Uterine polyps are found in up to 10% of women. A polyp is a lesion in the lining of the uterine cavity. Polyps can take up space within the uterine cavity, cause a zone of inflammation and can decrease pregnancy rates.
Polyps may be single or multiple and measure between a few millimeters to several centimeters.
The cause of uterine polyps is unknown but they seem to develop in response to the hormone estrogen. Most of the time they are asymptomatic, but some women who experience heavy menstrual bleeds, spotting in between menstrual periods or irregular menstrual bleeding may have polyps.
Uterine Polyps Diagnosis
Endometrial polyps are usually identified with hysterosalpingogram (HSG) or a saline hysterogram or sonogram (SHG).
Hysterosalpingography (HSG) is an x-ray study used as an initial screening study to evaluate the uterine cavity and tubal patency, whether the fallopian tubes are patent (open) or not. Most patients have this study performed in the beginning of their infertility evaluation. The HSG is very helpful in diagnosing polyps.
The saline hysterogram or sonogram (SHG) is a study in which sterile saline is placed into the uterine cavity with a catheter and a transvaginal ultrasound is performed. The saline produces a contrast media in order to visualize polyps accurately. Note that detection of polyps by simple ultrasound can be difficult especially when the uterine lining is thick.
Treatment for Uterine Polyps
Polyps are surgically removed using a hysteroscope. Hysteroscopy is a minor surgery perfromed in the operating room with IV sedation. Hysteroscopy is a procedure with little risk.
At the time of hysteroscopy, a specialized camera is introduced into the uterine cavity. Attached to the camera is a surgical instrument, which will allow your physician to remove your polyps.
The vast majority of endometrial polyps are benign, although some may be precancerous. Precancerous polyps account for less than 1% of uterine polyps.
During artificial insemination and in vitro fertilization, endometrial polyps have been shown to decrease pregnancy rates. They even may cause pregnancy loss. Thus, your doctor will look for uterine polyps on your ultrasound, HSG, or saline sonogram study.
Prior to artificial insemination, your physician will evaluate your uterine cavity with an ultrasound and request a hysterosalpingogram be performed. Most uterine polyps can be found when combining these two studies.
For more information about uterine polyps and a polypectomy, contact us.
