Polyp Removal

Uterine Polyps

Uterine (or endometrial) polyps are noncancerous, small finger-like growths that develop on the inner lining of the uterus. These are tiny and range between a few millimeters and several centimeters in size. Polyps form when cells in the endometrium overgrow. They are most common in women in their 40s and 50s. They can develop after menopause but are rare in women younger than 20 years of age.

What Causes Uterine Polyps?

Uterine polyps can develop from several causes, including:

• Excess estrogen stimulation: Excess estrogen stimulation causes polyp growth by stimulating overgrowth of the uterine lining (endometrium). Polyps are sensitive to estrogen, and when estrogen levels are too high or fluctuating, the endometrial glands multiply without the balancing effect of progesterone to shed them. This overgrowth accumulates in a localized area and forms a protruding mass.
• Hormonal imbalance: Estrogen causes the uterine lining to thicken. Changes in estrogen levels, especially during perimenopause (40s or 50s) or if you are taking estrogen without enough progesterone, cause polyps to develop.
• Obesity: Excess body fat raises estrogen levels and greatly increases the risk of polyps. High blood pressure. The exact cause is still being studied, but high blood pressure is thought to affect hormones and blood flow, leading to too much cell growth.
• Certain medications: Medications like tamoxifen, which is used to treat breast cancer, can affect the uterus and increase your chances of developing polyps.

When Is Polyp Removal Done?

Uterine polyps grow symptomless in many women. In many cases, they are detected in fertility check-ups and imaging tests. Gynaecologists recommended hysteroscopic polyp removal in any of the following conditions:

• Heavy menstrual bleeding
• Irregular menstrual cycles
• Bleeding between periods
• Bleeding after menopause
• Infertility or difficulty conceiving
• Recurrent miscarriages
• Recurrent IVF failure
• Occasional pelvic discomfort
• Large-sized or rapidly growing polyps
• Suspicion of precancerous changes

How To Prepare for Hysteroscopic Polyp Removal?

Your gynaecologist will perform a detailed pelvic examination to confirm the condition and severity. They will do an ultrasound scan, blood investigations, and a pregnancy test (if applicable). Make sure that you tell your doctor about any previous medications, allergies, anesthesia, and serious medical conditions. You will be advised to temporarily stop the blood thinner dosage for a few days before the procedure.

Hysteroscopic Polyp Removal Procedure

• The process begins with the administration of local or general anesthesia.
• The hysteroscope, with its camera, is carefully guided by the surgeon through the cervix into the uterus. The doctor inserts a thin tube called a hysteroscope into the vagina and then into the uterus. The hysteroscope is connected to a camera that transmits video in real time to a monitor so the doctor can see the polyps clearly.
• Through the hysteroscope, special miniature instruments, such as graspers, tiny scissors, or electrosurgical loops, are inserted to snip or shave the polyp off the wall of the uterus. The excised polyp tissues are removed and stored for lab testing.
• The hysteroscope is taken out, and the entire procedure usually takes 15 to 45 minutes.

What are the Benefits of Hysteroscopic Polyp Removal?

The procedure is simple, and it has the following benefits to the patient:

• No external incision
• Minimally invasive
• Precise removal
• Preserves the uterus
• Less pain
• Minimal bleeding
• Same-day discharge (in most cases)
• Faster recovery
• Improved fertility (some patients)

How is Recovery After Hysteroscopic Polypectomy?

Recovery is usually quick, and most women are back to normal activities within one to two weeks. Most patients may have mild cramping, light spotting, and slight watery discharge. It’s better to get adequate rest during the first 24 hours. Doctors advise avoiding sexual intercourse, using tampons, and physical exercises like swimming and heavy weight lifting for about 1-2 weeks.

Risks and Possible Complications

The following are possible complications of a hysteroscopic polyp removal, although these are uncommon:

• Infection
• Bleeding
• Uterine perforation
• Fluid overload (rare)
• Cervical injury
• Incomplete removal
• Polyp recurrence

Can Removing Polyps Aid Fertility?

Yes, endometrial polyps may interfere with embryo implantation or lead to an increased risk of miscarriage. Removal will:

• Increase embryo implantation rates
• Increase natural conception rates
• Increase IVF success rates
• Reduce miscarriage risk in selected patients

However, the exact benefits are dependent on age, fertility factors, and overall reproductive health. Your gynaecologist will consider the specific benefits and risks in the initial consultation.

Can Polyps Grow Back After Hysteroscopic Removal?

Although total removal reduces the chances of reoccurrence, some women may develop new polyps over a period of time. The reoccurrence rates are heavily influenced by the underlying hormonal factors, genetics, and severity of the condition (before removal). Regular gynecological follow-up is recommended, especially if symptoms re-emerge.

When to Call Your Doctor After Polyp Removal?

Call your doctor if you experience heavy bleeding, fever, severe abdominal pain, bad-smelling vaginal discharge, persistent dizziness, and difficulty urinating. These are signs of infection, organ perforation, and serious post-operative complications.

Is Hysteroscopic Polyp Removal Painful?

The procedure is usually performed under anesthesia, so you generally do not experience pain during surgery. Mild cramping afterward is common and usually resolves within a few days. Using over-the-counter painkiller medication will help during the early days after the procedure.

How Long Does the Procedure Take?

Hysteroscopic polyp removal is a simple procedure. This procedure usually takes between 15 and 45 minutes, depending on the size, number, and location of the polyps. Most patients do not need to stay in the hospital overnight. They can return home after a few hours of observation.

Is There Any Scar After the Procedure?

No. The procedure is performed through the vagina and cervix after required dilation. Since there are no external incisions or visible scars, the procedure does not lead to scar formation.

Will the Removed Polyp be Tested?

Yes. The removed tissue is usually sent to a laboratory for histopathological examination. Microscopic observation will be performed by a qualified and certified specialist. To confirm whether it is benign, precancerous, or cancerous in nature and to detect any abnormal changes.