Patient's question:
I had an abortion and found polyps. The doctor said that bleeding indicates the presence of polyps. Previously, I had vaginal bleeding, but the amount was not significant. The polyps are not small. Why wasn't it detected before? Do I need any other tests? What are uterine polyps? How are they treated?Doctor's answer:
Definition of Endometrial PolypsAny mass attached to the inner wall of the uterine cavity by a slender stalk can be clinically referred to as a 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 typically discovered during macroscopic examination after hysterectomy for other diseases or during diagnostic (D&C). Multiple, diffuse polyps are commonly associated with menorrhagia and prolonged menstrual periods, 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 D&C, followed by pathological examination of the retrieved tissue or excised polyp, can confirm the diagnosis and differentiate it from conditions such as dysfunctional uterine bleeding, submucosal fibroids, and endometrial cancer.
Treatment of Endometrial Polyps
Cervical dilation, polyp removal, and subsequent (scraping the entire uterine cavity) can eliminate diffuse small polyps and send them for pathological examination. Postoperative follow-up is essential to monitor recurrence and malignant transformation, with timely intervention. In recent years, hysteroscopic surgery or laser treatment has been successfully used for small polyps. For patients over 40 with significant bleeding symptoms, if the above treatments are ineffective or frequently recur, total hysterectomy may be considered.