Medical Edge Newspaper Column

Surgery to Remove Uterine Polyp Safe and Effective

August 29, 2008
Dear Mayo Clinic:
I am 28 years old and haven't had children yet. I recently had some bleeding and spotting between periods. A pelvic ultrasound revealed a 1 cm by 0.5 cm polyp. My doctor suggested an operative hysteroscopy to remove it. I am a bit scared by the surgery, and wonder if it's really necessary.

Answer:
A uterine polyp is a growth attached to the inner wall of the uterus. Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps. These polyps are usually noncancerous (benign), but they require treatment to eliminate the symptoms.

An operative hysteroscopy is the best approach for treating a uterine polyp like yours. Some small polyps that don't cause symptoms may go away on their own. In those cases, watchful waiting may be appropriate. Due to the size of the polyp you describe and the bleeding you're experiencing, I wouldn't recommend that approach for you.

Though the surgery is necessary, it doesn't have to be scary. An operative hysteroscopy is a minor outpatient surgery. It doesn't require a hospital stay. During the procedure, your doctor will insert a thin, flexible, lighted scope through your vagina and cervix into your uterus. This allows your doctor to see into your uterus and identify the polyp. Your doctor will then insert surgical instruments through the hysteroscope to remove the polyp.

Anesthesia usually is used to decrease discomfort during an operative hysteroscopy. Before the procedure, talk to your doctor about the type of anesthesia and pain control that's right for your situation.

Although most uterine polyps are benign, some precancerous changes of the uterus, such as endometrial hyperplasia, or actual uterine cancers can appear as uterine polyps. After your procedure, your doctor will send the polyp to a laboratory for pathologic evaluation to confirm that it's noncancerous.

In most cases, operative hysteroscopy resolves the problem and no follow-up treatment is needed. You can be confident that an operative hysteroscopy is a safe procedure with few risks. It won't have an impact on your ability to have children in the future.

If you have other questions or concerns about uterine polyps, talk to your doctor about them before you undergo treatment.

—Petra Casey, M.D., Obstetrics and Gynecology, Mayo Clinic, Rochester, Minn.