An endometrial polyp or uterine polyp is a mass in the inner lining of the uterus.[1] They may have a large flat base (sessile) or be attached to the uterus by an elongated pedicle (pedunculated).[2][3] Pedunculated polyps are more common than sessile ones.[4] They range in size from a few millimeters to several centimeters.[3] If pedunculated, they can protrude through the cervix into the vagina.[2][5] Small blood vessels may be present, particularly in large polyps.[2]
They often cause no symptoms.[4] Where they occur, symptoms include irregular menstrual bleeding, bleeding between menstrual periods, excessively heavy menstrual bleeding (menorrhagia), and vaginal bleeding after menopause.[3][6] 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.[7] If the polyp protrudes through the cervix into the vagina, pain (dysmenorrhea) may result.[5]
Endometrial polyps can be solitary or occur with others.[11] They are round or oval and measure between a few millimeters and several centimeters in diameter.[7][11] They are usually the same red/brown color of the surrounding endometrium although large ones can appear to be a darker red.[7] The polyps consist of dense, fibrous tissue (stroma), blood vessels and glandlike spaces lined with endometrial epithelium.[7] 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.[4]
Treatmentedit
Polyps can be surgically removed using curettage with or without hysteroscopy.[12] When curettage is performed without hysteroscopy, polyps may be missed. To reduce this risk, the uterus can be first explored using grasping forceps at the beginning of the curettage procedure.[7] Hysteroscopy involves visualising the endometrium (inner lining of the uterus) and polyp with a camera inserted through the cervix. Large polyps can be cut into sections before each section is removed.[7] The presence of cancerous cells may suggest a hysterectomy (surgical removal of the uterus).[3] A hysterectomy is usually not considered when cancer is not present.[7] In either procedure, general anesthetic is typically supplied.[10]
The effects of polyp removal on fertility has not been studied.[13]
Prognosisedit
Endometrial polyps are usually benign although some may be precancerous or cancerous.[3] About 0.5% of endometrial polyps contain adenocarcinoma cells.[14] Polyps can increase the risk of miscarriage in women undergoing IVF treatment.[3] If they develop near the fallopian tubes, they may lead to difficulty in becoming pregnant.[3] Although treatments such as hysteroscopy usually cure the polyp concerned, recurrence of endometrial polyps is frequent.[7] Untreated, small polyps may regress on their own.[15]
Epidemiologyedit
Endometrial polyps usually occur in women in their 40s and 50s.[3] Endometrial polyps occur in up to 10% of women.[2] It is estimated that they are present in 25% of women with abnormal vaginal bleeding.[8]
^WHO Classification of Tumours Editorial Board, ed. (2020). "6. Tumours of the uterine corpus: Endometrial polyp". Female genital tumours: WHO Classification of Tumours. Vol. 4 (5th ed.). Lyon (France): International Agency for Research on Cancer. p. 268. ISBN978-92-832-4504-9.
^ abcde Jane A. Bates (1997). Practical Gynaecological Ultrasound. Cambridge, UK: Cambridge University Press. ISBN1-900151-51-0.
^ abcSternberg, Stephen S.; Stacey E. Mills; Darryl Carter (2004). Sternberg's Diagnostic Surgical Pathology. Lippincott Williams & Wilkins. p. 2460. ISBN0-7817-4051-7.
^Chan SS, Tam WH, Yeo W, et al. (2007). "A randomised controlled trial of prophylactic levonorgestrel intrauterine system in tamoxifen-treated women". BJOG. 114 (12): 1510–5. doi:10.1111/j.1471-0528.2007.01545.x. PMID 17995495. S2CID 21145823.
^ abMacnair, Trisha. "Ask the doctor – Uterine polyps". BBC Health. Retrieved 2007-10-21.
^ abcBajo Arenas, José M.; Asim Kurjak (2005). Donald School Textbook Of Transvaginal Sonography. Taylor & Francis. p. 502. ISBN1-84214-331-X.
^. UCSF Medical Center. 2007-05-08. Archived from the original on 2008-04-11. Retrieved 2007-10-20.
^Jayaprakasan, K; Polanski, L; Sahu, B; Thornton, JG; Raine-Fenning, N (Aug 30, 2014). (PDF). The Cochrane Database of Systematic Reviews. 8 (8): CD009592. doi:10.1002/14651858.CD009592.pub2. PMC6544777. PMID 25172985. Archived from the original (PDF) on November 4, 2018. Retrieved November 4, 2018.
^Rubin, Raphael; David S Strayer (2007). Rubin's Pathology: Clinicopathologic Foundations of Medicine. Lippincott Williams & Wilkins. p. 806. ISBN978-0-7817-9516-6.{{cite book}}: CS1 maint: location missing publisher (link)
^Kaunitz, Andrew M. (2002-08-26). "Asymptomatic Endometrial Polyps: What Is the Likelihood of Cancer?". Medscape Ob/Gyn & Women's Health. Retrieved 2008-04-20.
External linksedit
April 18, 2024
endometrial, polyp, endometrial, polyp, uterine, polyp, mass, inner, lining, uterus, they, have, large, flat, base, sessile, attached, uterus, elongated, pedicle, pedunculated, pedunculated, polyps, more, common, than, sessile, ones, they, range, size, from, m. An endometrial polyp or uterine polyp is a mass in the inner lining of the uterus 1 They may have a large flat base sessile or be attached to the uterus by an elongated pedicle pedunculated 2 3 Pedunculated polyps are more common than sessile ones 4 They range in size from a few millimeters to several centimeters 3 If pedunculated they can protrude through the cervix into the vagina 2 5 Small blood vessels may be present particularly in large polyps 2 Endometrial polypOther namesUterine polypEndometrial polyp viewed by sonographySpecialtyGynecology Contents 1 Signs and symptoms 2 Cause 3 Diagnosis 4 Treatment 5 Prognosis 6 Epidemiology 7 See also 8 References 9 External linksSigns and symptoms edit nbsp Uterine polypsThey often cause no symptoms 4 Where they occur symptoms include irregular menstrual bleeding bleeding between menstrual periods excessively heavy menstrual bleeding menorrhagia and vaginal bleeding after menopause 3 6 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 7 If the polyp protrudes through the cervix into the vagina pain dysmenorrhea may result 5 Cause editNo definitive cause of endometrial polyps is known but they appear to be affected by hormone levels and grow in response to circulating estrogen 3 Risk factors include obesity high blood pressure and a history of cervical polyps 3 Taking tamoxifen or hormone replacement therapy can also increase the risk of uterine polyps 3 8 The use of an intrauterine system containing levonorgestrel in women taking tamoxifen may reduce the incidence of polyps 9 Diagnosis edit nbsp Micrograph of an endometrial polyp H amp E stain nbsp Myometrium smooth muscle cells versus endometrial stroma more cellular versus endometrial polyp stroma more collagenous H amp E stainEndometrial polyps can be detected by vaginal ultrasound sonohysterography hysteroscopy and dilation and curettage 3 Detection by ultrasonography can be difficult particularly when there is endometrial hyperplasia excessive thickening of the endometrium 2 Larger polyps may be missed by curettage 10 Endometrial polyps can be solitary or occur with others 11 They are round or oval and measure between a few millimeters and several centimeters in diameter 7 11 They are usually the same red brown color of the surrounding endometrium although large ones can appear to be a darker red 7 The polyps consist of dense fibrous tissue stroma blood vessels and glandlike spaces lined with endometrial epithelium 7 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 4 Treatment editPolyps can be surgically removed using curettage with or without hysteroscopy 12 When curettage is performed without hysteroscopy polyps may be missed To reduce this risk the uterus can be first explored using grasping forceps at the beginning of the curettage procedure 7 Hysteroscopy involves visualising the endometrium inner lining of the uterus and polyp with a camera inserted through the cervix Large polyps can be cut into sections before each section is removed 7 The presence of cancerous cells may suggest a hysterectomy surgical removal of the uterus 3 A hysterectomy is usually not considered when cancer is not present 7 In either procedure general anesthetic is typically supplied 10 The effects of polyp removal on fertility has not been studied 13 Prognosis editEndometrial polyps are usually benign although some may be precancerous or cancerous 3 About 0 5 of endometrial polyps contain adenocarcinoma cells 14 Polyps can increase the risk of miscarriage in women undergoing IVF treatment 3 If they develop near the fallopian tubes they may lead to difficulty in becoming pregnant 3 Although treatments such as hysteroscopy usually cure the polyp concerned recurrence of endometrial polyps is frequent 7 Untreated small polyps may regress on their own 15 Epidemiology editEndometrial polyps usually occur in women in their 40s and 50s 3 Endometrial polyps occur in up to 10 of women 2 It is estimated that they are present in 25 of women with abnormal vaginal bleeding 8 See also editCervical polyp Uterine fibroidsReferences edit WHO Classification of Tumours Editorial Board ed 2020 6 Tumours of the uterine corpus Endometrial polyp Female genital tumours WHO Classification of Tumours Vol 4 5th ed Lyon France International Agency for Research on Cancer p 268 ISBN 978 92 832 4504 9 a b c d e Jane A Bates 1997 Practical Gynaecological Ultrasound Cambridge UK Cambridge University Press ISBN 1 900151 51 0 a b c d e f g h i j k l Uterine polyps MayoClinic com 2006 04 27 a b c Sternberg Stephen S Stacey E Mills Darryl Carter 2004 Sternberg s Diagnostic Surgical Pathology Lippincott Williams amp Wilkins p 2460 ISBN 0 7817 4051 7 a b Dysmenorrhea Menstrual abnormalities at Merck Manual of Diagnosis and Therapy Professional Edition Endometrial Polyp GPnotebook Retrieved 2007 10 20 a b c d e f g h DeCherney Alan H Lauren Nathan 2003 Current Obstetric amp Gynecologic Diagnosis amp Treatment McGraw Hill Professional p 703 ISBN 0 8385 1401 4 a b Edmonds D Keith Sir John Dewhurst 2006 Dewhurst s Textbook of Obstetrics and Gynaecology Blackwell Publishing p 637 ISBN 1 4051 5667 8 Chan SS Tam WH Yeo W et al 2007 A randomised controlled trial of prophylactic levonorgestrel intrauterine system in tamoxifen treated women BJOG 114 12 1510 5 doi 10 1111 j 1471 0528 2007 01545 x PMID 17995495 S2CID 21145823 a b Macnair Trisha Ask the doctor Uterine polyps BBC Health Retrieved 2007 10 21 a b c Bajo Arenas Jose M Asim Kurjak 2005 Donald School Textbook Of Transvaginal Sonography Taylor amp Francis p 502 ISBN 1 84214 331 X Uterine bleeding Signs and Symptoms UCSF Medical Center 2007 05 08 Archived from the original on 2008 04 11 Retrieved 2007 10 20 Jayaprakasan K Polanski L Sahu B Thornton JG Raine Fenning N Aug 30 2014 Surgical intervention versus expectant management for endometrial polyps in subfertile women PDF The Cochrane Database of Systematic Reviews 8 8 CD009592 doi 10 1002 14651858 CD009592 pub2 PMC 6544777 PMID 25172985 Archived from the original PDF on November 4 2018 Retrieved November 4 2018 Rubin Raphael David S Strayer 2007 Rubin s Pathology Clinicopathologic Foundations of Medicine Lippincott Williams amp Wilkins p 806 ISBN 978 0 7817 9516 6 a href Template Cite book html title Template Cite book cite book a CS1 maint location missing publisher link Kaunitz Andrew M 2002 08 26 Asymptomatic Endometrial Polyps What Is the Likelihood of Cancer Medscape Ob Gyn amp Women s Health Retrieved 2008 04 20 External links edit Retrieved from https en wikipedia org w index php title Endometrial polyp amp oldid 1184136875, wikipedia, wiki, book, books, library,
