Uterine polyps are common growths within the uterus. While some individuals experience pain, it is often not the primary symptom. Irregular bleeding is more frequently reported.
Understanding Uterine Polyps
Uterine polyps, also known as endometrial polyps, are overgrowths of the endometrium, the tissue lining the inner wall of the uterus. These growths extend into the uterine cavity, attached by a broad base or a thin stalk. Their size varies significantly, from a few millimeters to several centimeters. While a single polyp can form, multiple polyps are also possible. These polyps are typically non-cancerous, though a small percentage can be pre-cancerous or cancerous.
Common Symptoms of Uterine Polyps
Many individuals with uterine polyps experience no symptoms. When symptoms occur, irregular uterine bleeding is most common. This can include heavy menstrual periods or bleeding between periods. Post-menopausal vaginal bleeding is also a significant symptom requiring medical evaluation.
Other potential symptoms include unusually long or frequent periods, unpredictable changes in menstruation, or spotting after sexual intercourse. Pain can occur, particularly with larger polyps, often described as a dull ache in the abdomen or lower back, similar to menstrual cramps. Uterine polyps can sometimes contribute to difficulty conceiving or infertility.
Diagnosing Uterine Polyps
Identifying uterine polyps often begins with a medical history review and physical examination. Imaging techniques are then employed to visualize them. A transvaginal ultrasound uses sound waves to create images of the uterus, often revealing thickened endometrial tissue or focal masses.
To enhance clarity, saline infusion sonography (SIS) or sonohysterography may be performed, involving sterile saline fluid injection to expand the uterine cavity for a clearer view. Hysteroscopy is another definitive diagnostic method, where a thin, lighted telescope is inserted into the uterus for direct visualization. During hysteroscopy, a biopsy can be performed to collect tissue samples for laboratory analysis to rule out cancerous cells.
Management and Treatment Approaches
The management of uterine polyps depends on symptom severity, patient age, and cancer risk factors. For small, asymptomatic polyps, especially in pre-menopausal individuals, watchful waiting may be recommended, as some can resolve on their own. However, if polyps cause symptoms like bleeding or pain, or if malignancy is a concern, removal is typically advised.
Surgical removal, known as polypectomy, is the standard treatment for symptomatic polyps. This procedure is most commonly performed via hysteroscopy, where instruments precisely cut and remove the polyps. The removed tissue is sent for laboratory examination to check for cancerous changes. While hormonal medications may temporarily alleviate symptoms, they are generally not a long-term solution as symptoms often return. Following polypectomy, patients may experience mild cramping and spotting, and recurrence is possible.