Version May 2024
| Indications for endometrial polyp removal | Comments |
| Bleeding | Bleeding (ie, abnormal uterine bleeding, postmenopausal bleeding) is the most common presenting symptom and is associated with an increased risk of malignancy compared with patients without symptoms[1]. |
| Infertility | Most clinicians perform polypectomy in patients with infertility, although data regarding the impact of polyp removal on fertility are limited[2]. |
| Multiple polyps | Multiple polyps are unlikely to regress and are likely to become symptomatic. |
| Prolapsed polyps | Prolapsed polyps are unlikely to regress, are likely to become symptomatic, and can typically be removed easily in an outpatient setting. |
| Recurrent polyps | While many clinicians remove recurrent polyps, data regarding management are limited. |
| Risk factors for endometrial hyperplasia or cancer | Risk factors for endometrial hyperplasia or carcinoma include chronic ovulatory dysfunction, obesity, early menarche, late menopause, increasing age, tamoxifen therapy, Lynch syndrome, and Cowden syndrome. These vary in degree of risk and are discussed in more detail in related UpToDate topics. |
| Large polyp size | Data are inconsistent regarding whether increased polyp size is associated with malignancy. Some studies report that polyps >1.5 cm in diameter are associated with an increased risk of malignancy or hyperplasia[3], although lower thresholds have been reported[4]. |
Most endometrial polyps are removed with polypectomy under hysteroscopic guidance. Occasionally, an endometrial polyp prolapses through the cervix and can be removed vaginally.
While many patients without the above indications can be managed expectantly, counseling must be individualized, and patients who remain concerned about the risk of malignancy may reasonably choose to undergo removal.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
