Treatment Of Uterine Polyps

Contents

• How Are Uterine Polyps Treated?
• Is A Large Polyp More Likely To Be Cancerous?
• Medications For Treating Uterine Polyps
• Surgical Treatment
• Natural Treatment

Topic Overview

Guide to Polyps

Uterine Polyps
Causes
Symptoms

How Are Uterine Polyps Treated?

If you are diagnosed with one or more uterine (endometrial) polyps, you are likely to ask your doctor "what is the chance the polyp is cancerous?” and “is removal necessary?”. In the first instance, the risk of cancer is less than 1 percent - fortunately the vast majority of both uterine and cervical polyps are benign. The second question is a little harder to answer because there are no established treatment protocols. Studies show that postmenopausal women with symptoms (primarily vaginal bleeding) are most at risk of polyps turning cancerous; and so removal is recommended. If polyps become very large and cause problems such as infertility (see symptoms of uterine polyps), then treatment is also recommended.

In asymptomatic women (those displaying no symptoms), the benefit of removing polyps is less clear. Around 25 percent of polyps disappear spontaneously without treatment over the course of 12 months. Smaller polyps, that is, those under 1cm in size, are most likely to regress because they don't have a central feeding blood vessel. Even in asymptomatic postmenopausal women, small polyps are unlikely to be malignant and observation may be the first line of treatment. However, those with a family history of endometrial cancer should consider polyp removal.

Is A Large Polyp More Likely To Be Cancerous?

No, studies show that there is no connection between the size of a polyp and cancer risk.

Medications For Treating Uterine Polyps

Hormone therapy can help to treat polyps and even prevent their formation, but success is limited and as soon as therapy is stopped, the polyps start growing again. Therapies include the use of a levonorgestrel releasing intrauterine device (Mirena coil). Read about the causes of uterine polyps and the effects of estrogen.

Surgical Treatment

Investigation (diagnosis) and the removal of polyps is usually carried out under general anesthetic (95 percent of cases, 5 percent are carried out with epidural anesthesia). In the past the only treatment available was a hysterectomy. Fortunately these days, new and less drastic medical procedures are available.

Dilation And Curettage (D&C)
A D&C procedure is where the doctor uses a long metal instrument with a loop on the end of it to scrape out the lining of your uterus. This can be done to collect a sample for biopsy or to remove a polyp. If the D&C is performed without first looking at the womb with a hysteroscope (a thin tube with a camera) it is called a 'blind curettage'. Reports show that a blind curettage is only successful in removing polyps in 8 percent of cases. The success rate is increased to 41 percent with the addition of a polyp forceps (a long tweezers that grips and twists the polyp off). If malignancy is suspected, a D&C with hysteroscopy is the treatment of choice because the polyp and surrounding tissue can be investigated and scrapped.

Hysteroscopic Resection/Polypectomy
Hysteroscopic resection (also called hysteroscopic polypectomy) has become the gold standard in the treatment of symptomatic polyps. That is, where there is abnormal vaginal bleeding, postmenopausal bleeding and infertility - but where polyps are localized in one area and considered benign. During the procedure a hysteroscope is passed into the vagina and up into the uterus. Another special instrument (loop wire) is inserted and placed around the polyp - an electrical current is passed through the wire which cuts the polyp (resection). The operation is relatively minor and takes about 45 minutes to perform. Some hospitals offer it as a day-case, others require you stay overnight. The hysteroscopy allows, under visual control, the complete removal of the base of the polyp, which prevents the likely recurrence on the same site. Of the polyp is to recur, it is likely to do so within the first year. The recurrence rate varies from study to study, but is between 2 and 5 percent. While the removal of polyps does not greatly improve heavy periods, it is usually very successful in curing breakthrough bleeding and postmenopausal bleeding. Polypectomy in women diagnosed with infertility improves fertility rates by anywhere between 40 and 80 percent. Both spontaneous pregnancy (natural) and IVF success rates are increased significantly.

Hysterectomy
If polyps remain persistent and symptomatic, a hysterectomy (complete removal of the womb) is the final line of treatment. It is only an option for women who have finished having children.

Natural Treatment

Alternative therapies such as naturopathic medicine may help in shrinking the size of polyps and in so doing, reduce unwanted symptoms. A typical approach of a naturopath would be first to identify and address potential underlying causes in your lifestyle - such as obesity and diet. Where appropriate, a number of different therapeutic treatments will be suggested, including:

• Herbal medicines.
• Hydrotherapy, the use of water to stimulate circulation.
• Inner body cleansing detox.
• Nutritional supplements.
• Homeopathic medicines.
• Acupuncture.
• Bowen Therapy, a simple hands on therapy that helps to reduce pain.
• Lifestyle counseling.
• Relaxation and meditation techniques.

Related Articles on Polyps

For more on related conditions, see the following:

• Treatment of cervical polyps and causes of cervical polyps.
• Cervical polyps in pregnancy: Treatment and management.

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