Gynaecology

The Science of Women

Polyps


What are Polyps?

Polyps are extra folds and overgrowth of the overlying skin or lining.

Endometrial Polyps are overgrowths of the endometrial lining inside the womb.

Cervix Polyps are overgrowths of the cervix lining at the endocervix or external cervix.

Why do Polyps form?

The cause of Polyps is unknown.

Hormonal imbalance and genetic factors (like abnormalities of chromosome 6 and 12) may be the cause. (Vanni et al)

An increase in p63 proteins which encourage the basal cell activity of the endometrium has also been reported. (Norgueira et al)

Who are likely to have Polyps?

Depending on the population surveyed and the diagnostic test used, 8-35% of women have Polyps.
Older women who are obese are likely to have Polyps. It seems to occur more in postmenopausal women (12%) than premenopausal women (6%).

Women with hypertension are also at risk.

Polyps are also found more often in women on Tamoxifen for breast cancer treatment.

Women taking the birth control pill have a lower risk of Polyps (2% vs 6%). (Dreisler et al)

The common symptoms of Polyp are:-

❖ abnormal and irregular vaginal bleeding
❖ pre and post menstrual spotting
❖ bleeding at sex and after exercises
❖ subfertility possibly from the Polyp blocking the fallopian tube entrances. Studies have shown higher pregnancy rates after Polyp removal. (Lieng et al)

30% of women with Polyp have no symptoms; their Polyps are found on health screening.

Symptoms do not seem to correlate with Polyp number, size or site. (Hassa et al)

What happens to a Polyp? Can it become a Cancer?

Up to 27% of Polyp can disappear after 1 year. This tends to be the case for smaller Polyps (<10mm) (Lieng et al)

The risk of Cancer in a Polyp is low. Cancer is found mostly in the postmenopausal woman with symptoms (5%). (Lieng et al)

How is a Polyp removed?

Polyp can be effectively and completely removed by a minor surgery called Hysteroscopic Polypectomy. This surgery is done with a small scope placed inside the womb. The polyp is visualised and removed with scissors or surgical loops.

Blind Dilation & Curettage (D&C) is not encouraged for Polyp removal as it is less than 50% successful and often incomplete. (Svirsky et al)