Uterine polyps are noncancerous growths that develop from an overgrowth of cells in the uterine lining. They vary in size and attach to the uterine wall by a stalk or broad base. The most common type is mucus polyps, which can arise from the body or cervix of the uterus. Uterine polyps may be asymptomatic but can sometimes cause irregular bleeding, heavy periods, or bleeding after menopause. Diagnosis involves physical examination, ultrasound, hysteroscopy, or biopsy. Treatment options include watchful waiting for small polyps, hormonal medication to reduce symptoms, or surgical removal by curettage, hysterotomy, or hysterectomy depending on the size and location of the poly

1. UTERINE POLYPS
INTRODUCTION
Uterine polyps are growths attached to the inner wall of the uterus that extend into
the uterine cavity. Overgrowth of cells in the lining of the uterus (endometrium)
leads to the formation of uterine polyps, also known as endometrial polyps. These
polyps are usually noncancerous (benign), although some can be cancerous or can
eventually turn into cancer (precancerous polyps).
Uterine polyps range in size from a few millimeters — no larger than a sesame
seed — to several centimeters — golf-ball-size or larger. They attach to the uterine
wall by a large base or a thin stalk.
DIFFERENT TYPE OF POLYPS
Mucus
Fibroid
Placental
De Novo
SecondaryChanges Of Benign Polyp
Benign polyp is a clinical entity referring a tumor attached by a pedicle.
Mucus the commonest type of benign uterine polyp is mucus one. It may arise
from the bodyof the uterus or from the cervix.
Fibroid polyp may arise from the bodyof the uterus or from the cervix.
Placental polyp retained bit of placental tissue when adherent to the uterine wall
get Organized with the surrounding blood clots.
PATHOGENESIS
Body
The part of the thick endometrium project into the clarity ultimately attains a
pedicle.It seems to arise from the basal endometrium surrounded by the functional
zone. responsiveness to hormone. Multiple polyposis in endometrial hyperplasia
Due to hyperoestrogenism is excluded from such discrete polyp.
Nakedeye appearance - show a small polyp size of about 1-2 cm , look reddish
and feel soft

2. Polyp may at times be long enough to make the polyp protruded from the cervix.
Microscopically
The core contents stromal cells , glands, and large thick walled vascular channel
the surface is lined by endometrium may undergo squamous metaplasia
Rarely smooth muscle invade the polyp and is then called adenomyoma.
Cervical
The polyp arrived from the endocervix and rarely from the ectocervix . The
stimulus of Epithelial growth is probably due to hyperoestrogenism.
Nakedeye appearance showthe polyp of usually small size exceeding 1-2 cm ,
single and Red in colour .the pedicle may at times be long enough to reach the
vaginal interoitus
Microscopically
The stroma consists of fibrous connective tissue with numerous small blood
vessels and Cervical gland the lining epithelium is tall columnar like that of
endocervix. stroma dense and Fibrous and the term fibroadenomatous poly is used
CLINICAL FEATURES
There may not be any symptoms
 Irregular menstrual bleeding — for example, having frequent, unpredictable
periods of variable length and heaviness
 Bleeding between menstrual periods
 Excessively heavy menstrual periods
 Vaginal bleeding after menopause
 Infertility
 Contact bleeding if the polyp is situated at or outside the cervix
 Excessive vaginal discharge which may be offensive
DIAGNOSIS
1-History collection
2-Physical examination per vaginal examination the uterus is bulky with the
patulous cervical canal.

3. 3-Sound test to differentiate a fibroid polyp from chronic inversion, sound test
is done if an uterine sound is fast all-round between the pedicle and dilating
cervical canal it is a polyp incomplete chronic inversion the sound cannot be
passed.
4-Transvaginalultrasound. A slender, wand-like device placed in vagina
emits sound waves and creates an image of uterus, including its interior.
See a polyp that's clearly present or may identify a uterine polyp as an area
of thickened endometrial tissue.
A related procedure, known as hysterosonography involves having salt
water (saline) injected into your uterus through a small tube threaded
through vagina and cervix. The saline expands uterine cavity, which gives a
clearer view of the inside of uterus during the ultrasound.
5-Hysterosalpingography to detect the filling defect in fibroid polyp.
6-Hysteroscopy
7-D&E examination under anaesthesia and exploration of the uterine cavity by
curette aur ovum aur ring forceps
8-Endometrial biopsy.
MANAGEMENT
 Watchful waiting. Small polyps without symptoms might resolve on their
own. Treatment of small polyps is unnecessary unless at risk of uterine
cancer.
 Medication. Certain hormonal medications, including progestins and
gonadotropin-releasing hormone agonists, may lessen symptoms of the polyp.
But taking such medications is usually a short-term solution at best —
symptoms typically recur once stop taking the medicine.
 Mucous polyp
a) Endometrial polyp are usually removed by uterine curettage
b) In case of recurrence hysterectomy

4. Cervical polyps are removed by twisting of the pedicle the base of the pedicle
should be cauterized to prevent recurrence
 Fibroid polyp
a) Removal politician by cutting the anterior wall of the uterus anterior
hysterotomy
b) Uterus to be removed hysterectomy is done with the fibroid polyp in situ.
 Did fibroid line in the vagina remove by morcellement followed by
transfixation sutures on the pedicle