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Endometrial polyp

Endometrial polyp
Classification & external resources
ICD-10 N84.0
ICD-9 621

An endometrial polyp or uterine polyp is a polyp or lesion in the lining of the uterus (endometrium) that takes up space within the uterine cavity. Commonly occurring, they are experienced by up to 10% of women.[1] They may have a large flat base (sessile) or be attached to the uterus by an elongated pedicle (pedunculated).[1][2] Pedunculated polyps are more common that sessile ones.[3] They range in size from a few millimeters to several centimeters.[2] If pedunculated, they can protrude through the cervix into the vagina.[1][4] Small blood vessels may be present in polyps, particularly large ones.[1]


Cause and symptoms

No definitive cause of endometrial polyps is known, but they appear to be affected by hormone levels and grow in response to circulating estrogen.[2] They often cause no symptoms.[3] Where they occur, symptoms include irregular menstrual bleeding, bleeding between menstrual periods, excessively heavy menstrual bleeding (menorrhagia), and vaginal bleeding after menopause.[2][5] 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.[6] If the polyp protrudes through the cervix into the vagina, pain (dysmenorrhea) may result.[4]


Endometrial polyps can be detected by vaginal ultrasound (sonohysterography), hysteroscopy and dilation and curettage.[2] Detection by ultrasonography can be difficult, particularly when there is endometrial hyperplasia (excessive thickening of the endometrium).[1] Larger polyps may be missied by curettage.[7]


Polyps can be surgically removed using curettage or hysterescopy.[8] When curettage is performed, polyps may be missed. To reduce this risk, the uterus can be first explored using grasping forceps at the beginning of the curettage procedure.[6] During hysterescopy, the polyp can be visualized and removed through the cervix. If it is a large polyp, it can be cut into sections before each section is removed.[6] If cancerous cells are discovered, a hysterectomy may be performed.[2] A hysterectomy would usually not be considered if cancer has been ruled out.[6] Whichever method is used, polyps are usually treated under general anesthetic.[7]

Prognosis and complications

Endometrial polyps are usually benign although some may be precancerous or cancerous.[2] About 0.5% of endometrial polyps contain adenocarcinoma cells.[9] Polyps can increase the risk of miscarriage in women undergoing IVF treatment.[2] If they develop near the fallopian tubes, they may lead to difficulty in becoming pregnant.[2] Although treatments such as hysterescopy usually cure the polyp concerned, recurrence of endometrial polyps is frequent.[6]

Risk factors and epidemiology

Endometrial polyps usually occur in women in their 40s and 50s.[2] Risk factors include obesity, high blood pressure and a history of cervical polyps.[2] Taking tamoxifen or hormone replacement therapy can also increase the risk of uterine polyps.[2][10] Endometrial polyps occur in up to 10% of women.[1] It is estimated that they are present in 25% of women with abnormal vaginal bleeding.[10]


Endometrial polyps can be solitary or occur with others.[11] They are round or oval and measure between a few millimeters to several centimeters in diameter.[11][6] They are usually the same red/brown color of the surrounding endometrium although large ones can appear to be a darker red.[6] The polyps consist of dense, fibrous tissue (stroma), blood vessels and glandlike spaces lined with endometrial epithelium.[6] 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.[3]

See also


  1. ^ a b c d e f Bates, Jane (2007). Practical Gynaecological Ultrasound. Cambridge University Press, 65. ISBN 1900151510. 
  2. ^ a b c d e f g h i j k l Uterine polyps. (2006-04-27). Retrieved on 2007-10-20.
  3. ^ a b c Sternberg, Stephen S.; Stacey E. Mills, Darryl Carter (2004). Sternberg's Diagnostic Surgical Pathology. Lippincott Williams & Wilkins, 2460. ISBN 0781740517. 
  4. ^ a b Dysmenorrhea: Menstrual abnormalities. Merck Manual of Diagnosis and Therapy (2005). Retrieved on 2007-10-20.
  5. ^ Endometrial Polyp. GPnotebook. Retrieved on 2007-10-20.
  6. ^ a b c d e f g h DeCherney, Alan H.; Lauren Nathan (2003). Current Obstetric & Gynecologic Diagnosis & Treatment. McGraw-Hill Professional, 703. ISBN 0838514014. 
  7. ^ a b Macnair, Trisha. Ask the doctor - Uterine polyps. BBC Health. Retrieved on 2007-10-21.
  8. ^ Uterine bleeding - Signs and Symptoms. UCSF Medical Center (2007-05-08). Retrieved on 2007-10-20.
  9. ^ Rubin, Raphael; David S Strayer (2007). Rubin's Pathology: Clinicopathologic Foundations of Medicine, 806. ISBN 0781795168. 
  10. ^ a b Edmonds, D. Keith; Sir John Dewhurst (2006). Dewhurst's Textbook of Obstetrics and Gynaecology. Blackwell Publishing, 637. ISBN 1405156678. 
  11. ^ a b c Bajo Arenas, José M.; Asim Kurjak (2005). Donald School Textbook Of Transvaginal Sonography. Taylor & Francis, 502. ISBN 184214331X. 
This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Endometrial_polyp". A list of authors is available in Wikipedia.
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