01Endometrial polyps are protrusions or growths in the endometrium, the lining of the uterus. Contain abundant inside your blood vessels and endometrial glands that respond to hormonal stimuli.

Polyps proliferate to form a region of the basal layer of the endometrium, and are less responsiveness to hormonal changes. Taking place repetition of menses, the endometrium functional layer surrounding the polyp breaks off and becomes increasingly individual from a pedicle.

These are usually benign, but 0.5-1% may become malignant, especially after menopause.

According to their histological structure they may be functioning, hyperplastic or atrophic.

They can be single or multiple, pedunculated or sessile (broad base of implantation) and of different sizes.

This is a frequent pathology in gynecology, appearing in around 20% of the general population, mostly between 40 and 65 years old.

The most characteristic symptom is abnormal uterine bleeding in different ways: hipermenorreas or heavy menstrual bleeding, intermenstrual spotting, postmenopausal vaginal bleeding, irregular bleeding, etc.

However many cases are completely asymptomatic and are discovered after an ultrasound scan.

The ultrasound scan is the preferred method to diagnose any suspicions and the hysteroscopy will be the method to confirm the findings.  At the same time, the hysteroscopy allows us to take a biopsy of the polyp or the entire extraction without anaesthesia or sedation being necessary.

02When it is not possible to perform an ambulatory hysteroscopy + polypectomy due to the size or the number of polyps, surgical hysteroscopy may be required with anaesthesia and further surgical tools for the polypectomy and the cauterizing of the base of the polyp.

Polypectomy is recommended in any symptomatic endometrial polyps, advised when asymptomatic polyps are bigger than 1 cm and required for patients prior to assisted reproductive treatments.

Dr. José M. LozanoMedical Director of Instituto Bernabeu in Benidorm.

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