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An endometrial polyp or uterine polyp is a mass in the inner lining of the uterus. [1] They may have a large flat base or be attached to the uterus by an elongated pedicle (pedunculated). [2] [3] Pedunculated polyps are more common than sessile ones. [4] They range in size from a few millimeters to several centimeters. [3]
A polyp is an abnormal growth of tissue projecting from a mucous membrane. If it is attached to the surface by a narrow elongated stalk, it is said to be pedunculated; if it is attached without a stalk, it is said to be sessile. Polyps are commonly found in the colon, stomach, nose, ear, sinus(es), urinary bladder, and uterus.
The underlying causes may include ovulation problems, fibroids, the lining of the uterus growing into the uterine wall, uterine polyps, underlying bleeding problems, side effects from birth control, or cancer. [3] More than one category of causes may apply in an individual case. [3] The first step in work-up is to rule out a tumor or pregnancy.
DES gained notoriety when it was shown to cause a rare vaginal tumor in girls and young women who had been exposed to this drug in utero.In 1971, the New England Journal of Medicine published a report showing that seven of eight girls and young women (ages 14 to 22) who had been diagnosed with vaginal clear cell adenocarcinoma had been exposed prenatally to DES. [5]
Cancers of the vagina or fallopian tubes are rare causes of hemorrhage. Uterine fibroids represent a common, benign condition that may lead to bleeding, specifically if the lesion affects the uterine cavity. Polyps of the uterine lining are a common cause of bleeding, but such bleeding tends to be light.
Initial evaluation during diagnosis aims at determining pregnancy status, menopausal status, and the source of bleeding. One definition for diagnosing the condition is bleeding lasting more than 7 days or the loss of more than 80 mL of blood heavy flow. [3] Treatment depends on the cause, severity, and interference with quality of life. [4]
Bleeding which occurs before 24 weeks is known as early pregnancy bleeding. Causes of bleeding before and during childbirth include cervicitis, placenta previa, placental abruption and uterine rupture. [4] [5] Causes of bleeding after childbirth include poor contraction of the uterus, retained products of conception, and bleeding disorders. [4]
PALM - Structural causes of uterine bleeding. Polyps: Endometrial polyps are benign growths that are typically detected during gynecologic ultrasonography and confirmed using saline infusion sonography or hysteroscopy, often in combination with an endometrial biopsy providing histopathologic confirmation.