How to perform surgery on endometrial polyps

Written by Liu Jian Wei
Obstetrics and Gynecology
Updated on March 24, 2025
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Currently, most hospitals require hospitalization for further examinations for endometrial polyps, followed by surgery in the operating room. Generally, anesthesia is administered to the patient before surgery, usually in the form of spinal anesthesia. After the anesthesia, the patient remains conscious, but feels no pain from the lower abdomen to the legs. Under these conditions, the surgery to remove the endometrial polyp is performed. Under the exploration of a hysteroscope, the polyps are removed sequentially with an electrosurgical loop, and the removed tissue is sent for pathological examination.

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Symptoms of endometrial polyp malignancy

When endometrial polyps in women undergo malignant transformation, it can lead to a large amount of vaginal discharge. This discharge may be accompanied by a foul odor, which could possibly be due to an associated infection. Additionally, when endometrial polyps undergo malignant transformation and form tumors, their growth rate accelerates, and the blood supply may not meet the growth needs of the polyps. This may lead to localized ulceration and bleeding, causing women to experience irregular vaginal bleeding. This bleeding can manifest as blood streaks in vaginal discharge or as persistent vaginal bleeding. As the tumor gradually enlarges, it increases the pressure in the uterine cavity, leading to abdominal pain in some women.

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How to check for endometrial polyps?

Endometrial polyp examinations are generally conducted through ultrasound at hospitals, which can provide a clear diagnosis. The best time for this ultrasound is within three to seven days after the end of menstruation. During this period, the thickness of the endometrium is between three to four millimeters, and the endometrial echo is uniform. If, during this period, the endometrial thickness is greater than four millimeters and the echo suggests unevenness, this generally indicates a high possibility of endometrial polyps. Patients with endometrial polyps typically experience shorter menstrual cycles, usually occurring every 20 days, with longer menstruation periods. Normally, the menstruation period lasts from three to seven days, but in patients with endometrial polyps, it can extend to over eight to ten days. Therefore, through symptoms and ultrasound, it is possible to determine whether there are endometrial polyps.

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Written by Liu Wei Jie
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Endometrial polyp pain sensation

Do endometrial polyps feel painful? Generally, endometrial polyps do not cause any pain unless there is malignant transformation. In such cases, one might experience discomfort or a dragging pain in the lower abdomen. How are endometrial polyps typically diagnosed? They are diagnosed due to clear changes such as excessively heavy menstrual flow. An ultrasound can reveal polyps, or if the menstrual flow is too heavy, a dilation and curettage (D&C) procedure is performed, and the material removed is sent for pathological examination to confirm the presence of endometrial polyps. If the polyp is small, it can be left alone as 27% of them resolve on their own. However, if the polyp is large and causes changes in menstruation or affects fertility, a hysteroscopy is necessary.

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Will uterine polyps cause bleeding during intercourse?

Endometrial polyps generally do not cause bleeding after sexual intercourse. However, bleeding after sexual intercourse can occur if there are polyps in the cervical canal. Clinically, endometrial polyps generally present with shorter menstrual cycles, occurring every 20-something days. The period duration is also typically longer; normally, a period lasts from three to seven days. In patients with endometrial polyps, the period can extend up to eight or nine days. Under such circumstances, endometrial polyps are generally suspected, and patients are often advised to visit a hospital for an ultrasound to examine the thickness of the endometrial lining and its echo characteristics, allowing for a definitive diagnosis of endometrial polyps. Endometrial polyps do not cause bleeding after sexual intercourse. Bleeding after intercourse is generally considered clinically if there are conditions such as cervical cancer, precancerous cervical conditions, cervical polyps, or other cervical alterations. Thus, if bleeding after intercourse occurs, it is crucial to undergo cervical cancer screening at a hospital.

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Endometrial polyp removal time

Endometrial polyps require hysteroscopic polypectomy, which is a type of minimally invasive surgery, performed under intravenous anesthesia or general anesthesia. If the polyp is small and the cervical opening is relaxed, the surgery typically concludes within about an hour. After the surgery, the patient can leave the operating room once they regain consciousness. However, if the polyp is located near the uterine corner and the cervix is relaxed, it can complicate the surgical procedure, extending the duration to about one and a half to two hours. Post-surgery, it is important to monitor the patient's bleeding levels.