Endometrial Polyps Treatment in Nagpur

In most women it is not. Pooled data from two meta-analyses put premalignant or malignant changes at around 1.1 per cent of polyps in women before menopause and between 3.4 and 4.9 per cent after menopause, and the figure is higher when there is abnormal bleeding. That means the great majority are benign, but it also means the possibility is not zero, which is why any polyp that is removed is sent for histopathology rather than being judged by its appearance on the scan.

No. Expectant management with an interval scan is a recognised option for a woman before menopause who has no symptoms, a small polyp and no risk factors, and roughly a quarter of polyps resolve on their own, most often those under 10 mm. Removal is advised when there is abnormal bleeding, when the polyp is large, when you have crossed menopause, when you are on tamoxifen, or when you are trying to conceive. Dr. Kunda will tell you which of these applies to you.

The commonest is a change in bleeding: heavier periods, bleeding between periods, spotting after intercourse, or any bleeding at all after menopause. Some women have irregular cycles and some are found to have a polyp during a fertility assessment with no bleeding symptoms at all. Polyps are not usually a cause of severe pelvic pain, so if pain is your main complaint the cause is likely to be something else and worth assessing separately.

Often yes, but timing matters a great deal. A transvaginal scan performed in the first half of the cycle, roughly days 5 to 10, shows the lining thin and a polyp stands out against it. The same polyp can be hidden inside a thick secretory lining if the scan is done in the second half of the cycle. Colour Doppler helps, because a polyp usually has a single feeding vessel running into its stalk.

A small volume of sterile saline is placed into the uterine cavity through a fine catheter while the transvaginal scan is running. The fluid separates the walls of the cavity, so a polyp is outlined rather than blending into the lining. It is done at Mayflower Clinic in the outpatient department, takes a few minutes, and it is the test that most often settles whether a suspicious area on a routine scan is really a polyp, a fibroid pressing into the cavity, or simply thickened lining.

It is not the right operation for a polyp, and current guidance says so plainly. Blind dilatation and curettage removes tissue without the operator seeing the cavity, so a polyp on a stalk is frequently pushed aside and left behind. Dr. Kunda performs dilatation and curettage where it is the correct procedure for other reasons, but a polyp is removed under direct hysteroscopic vision so that it can be seen, taken out at its base, and the cavity checked afterwards.

Scanning, saline sonohysterography and all the counselling happen at Mayflower Clinic in Dhantoli. The hysteroscopy itself is performed by Dr. Kunda at a hospital in Dhantoli where she is attached, because it needs an operating theatre and anaesthetic cover. It is a day procedure. You are seen back at the clinic afterwards for the histopathology report and the follow-up plan, so the person who found the polyp is the person who removes it and the person who explains the result.

Most women go home the same day and are back to ordinary activity within a day or two. Light bleeding or brownish discharge for a few days is expected and settles on its own. Complications are uncommon, estimated at under 3 per cent of hysteroscopic polypectomies, and they are discussed with you before you consent rather than afterwards. Contact the clinic if bleeding becomes heavy, if you develop fever, or if pain increases instead of settling.

It can contribute. A polyp sitting in the cavity may alter the lining where an embryo would implant, and removing it is a reasonable step when a couple is being assessed for difficulty conceiving. It is rarely the only factor, so Dr. Kunda assesses the cycle, the tubes and the semen analysis alongside it rather than treating the polyp in isolation. Ovulation induction and follicular tracking are done at the clinic; IVF and related treatments are not performed here and are referred on.

Bleeding after menopause is always investigated, whatever the scan shows. In that situation the polyp is removed rather than watched, because this is the group in which the risk of a premalignant or malignant change is highest and because tissue is needed for a diagnosis. The lining around the polyp is assessed at the same time. If the histopathology shows an abnormality beyond a simple benign polyp, care is transferred to a gynaecological cancer specialist and Dr. Kunda stays involved in the follow-up.

Some do. Recurrence is reported in a minority of women and is more likely if more than one polyp was present or if the original polyp was removed incompletely, which is one of the reasons for taking it out under vision at its base rather than blindly. If your bleeding pattern changes again after a period of being normal, that is the point to come back for a repeat scan rather than assuming it is the same problem returning by itself.

Dr. Kunda will tell you what it looks like and what she expects, and she will also tell you that the appearance alone does not settle it. A polyp that looks entirely ordinary at hysteroscopy is occasionally reported differently by the pathologist, and that is precisely why every specimen is sent. The report usually takes a few days and is explained to you in person rather than handed over at the counter.