Uterine Polyps: When Surgery is Necessary - Obstetrics and Gynecology

Endometrial polyps

Hello, Director Cao! I am 50 years old and have not yet reached menopause, but my menstrual cycle has been irregular.
Recently, I discovered a small polyp in my uterus measuring 1.7 x 1.2 x 0.7 cm, and my endometrium has thickened.
I would like to know if I need to have surgery to remove it.
If surgery is necessary, what type of surgery would it be? I currently have cervicitis and vaginitis; should these conditions be treated before considering surgery? Thank you for taking the time to respond! Wishing you peace and health! Wendy

Wendy, 50~59 year old female. Ask Date: 2020/04/01

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, my suggestion is to observe temporarily.
You can also discuss this in detail with your obstetrician-gynecologist.
Wishing you good health.

Reply Date: 2020/04/01

More Info

Hello Wendy,
Thank you for your question regarding uterine polyps and the considerations surrounding surgery. Uterine polyps are growths that occur on the inner lining of the uterus (the endometrium). They can vary in size and number, and while many are benign (non-cancerous), they can sometimes lead to complications or symptoms that warrant surgical intervention.

Given your age of 50 and the fact that you are still experiencing menstrual irregularities, it is essential to evaluate the situation carefully. The size of the polyp you mentioned (1.7 x 1.2 x 0.7 cm) is significant enough to consider further investigation. Uterine polyps can cause symptoms such as heavy menstrual bleeding, bleeding between periods, or even infertility in some cases. In your case, the thickening of the endometrium and the presence of inflammation in the cervix and vagina may also be contributing factors to your symptoms.

Regarding whether surgery is necessary, it often depends on several factors, including:
1. Symptoms: If you are experiencing heavy bleeding, pain, or other significant symptoms, surgery may be recommended to alleviate these issues.

2. Polyp Characteristics: If there are concerns about the nature of the polyp (e.g., if it appears atypical or if there is a risk of malignancy), surgical removal is typically advised.

3. Response to Treatment: Since you mentioned having cervical and vaginal inflammation, it is generally advisable to treat these infections before proceeding with any surgical intervention. This is to ensure that the surgical site is healthy and to reduce the risk of complications.

If surgery is deemed necessary, the most common procedure for removing uterine polyps is a hysteroscopic polypectomy. This minimally invasive procedure involves inserting a hysteroscope (a thin, lighted tube) through the vagina and cervix into the uterus. The surgeon can then visualize the polyp and remove it using specialized instruments. This procedure is typically performed on an outpatient basis, meaning you can go home the same day.

In some cases, if there are multiple polyps or if the polyp is large, a dilation and curettage (D&C) may be performed, where the lining of the uterus is scraped to remove the polyp and any abnormal tissue.

Post-surgery, it is essential to follow up with your healthcare provider to monitor your recovery and ensure that any underlying issues, such as the inflammation you are experiencing, are adequately addressed. Recovery time can vary, but many women return to their normal activities within a few days.

In summary, while surgery may be necessary depending on your symptoms and the characteristics of the polyp, it is crucial to address any infections first. I recommend discussing your concerns and treatment options with your gynecologist, who can provide personalized advice based on your specific situation.

Wishing you good health and a smooth recovery!
Best regards,
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