Polyps are small tumour like growth found inside the uterine cavity and are usually overgrowth of cells in the lining of the uterus (endometrium). Uterine polyps are usually non cancerous overgrowth, although some can be cancerous or can eventually turn into cancer (precancerous polyps).Hence when suspected it is advised to be removed and subjected to histopathology.Polyps are localized, pedunculated or sessile tissue growths, soft in consistency and presents with abnormal bleeding. The women can suffer from heavy bleeding or irregular bleeding. Intrauterine polyps can be a cause for infertility as well. Women usually present with this in theirlate reproductive years. However polyps are also an important cause of postmenopausal bleeding. Ultrasound can diagnose polyps but a thick endometrium seen in ultrasound raises the suspicion of polyp. The confirmation is made on hysteroscopy when the polyp can be directly visualized.
Signs and symptoms of uterine polyps
- Irregular menstrual bleeding
- Spotting or heavy bleeding in between menstrual cycles.
- Heavy menstrual periods
- Vaginal bleeding after menopause
Abnormal hormonal secretion play a role in polyp formation. Uterine polyps are estrogen-sensitive, and are found often in women with excessive estrogen secretion. Once removed with hysteroscope, progesterone therapy in form of cyclical progesterones or LNG-IUCD (Mirena) is advised to prevent recurrence.
Hysteroscopicpolypectomy is the gold standard treatment of symptomatic polyps. During the procedure a hysteroscope is passed into the vagina and into the uterus. After visualizing the polyp, the base is identified and is then removed using either a scissors, loop or bipolar needle. Complete removal of the base of the polyp prevents the likelyhood of recurrence on the same site. The operation is relatively minor and takes about 30 minutes to perform. It is almost always done as day care surgery. The removed polyp is then sent for histopathological examination. Removing polyps can improve the intermenstrual and post menopausal bleeding, preventing the need for a major surgery like hysterectomy. It also improves fertility in women suffering from infertility due to polyps.
Was invited to operate at Raipur Medical College at the FOGSI North Zone Yuva Congress. Dr Rooma Sinha demonstrated urogynecological surgeries for the delegates and later also gave lecture on setting standards for caesarean Section.