Endometrial polyps are surface-swelling lesions arising from the endometrium layer that lines the inner part of the uterus. These lesions look similar to skin tags in shape. Endometrial polyps can be detected both during the reproductive age and after menopause.
The location of the polyps in the uterus may vary. There may be a single endometrial polyp in the uterus, or there may be multiple polyps. The cause of the formation of endometrial polyps is not clearly known today.
There is an increased growth response to the estrogen hormone due to various genetic changes in endometrial polyp cells. For this reason, polyp tissue tends to grow more than other areas in the uterus.
Endometrial polyps are common in women of reproductive age. It is detected less frequently in young women. Generally, the incidence of endometrial polyps increases with age. However, endometrial polyps are detected less frequently in menopause. In a study, it was stated that endometrial polyps were detected at a rate of 12% in pre-menopausal women and 6% in post-menopausal women. Situations that are risky for endometrial polyp formation are obesity, use of drugs containing estrogen hormones (post-menopausal hormone replacement therapy), tamoxifen use and some genetic syndromes (e.g. Lynch syndrome).
Some endometrial polyps may not cause any symptoms, routinely. It can be detected during ultrasonography during gynecological control. The most common symptom of endometrial polyps is abnormal vaginal bleeding. The most common type of bleeding in women of reproductive age is abnormal vaginal bleeding that occurs between menstruations. They can also cause bleeding after menopause. These bleeding may be in the form of spotting or may be similar to menstrual bleeding.
For diagnosis, the hysterosonography method is used, in which the polyp is clearly detected by administering sterile saline into the uterus during ultrasound evaluation of the uterus. In cases where the diagnosis is uncertain, imaging the inside of the uterus with a camera (hysteroscopy) can be used. For a definitive diagnosis of polyps, they must be completely removed and sent for pathological examination.
In the pathological examination of endometrial polyps, most of them (95%) are benign. It is known that it does not contain cancer. While the risk of cancer before menopause is only 1%, the risk of cancer increases to approximately 5% in polyps detected after menopause. In addition, the likelihood of cancer being detected in polyps that cause abnormal bleeding is higher than in those that do not. For this reason, caution should be taken in terms of cancer risk, especially in polyps detected during menopause and accompanied by vaginal bleeding.
Endometrial polyps are occasionally encountered in women who want to have children. It is recommended to remove endometrial polyps when they are detected in patients undergoing infertility treatment.
Removal of endometrial polyps is performed by hysteroscopy. In this method, the location and size of the polyps are clearly determined by entering the uterus with a camera. With the same method, polyps can be removed by cutting them from their base with the help of various instruments.
The removed pieces are sent to pathologists for examination and it is determined whether there is any cancer. The procedure is usually performed under general anesthesia and takes approximately half an hour. After the operation, our patients can usually go home the same day and the pain is minimal. You can return to normal life within a few days.
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