Removal of uterine polyps

A polyp is an overgrowth of endometrial tissue in the uterus. The tumor is shaped like a wart or fungus and is usually benign. But if you ignore the treatment, it can eventually transform into malignant. Many patients believe that the removal of polyps in the uterus is not a mandatory procedure, if they do not cause discomfort. The consequences of this approach are bleeding, inflammation, heavy and painful menstruation, infertility.

The decision on the operation the gynecologist and the patient make together. The doctor explains the degree of possible risk and consequences of refusal of polypectomy.

Indications for surgery are:

• progression of the pathological process: the size of the polyp increases, the symptoms increase, the histology results change;

• the tumor is of medium or large size;

• inability to achieve the effect by means of medical treatment;

• detection of cancer cells;

•  the patient’s age exceeds 40 years (in this case, hormonal changes will provoke the growth of the polyp, increasing the risk of cancer).

It is possible to postpone the decision only in case of pregnancy but only if there are no  dangerous symptoms, and, if the polyp was reduced in size under the influence of medication or if the disease is asymptomatic and slow.

Contraindications to polypectomy are:

• diseases of the external genitals of any origin (cancer, venereal, fungal);

• pathology of the cervix that does not allow to perform the surgery (cancer, stenosis and other);

• infectious diseases in the acute stage;

• aggravated chronic diseases (high blood pressure, thrombophlebitis, exacerbation of ulcers, etc.);

• bleeding caused by another gynecological disease.

In such situations it is necessary to eliminate the reason which does not allow to perform the operation.

Before the polypectomy procedure the gynecologist conducts a conversation with the patient. During the conversation the doctor tells about the upcoming intervention and the course of the operation, as well as instructs on the preparation.

Preparation for polypectomy

Preparation begins with the full diagnostic examination described above. In addition, the patient must do an ECG, fluorography and test blood for hepatitis, syphilis and HIV. One week before polypectomy it is necessary to refrain from sexual intercourses.

The day before the procedure it is undesirable:

• to use vaginal tablet;

• to do vaginal douching;

• to use medical tampons;

• to use suppository.

Polypectomy is performed on the third day after the end of menstruation (during this period the endometrium is no longer rejected, but is not yet fully restored). The day before it is recommended to follow a diet.

In the "Oxford medical" clinic in Kiev the removal of polyps is carried out in two ways:

1. Scraping - minimally invasive surgery, which is performed under local anesthesia or general anesthesia (depending on the location and size of the polyp, and on patient’s wishes). The method does not involve a hospital stay. After the procedure the patient can immediately go home. The duration of the procedure is about 1 hour.

2. Hysteroscopy - is carried out with the help of a special device with a camera (hysteroscope), which gives visual access to the intrauterine space and the cervix. It is carried out under general anesthesia, lasts from 15 minutes to 2 hours.

Hysteroscopy procedure favorably differs from scraping due to the following factors:

• Informative - the doctor analyzes the high-quality  image that is displayed on the monitor in real time;
• the procedure is not traumatic;
• possibility to carry out both diagnostic and therapeutic measures simultaneously;
• ability to take tissues for laboratory analysis.