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Uterine polyps are usually the result of the overgrowth of cells in the lining of the uterus (endometrium). The growths that are attached to the inner wall of the uterus and that protrude into the uterine cavity are known as uterine polyps. These polyps attach to the wall of the uterine by a thin stalk or a large base. The size of a polyp may range from just a few millimeters to several centimeters. A person may develop one uterine polyp, or several ones. This condition usually occurs in women in their 40s and 50s, but it could occur earlier, meaning that it can develop in pre- or postmenopausal women. These polyps usually stay contained within the uterus, but in some cases, they may slip down through the opening of the uterus (cervix) into the vagina.
Uterine polyps don't always cause signs and symptoms. When the polyps do cause signs and symptoms, they may be:
Usually, postmenopausal women experience only spotting or light bleeding.
Uterine polyps seem to respond to estrogen in the same way that the endometrium (lining of the uterus) does; they grow in response to circulating estrogen. This means that hormonal factors play a role in the development of uterine polyps. However, the exact cause of this condition is still not known. Some of the factors that may increase a woman's chances of developing uterine polyps include:
In case a woman is experiencing infertility and has uterine polyps, removing them may promote her fertility. However, it's still not entirely clear if uterine polyps actually cause infertility. One study has shown that infertile women who've had IUI (intrauterine insemination) before having the polyp surgically removed (hysteroscopic polypectomy) had much higher pregnancy rates than those who had IUI alone. The difference was about 63% vs. 28%. A woman who is undergoing in vitro fertilization (IVF) will be recommended the removal of the polyp before embryo transfer because uterine polyps have been associated with an increased risk of miscarriage in women undergoing IVF.
Some of the possible treatment options for polyps are:
Unless a person is at risk of uterine (endometrial) cancer, small and asymptomatic polyps won't require any treatment because they may resolve on their own.
A uterine polyp may shrink and its symptoms may lessen if a woman takes progestine and gonadotropin-releasing hormone agonists. However, these medications are usually used as a short term treatment, and once they are stopped, the signs and symptoms recur.
Surgical removal (excision):
Hysteroscopy is a procedure in which the polyps are cut away and removed with the use of instruments that are inserted through the hysteroscope. However, before removing the polyps, they should be identified first. The polyps could also be microscopically examined if they are sent to a laboratory.
A hysterectomy will be necessary in case a closer examination of the polyp reveals that it contains cancerous cells. The entire uterus is removed in this procedure.
Uterine polyps can recur, even if they are removed. In this case, a woman may have to undergo treatment more than once.
Dr. Samer Al-Jneidy
Samir Moussa M.D.
Dr. Tahsin Martini
Dr. Hani Najjar
Dr . Dirar Abboud
Dr. Talal Sabouni
Dr. Faisal Dibsi
Yaser Habrawi , F.R.C.S.Ed