Uterine polyps: symptoms and treatment

Endometrial polyps are benign growth inside the uterus, common in women between 40 and 60 years. They are usually asymptomatic, although they can cause abnormal bleeding or affect fertility. They are diagnosed by ultrasound and are usually removed by hysteroscopy, since their risk of malignization, although low, is not void.

Endometrial polyps are rounded or oval formations of solid or soft solid-chemical tissue that grow inside the uterus and constitute one of the most frequent gynecological pathologies. Let’s see how they occur and how they can be treated.

How do polyps develop?

Inside the uterus grows periodically, throughout the fertile age of women, a fabric called Endometriumvery delicate and fragile, which is designed to Welcome and nurture pregnancy If this occurs. If there is no pregnancy, the tissue deteriorates, transforms and we detach from it during menstrual bleeding giving way to the construction of a new one immediately. After the menopausewhen the reproductive function no longer exists, This space is completely inactive and an empty cavity is identified.

Why do they develop?

In the bosom of this tissue is where endometrial polyps grow. The cause of its origin is uncertain, they are involved hormonal, inflammatory and genetic factors. They can be presented at any age, although they are very uncommon in women under 20 years. Its incidence increases with age, being the most frequent strip between 40 and 60.

The tissue of which they are composed includes glands and a large number of vessels, so their most common symptom are bleeding, including an increase in the volume of menstrual bleeding or intermestrual bleeding or after menopause.

What symptoms cause?

The most frequent is that they do not cause any symptoms and are diagnosed incidentally in a routine ultrasound. Other less common symptoms are pain or infertilitybecause the fact that they develop inside the cavity where pregnancy is also can limit fertility and, depending on the position of the polyp, can hinder the proper rise of spermsince it can block the tube.

Diagnosis

By one transvaginal ultrasoundduring menopause in which the endometrial cavity must be completely empty, and at certain times of the cycle in premenopausal women it is very easy to identify them as a firm nodular mass within the uterine cavity, which is refringent (with the capacity to divert or refract light) in ultrasounds and can have a size that varies from some millimeters to 1-2 cm.

The polyps that exceed 2 cm are not common. You can easily identify the arterial pedicle that nourishes it using the Ecographic Doppler function. During the second phase of the menstrual cycle its diagnosis may be more difficult because the endometrium is very grown at that time and is also ecorefringent (capable of reflecting or diverting ultrasound waves -used in ultrasound -) which can go unnoticed. In doubtful cases, ultrasound is repeated after the rule, at which time the cavity is empty.

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Treatment

When diagnosed, its surgical removal for various reasons is generally recommended:

• Although it is a benign condition, it has a very low risk of malignization, but not null, which is calculated from approximately 1%, especially in postmenopausal women.
• It is rare that they resolve themselves, and the only thing that can happen is that they continue to increase in size and end up causing symptomatology.
• Another important reason why they do not usually be observed is that the surgical procedure is quite simple and has a low rate of recurrences and complications.

This procedure is a Surgical hysteroscopy: It’s about inserting a device with camera Endoscopy by the vagina and cervix hole towards the interior of the uterus. The image is recorded by a camera, as in any endoscopy, which is reproduced in a monitor identifying the polyp inside the cavity, together with it by a more or less broad pedicle. The device includes a tool that facilitates cutting, allowing Section and extract the endometrial polyp in one piece or fragments to send it to the pathological anatomy analysis laboratory.

This procedure is commonly performed in an outpatient manner, without anesthesia or regional anesthesia or sedation, allowing hospital discharge shortly after. The frequency of complications of the procedure is minimal, and the postoperative period generally does not cause pain, allowing the back to everyday activities almost immediately.

In summary, it is one of the most frequent gynecological pathologies and, without a doubt, the most common surgical procedure in gynecology. Although it is a mostly benign entity, when its removal is planned.

What you should know …

• Endometrial polyps are fabric growths inside the uterus that can be developed due to hormonal, inflammatory and genetic factors.
• Most endometrial polyps do not cause symptoms and are detected incidentally in routine ultrasound. In some cases, they can cause abnormal bleeding or fertility problems.
• Although polyps are benign, their surgical removal is recommended because the risk of malignization is not null since they can increase in size.