Endometrial polyp | |
---|---|
Other names | Uterine polyp |
Endometrial polyp, viewed by sonography | |
Specialty | Gynecology |
An endometrial polyp or uterine polyp is a mass in the inner lining of the uterus. [1] They may have a large flat base ( sessile) or be attached to the uterus by an elongated pedicle ( pedunculated). [2] [3] Pedunculated polyps are more common than sessile ones. [4] They range in size from a few millimeters to several centimeters. [3] If pedunculated, they can protrude through the cervix into the vagina. [2] [5] Small blood vessels may be present, particularly in large polyps. [2]
They often cause no symptoms. [4] Where they occur, symptoms include irregular menstrual bleeding, bleeding between menstrual periods, excessively heavy menstrual bleeding ( menorrhagia), and vaginal bleeding after menopause. [3] [6] Bleeding from the blood vessels of the polyp contributes to an increase of blood loss during menstruation and blood "spotting" between menstrual periods, or after menopause. [7] If the polyp protrudes through the cervix into the vagina, pain ( dysmenorrhea) may result. [5]
No definitive cause of endometrial polyps is known, but they appear to be affected by hormone levels and grow in response to circulating estrogen. [3] Risk factors include obesity, high blood pressure and a history of cervical polyps. [3] Taking tamoxifen or hormone replacement therapy can also increase the risk of uterine polyps. [3] [8] The use of an intrauterine system containing levonorgestrel in women taking tamoxifen may reduce the incidence of polyps. [9]
Endometrial polyps can be detected by vaginal ultrasound (sonohysterography), hysteroscopy and dilation and curettage. [3] Detection by ultrasonography can be difficult, particularly when there is endometrial hyperplasia (excessive thickening of the endometrium). [2] Larger polyps may be missed by curettage. [10]
Endometrial polyps can be solitary or occur with others. [11] They are round or oval and measure between a few millimeters and several centimeters in diameter. [7] [11] They are usually the same red/brown color of the surrounding endometrium although large ones can appear to be a darker red. [7] The polyps consist of dense, fibrous tissue ( stroma), blood vessels and glandlike spaces lined with endometrial epithelium. [7] If they are pedunculated, they are attached by a thin stalk (pedicle). If they are sessile, they are connected by a flat base to the uterine wall. [11] Pedunculated polyps are more common than sessile ones. [4]
Polyps can be surgically removed using curettage with or without hysteroscopy. [12] When curettage is performed without hysteroscopy, polyps may be missed. To reduce this risk, the uterus can be first explored using grasping forceps at the beginning of the curettage procedure. [7] Hysteroscopy involves visualising the endometrium (inner lining of the uterus) and polyp with a camera inserted through the cervix. Large polyps can be cut into sections before each section is removed. [7] The presence of cancerous cells may suggest a hysterectomy (surgical removal of the uterus). [3] A hysterectomy is usually not considered when cancer is not present. [7] In either procedure, general anesthetic is typically supplied. [10]
The effects of polyp removal on fertility has not been studied. [13]
Endometrial polyps are usually benign although some may be precancerous or cancerous. [3] About 0.5% of endometrial polyps contain adenocarcinoma cells. [14] Polyps can increase the risk of miscarriage in women undergoing IVF treatment. [3] If they develop near the fallopian tubes, they may lead to difficulty in becoming pregnant. [3] Although treatments such as hysteroscopy usually cure the polyp concerned, recurrence of endometrial polyps is frequent. [7] Untreated, small polyps may regress on their own. [15]
Endometrial polyps usually occur in women in their 40s and 50s. [3] Endometrial polyps occur in up to 10% of women. [2] It is estimated that they are present in 25% of women with abnormal vaginal bleeding. [8]
{{
cite book}}
: CS1 maint: location missing publisher (
link)
Endometrial polyp | |
---|---|
Other names | Uterine polyp |
Endometrial polyp, viewed by sonography | |
Specialty | Gynecology |
An endometrial polyp or uterine polyp is a mass in the inner lining of the uterus. [1] They may have a large flat base ( sessile) or be attached to the uterus by an elongated pedicle ( pedunculated). [2] [3] Pedunculated polyps are more common than sessile ones. [4] They range in size from a few millimeters to several centimeters. [3] If pedunculated, they can protrude through the cervix into the vagina. [2] [5] Small blood vessels may be present, particularly in large polyps. [2]
They often cause no symptoms. [4] Where they occur, symptoms include irregular menstrual bleeding, bleeding between menstrual periods, excessively heavy menstrual bleeding ( menorrhagia), and vaginal bleeding after menopause. [3] [6] Bleeding from the blood vessels of the polyp contributes to an increase of blood loss during menstruation and blood "spotting" between menstrual periods, or after menopause. [7] If the polyp protrudes through the cervix into the vagina, pain ( dysmenorrhea) may result. [5]
No definitive cause of endometrial polyps is known, but they appear to be affected by hormone levels and grow in response to circulating estrogen. [3] Risk factors include obesity, high blood pressure and a history of cervical polyps. [3] Taking tamoxifen or hormone replacement therapy can also increase the risk of uterine polyps. [3] [8] The use of an intrauterine system containing levonorgestrel in women taking tamoxifen may reduce the incidence of polyps. [9]
Endometrial polyps can be detected by vaginal ultrasound (sonohysterography), hysteroscopy and dilation and curettage. [3] Detection by ultrasonography can be difficult, particularly when there is endometrial hyperplasia (excessive thickening of the endometrium). [2] Larger polyps may be missed by curettage. [10]
Endometrial polyps can be solitary or occur with others. [11] They are round or oval and measure between a few millimeters and several centimeters in diameter. [7] [11] They are usually the same red/brown color of the surrounding endometrium although large ones can appear to be a darker red. [7] The polyps consist of dense, fibrous tissue ( stroma), blood vessels and glandlike spaces lined with endometrial epithelium. [7] If they are pedunculated, they are attached by a thin stalk (pedicle). If they are sessile, they are connected by a flat base to the uterine wall. [11] Pedunculated polyps are more common than sessile ones. [4]
Polyps can be surgically removed using curettage with or without hysteroscopy. [12] When curettage is performed without hysteroscopy, polyps may be missed. To reduce this risk, the uterus can be first explored using grasping forceps at the beginning of the curettage procedure. [7] Hysteroscopy involves visualising the endometrium (inner lining of the uterus) and polyp with a camera inserted through the cervix. Large polyps can be cut into sections before each section is removed. [7] The presence of cancerous cells may suggest a hysterectomy (surgical removal of the uterus). [3] A hysterectomy is usually not considered when cancer is not present. [7] In either procedure, general anesthetic is typically supplied. [10]
The effects of polyp removal on fertility has not been studied. [13]
Endometrial polyps are usually benign although some may be precancerous or cancerous. [3] About 0.5% of endometrial polyps contain adenocarcinoma cells. [14] Polyps can increase the risk of miscarriage in women undergoing IVF treatment. [3] If they develop near the fallopian tubes, they may lead to difficulty in becoming pregnant. [3] Although treatments such as hysteroscopy usually cure the polyp concerned, recurrence of endometrial polyps is frequent. [7] Untreated, small polyps may regress on their own. [15]
Endometrial polyps usually occur in women in their 40s and 50s. [3] Endometrial polyps occur in up to 10% of women. [2] It is estimated that they are present in 25% of women with abnormal vaginal bleeding. [8]
{{
cite book}}
: CS1 maint: location missing publisher (
link)