Polyps are elevated lesions originating from the lining of hollow organs such as the uterus, bladder, gallbladder, and intestines. When a polyp is located within the uterus, it is referred to as an endometrial polyp. The prevalence of endometrial polyps in the community has been documented in the literature as 6 per 100 women. Endometrial polyps are associated with abnormal menstrual bleeding, intermenstrual bleeding, threatened miscarriage during pregnancy, and difficulties in achieving pregnancy. Endometrial polyps can be observed in both women of reproductive age and postmenopausal women.
Endometrial polyps occur due to fluctuations in estrogen and progesterone hormones, with a relative excess of estrogen or insufficient progesterone during the monthly menstrual cycle. The increased occurrence of endometrial polyps in patients with polycystic ovary syndrome (PCOS), who have ovulation problems, is attributed to this factor. Theoretically, endometrial polyp cells can undergo transformation, approximately at a rate of 1%, leading to the development of cancer cells. Therefore, endometrial polyps should be monitored, and in cases of growth, bleeding, or difficulties in achieving pregnancy, they should be removed through hysteroscopy and sent for pathological examination.
The diagnosis of endometrial polyps can be easily visualized through pelvic ultrasound. Some endometrial polyps can also be detected on a uterine X-ray without causing any symptoms.
The risk factors for endometrial polyps include polycystic ovary syndrome, hormone therapy, obesity, postmenopausal hormone replacement therapy, the use of tamoxifen and letrozole drugs in breast cancer treatment, and Lynch syndrome (a hereditary condition associated with an increased risk of polyps and cancer development in the colon).
The risk of endometrial polyps transforming into cancer is 1% in premenopausal women, but it increases fivefold when detected in postmenopausal women. A pathological evaluation must be performed, and consideration should be given to family history and medication use.
The gold standard for the treatment of endometrial polyps is hysteroscopic resection, which involves surgically removing them. The procedure can be performed as a day case under general anesthesia in hospital conditions and typically takes about 30 minutes.
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