Do uterine polyps require surgery?

Written by Sun Shan Shan
Obstetrics and Gynecology
Updated on March 24, 2025
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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.

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Symptoms of endometrial polyps

The most common clinical symptom of endometrial polyps is vaginal bleeding, which manifests in the following ways: Some women may experience heavy menstrual flow with a large amount of blood clots. This is because most patients with endometrial polyps have excessive proliferation of the endometrial lining. When this excessively proliferated endometrium sheds during menstruation, it can result in a heavier flow. Additionally, some women may experience vaginal bleeding after their menstruation has ended. Typically, this bleeding is not heavy and is dark red in color. This could indicate the presence of endometrial polyps.

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Written by Hou Jie
Obstetrics and Gynecology
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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 Yue Hua
Obstetrics and Gynecology
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Can you get pregnant with endometrial polyps?

It is best to get pregnant after surgery for endometrial polyps, as this condition can lead to infertility. Endometrial polyps refer to an excessive growth of the uterine lining, where a polyp-like mass is found inside the uterine cavity. In this case, the presence of a foreign body around the uterine cavity can prevent a fertilized egg from implanting inside the uterus. Therefore, if suffering from endometrial polyps, which can also cause infertility, it is necessary to promptly remove the polyps and then send them for pathological examination. If there are no problems, it is best to consider pregnancy after three months.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Can endometrial polyps be cured?

Women with endometrial polyps can be completely cured. First, endometrial polyps are benign lesions, which may be due to abnormally high levels of estrogen in women, leading to proliferative lesions. It is possible to completely remove the polyps through hysteroscopic endometrial polyp electrocision surgery. However, after surgery, some women may experience recurrence. To prevent this, periodic oral progestogen medication can also be administered to prevent recurrence. Some women may have endometrial inflammation, leading to the recurrence of endometrial polyps. In this case, broad-spectrum antibiotics can be used for anti-inflammatory treatment to prevent recurrence. (The use of drugs should be carried out under the guidance of a professional doctor.)

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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.