D&C: Do You Need It for Uterine Polyps and Fibroids? - Obstetrics and Gynecology

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Hello, 小兔子:
Thank you for your thoughtful question regarding the management of uterine polyps and fibroids, especially in the context of your current health situation. Let's break down your concerns regarding the need for a dilation and curettage (D&C) procedure, as well as the treatment options available for your uterine polyp and fibroid.


Understanding D&C and Its Purpose
Dilation and curettage (D&C) is a surgical procedure that involves dilating the cervix and scraping the uterine lining (endometrium) to remove tissue. This procedure can be performed for various reasons, including abnormal uterine bleeding, to obtain a tissue sample for biopsy, or to remove polyps and fibroids.
In your case, you have a uterine polyp measuring 1.7 x 1.2 x 0.7 cm and a fibroid measuring 0.83 x 0.26 cm, along with thickening of the endometrium. Given that you are 50 years old and have recently experienced changes in your menstrual cycle, it is important to evaluate the need for a D&C carefully.


Do You Need a D&C?
1. Symptoms and Diagnosis: If you are experiencing symptoms such as heavy bleeding, pelvic pain, or other concerning signs, a D&C may be warranted to address these issues. However, if you are asymptomatic and the findings are incidental, your healthcare provider may recommend a watchful waiting approach or medical management instead.

2. Medical Management: In some cases, medications such as hormonal therapies (e.g., progestins or hormonal IUDs) can help manage symptoms associated with uterine polyps and fibroids. These treatments may help reduce bleeding and regulate your menstrual cycle, especially since you have recently stopped menstruating.

3. Surgical Considerations: If a D&C is performed, it is important to note that while the procedure can remove the endometrial lining, it may not necessarily remove the fibroid if it is embedded in the uterine wall. The polyp, however, can typically be removed during the D&C if it is accessible. Your healthcare provider will assess the situation and determine the best approach during the procedure.


What Happens During a D&C?
During a D&C, the physician will first dilate the cervix and then use a curette (a surgical instrument) to scrape the uterine lining. If polyps are present, they can often be removed during this process. However, if fibroids are larger or located deeper within the uterine wall, they may require a different surgical approach, such as a myomectomy, which specifically targets fibroids.


Conclusion
Ultimately, the decision to proceed with a D&C or to explore medical management should be made in consultation with your healthcare provider. They will consider your symptoms, the size and location of the polyp and fibroid, and your overall health status. If you have concerns about the procedure or the potential for complications, do not hesitate to discuss these with your doctor.

I hope this information helps clarify your situation. Wishing you a Merry Christmas and good health ahead!
Best regards,
Doctor Q&A Teams