fibroids, endometrial polyps, adenomyoma-like polyps, and malignant polyps (cancer or sarcoma).Etiology of Endometrial Polyps
The formation of polyps may be related to inflammation, endocrine disorders, particularly excessively high estrogen levels. Most scholars believe that polyps originate from immature endometrium, especially at the base.
Clinical Manifestations of Endometrial Polyps
This condition can occur at any age after puberty but is more common in women over 35. Single, small endometrial polyps often show no clinical symptoms and are usually discovered during postoperative gross examination after hysterectomy for other diseases or diagnosed after diagnostic curettage. Multiple, diffuse polyps are commonly associated with menorrhagia and prolonged menstruation, which are related to increased endometrial area and excessive endometrial hyperplasia. Large polyps or those extending into the cervical canal are prone to secondary infection, necrosis, and may cause irregular bleeding and foul-smelling bloody discharge.
Diagnosis of Endometrial Polyps
The main symptoms include increased menstrual volume or irregular uterine bleeding; visible or palpable polyps at the cervix; and a slightly enlarged uterus. Diagnostic hysteroscopy or fractional curettage, followed by pathological examination of the collected tissue or excised polyps, can confirm the diagnosis and differentiate it from conditions such as dysfunctional uterine bleeding, submucosal fibroids, and endometrial cancer. Dilating the cervix, removing the polyps, and then scraping the entire uterine cavity can help remove diffuse small polyps.