At what size do endometrial polyps require surgery?

Endometrial polyps are a common gynecological disease. The occurrence of endometrial polyps is generally caused by inflammatory stimulation. Endometrial polyps will affect women's physical health and affect women's menstruation. If women who want to have children do not receive timely treatment, it will also affect future fertility. Endometrial polyps need to be treated surgically in time, but not all endometrial polyps require surgery.

At what size do endometrial polyps require surgery?

Generally speaking, if endometrial polyps are larger than one centimeter and have symptoms, resection is recommended. Hysteroscopic polypectomy or curettage is generally recommended because the misdiagnosis rate of blind curettage is very high. However, with our many years of clinical experience, although polyps are very small, with a diameter of less than one centimeter and no symptoms, the natural disappearance rate after one year is only 27%, but there is still a certain rate of malignancy.

Moreover, color Doppler ultrasound examination has certain inaccuracies, so we recommend that as long as the color Doppler ultrasound examination indicates endometrial polyps, we still perform hysteroscopy, hysteroscopic removal of endometrial polyps or curettage.

After the operation, the resected tissue will be sent for pathological examination, and the next step of treatment will be decided based on the results of the pathological examination. If the pathological examination confirms that it is an endometrial polyp.

To prevent recurrence, we recommend drug treatment, generally a full cycle of progestin treatment is adopted, the treatment time is six months. For those who do not have fertility requirements or no fertility plans in the near future, oral contraceptives can also be considered. Another method is to place Mirena IUD, which is the levonorgestrel intrauterine sustained-releasing system, into the uterine cavity to reduce postoperative recurrence.

How big are endometrial polyps?

Endometrial polyps are caused by excessive growth of the local endometrium of the uterus. The size ranges from several millimeters to several centimeters, usually around 1-2 centimeters. Endometrial polyps are composed of glands, media, and blood vessels of the endometrium. The high-risk factor is related to excessively high estrogen levels in the body. In addition, long-term inflammatory stimulation, aging, hypertension, obesity, diabetes, and long-term use of tamoxifen after breast cancer surgery are also factors that increase the incidence of endometrial polyps.

If color Doppler ultrasound can initially diagnose endometrial polyps, hysteroscopy is recommended. Under hysteroscopy, the morphology of the entire uterine cavity, the thickness of the endometrium, the location of the endometrium, and the condition of the endocervical canal can be explored. Resection of endometrial lesions under hysteroscopy or endometrial curettage. If the postoperative pathological results suggest: endometrial polypoid hyperplasia. To prevent recurrence after surgery, systemic progestin therapy can be given. Because endometrial polyps are associated with elevated estrogen levels.

The progestogens generally used are natural progestogens, such as progesterone capsules or dydrogesterone tablets. Artificially synthesized medroxyprogesterone acetate can also be used. If there is no desire to have children, an M ring or an oral combined short-acting contraceptive can be placed in the uterine cavity.