Uterine (endometrial) polyps: do they need to be removed?

Uterine polyps, also known as endometrial polyps, are excessive growths found in the uterine lining. The condition may be asymptomatic but when apparent include abnormal bleeding. Leading London gynaecologist Mr Mahantesh Karoshi explains more about whether the small, soft bumps need to be removed.

What are the symptoms of uterine or endometrial polyps?

The size of a uterine polyp can vary, from being as small as a seed to the size of a golf ball. Most polyps are not to be confused with cancer although a small percentage may turn into cancer later on. Symptoms can include:

Heavy periods
Bleeding in between periods
Excessive vaginal discharge
Post-coital bleeding

The more the number of polyps, the higher the risk of pre-malignant and malignant transformation.

Who is most likely to have uterine polyps?

Polyps in the uterus tend to develop in pre or post-menopausal women.

Do uterine polyps need to be removed?

The doctor will likely recommend the removal of the polyp from the uterus and will send a tissue sample to the laboratory for analysis to check that it is not uterine cancer. A diagnosis is made by a hysteroscopy, a procedure where a thin telescope is inserted into the uterine cavity. This allows the surgeon to look inside the uterus. Following this procedure, and in the majority of cases, patients will be told that the polyps need to be removed.

Do uterine polyps affect fertility?

Polyps can cause problems with fertility but it sometimes depends on where it is placed on the cervix. As polyps can stop a woman from getting pregnant or cause a miscarriage, they should be removed if the woman is trying to conceive.

How are uterine polyps removed?

Polyp removal is performed using a hysteroscopy or curette, the same instruments used for diagnosis. The polyp can be cut and retrieved at the same time. It is important that the base of the polyp has been completely excised as some studies have shown that the pre-malignant and malignant change can happen at the root of the polyp.

Removal occurs on a day-case basis without an overnight stay in a hospital. Once removed, however, there is a chance that it can recur and the patient may need to have the treatment more than once. If the polyps contain cancerous cells, removal of the uterus (hysterectomy) is necessary.