Can endometrial polyps be misdiagnosed?

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 06, 2024
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Endometrial polyps can be misdiagnosed as they are caused by excessive proliferation of the endometrial lining. Clinically, the thickness of the endometrium varies throughout the menstrual cycle. Typically, just before menstruation, the endometrium is quite thick. As a result, some women might notice that their endometrium appears thick, resembling a polyp. If such a condition is observed, it is advisable to wait until after a menstrual period when the endometrium has shed before undergoing an ultrasound examination. If it is indeed an endometrial polyp, it will not shed with the menstrual flow. If it’s just thickened endometrium, it will resolve after menstruation. Therefore, it is essential to perform an ultrasound after menstruation to confirm if it is an endometrial polyp. If the polyp persists after a clean menstrual cycle, it can be diagnosed definitively.

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Written by Zhang Chun Yun
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How to treat malignant endometrial polyps?

Endometrial polyps rarely become malignant, but there is indeed the possibility of cancerous changes, so it is generally best to visit the hospital once diagnosed with endometrial polyps for accurate diagnosis and to receive appropriate, correct, and standardized treatment under the guidance of a doctor. If the condition unfortunately turns cancerous, the treatment approach will depend on several factors including the size of the uterus, whether the muscle layer is infiltrated by cancerous tissue, whether the cervical canal is involved, the differentiation of cancer cells, and the overall condition of the patient. The doctor will make a comprehensive analysis to determine the treatment plan. Main treatment options include surgery, radiation therapy, and medication, which can be used individually or in combination. Specific treatment plans will be provided by the doctor, and it is essential to follow the doctor's instructions, cooperate with the doctor for appropriate and correct treatment to improve the five-year survival rate. After completing the treatment, regular follow-ups should be scheduled to timely determine if there is any recurrence, and it is generally best to strictly adhere to the doctor’s advice and accurate diagnosis.

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Written by Wang Jing Hua
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Can uterine polyps disappear on their own?

Endometrial polyps are generally located in the uterine cavity. Some endometrial polyps may be expelled during menstruation, as each menstrual period involves the shedding of the endometrial lining, causing some small polyps to disappear after menstruation. However, if the endometrial polyps persist and are relatively large, causing irregular bleeding, excessive menstrual flow, or affecting pregnancy, it might be necessary to perform a hysteroscopy for examination and treatment, and to send samples for pathological testing.

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Written by Yue Hua
Obstetrics and Gynecology
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How to investigate endometrial polyps?

Endometrial polyps require an ultrasound examination to be detected, as they are located within the uterine cavity and cannot be seen by a gynecological examination alone. Under ultrasound, one can see a polyp-like object in the uterine cavity, which usually measures only a few millimeters, although some may be about ten or more millimeters in size. Certainly, if possible, a hysteroscopy can also identify them. However, generally, an ultrasound is conducted first to observe the endometrial polyps, followed by a hysteroscopy to remove them.

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Written by Hou Jie
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Benign characteristics of endometrial polyps

If a woman is diagnosed with endometrial polyps, then the condition is benign. If there are symptoms such as irregular vaginal bleeding, increased menstrual flow, or prolonged menstruation, endometrial polyps should be considered. It is advised to undergo diagnostic curettage or hysteroscopic endometrial polyp electrosurgical resection, and the removed tissue should be sent for pathological examination. Whether it is benign or malignant is mainly determined by the pathological examination as the final diagnostic basis. If confirmed as endometrial polyps, then it is benign. If precancerous lesions are present or if it is confirmed as malignant tumor, the case will be described in detail.

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Written by Sun Shan Shan
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Do uterine polyps require surgery?

Endometrial polyps are caused by excessive growth of the endometrial lining, and can be single or multiple, with diameters ranging from a few millimeters to several centimeters. They can be pedunculated or sessile. Endometrial polyps smaller than one centimeter in diameter, if asymptomatic, have a natural resolution rate of about 27% within a year and a low rate of malignancy. If the polyp is large, greater than one centimeter, it requires hysteroscopic endometrial polypectomy or curettage. However, curettage has disadvantages, as it can easily miss polyps, and there is a high chance of recurrence after the surgery. Therefore, once an endometrial polyp larger than one centimeter is identified, it is advisable to promptly visit a hospital for examination and treatment. Postoperative treatment should be guided based on the pathological findings.