During a transvaginal ultrasound, your doctor or a medical technician inserts a wandlike device (transducer) into your vagina while you lie on your back on an exam table. The transducer emits sound waves that generate images of your pelvic organs.
During hysterosonography (his-tur-o-suh-NOG-ruh-fee), your doctor uses a thin, flexible tube (catheter) to inject salt water (saline) into the hollow part of your uterus. Using an ultrasound probe, your doctor obtains images of the inside of your uterus and checks for any irregularities.
During hysteroscopy, your doctor uses a thin, lighted instrument (hysteroscope) to view the inside of your uterus.
If your doctor suspects you have uterine polyps, he or she might perform one of the following:
Transvaginal ultrasound. A slender, wand-like device placed in your vagina emits sound waves and creates an image of your uterus, including its interior. Your doctor may see a polyp that's clearly present or may identify a uterine polyp as an area of thickened endometrial tissue.
A related procedure, known as hysterosonography (his-tur-o-suh-NOG-ruh-fee) — also called sonohysterography (son-oh-his-tur-OG-ruh-fee) — involves having salt water (saline) injected into your uterus through a small tube threaded through your vagina and cervix. The saline expands your uterine cavity, which gives the doctor a clearer view of the inside of your uterus during the ultrasound.
- Hysteroscopy. Your doctor inserts a thin, flexible, lighted telescope (hysteroscope) through your vagina and cervix into your uterus. Hysteroscopy allows your doctor to examine the inside of your uterus.
- Endometrial biopsy. Your doctor might use a suction catheter inside the uterus to collect a specimen for lab testing. Uterine polyps may be confirmed by an endometrial biopsy, but the biopsy could also miss the polyp.
Most uterine polyps are noncancerous (benign). However, some precancerous changes of the uterus (endometrial hyperplasia) or uterine cancers (endometrial carcinomas) appear as uterine polyps. Your doctor will likely recommend removal of the polyp and will send a tissue sample for lab analysis to be certain you don't have uterine cancer.
For uterine polyps, your doctor might recommend:
- Watchful waiting. Small polyps without symptoms might resolve on their own. Treatment of small polyps is unnecessary unless you're at risk of uterine cancer.
- Medication. Certain hormonal medications, including progestins and gonadotropin-releasing hormone agonists, may lessen symptoms of the polyp. But taking such medications is usually a short-term solution at best — symptoms typically recur once you stop taking the medicine.
- Surgical removal. During hysteroscopy, instruments inserted through the hysteroscope — the device your doctor uses to see inside your uterus — make it possible to remove polyps. The removed polyp will likely be sent to a lab for microscopic examination.
If a uterine polyp contains cancerous cells, your doctor will talk with you about the next steps in evaluation and treatment.
Rarely, uterine polyps can recur. If they do, you might need more treatment.
Preparing for your appointment
Your first appointment will likely be with either your primary care provider or a gynecologist.
What you can do
- Write down your symptoms and when they began. Include all of your symptoms, even if you don't think they're related.
- Make a list of medications, vitamins and supplements you take. Write down doses and how often you take them.
- Have a family member or friend accompany you, if possible. He or she can help you remember the information you receive.
- Take a notebook or notepad with you. Use it to jot down important information during your visit.
- List questions to ask your doctor. This will help you remember what you want to know.
For uterine polyps, some basic questions to ask include:
- What could be causing my symptoms?
- What tests might I need?
- Are medications available to treat my condition?
- What side effects can I expect from medication use?
- Under what circumstances do you recommend surgery?
- Could uterine polyps affect my ability to become pregnant?
- Will treatment of uterine polyps improve my fertility?
- Can uterine polyps be cancerous?
Don't hesitate to ask other questions.
What to expect from your doctor
Some questions your doctor might ask include:
- When did your symptoms start?
- How often do you have these symptoms?
- How severe are your symptoms?
- Does anything seem to improve your symptoms?
- Does anything seem to make your symptoms worse?
- Have you been treated for uterine polyps or cervical polyps before?
- Have you had fertility problems? Do you want to become pregnant?
- Does your family have a history of breast, colon or endometrial cancer?
Dec. 17, 2020
- Stewart EA. Endometrial polyps. https://www.uptodate.com/contents/search. Accessed Dec. 10, 2020.
- Cooper NAM, et al. Outpatient versus inpatient uterine polyp treatment for abnormal uterine bleeding: Randomised controlled non-inferiority study. British Medical Journal. 2015;350:h1398.
- Salim S, et al. Diagnosis and management of endometrial polyps: A critical review of the literature. The Journal of Minimally Invasive Gynecology. 2011;18:569.