Is ultrasound the first thing to do when endometrial polyp is suspected and can ultrasound confirm the diagnosis? I. How to diagnose endometrial polyp? Hysteroscopy is an important diagnostic method? Endometrial polyps are common in gynecology, most of them have no clinical symptoms and are often found by chance during ultrasound or physical examination due to other diseases. Patients who present with symptoms mainly present with irregular menstruation, heavy menstruation and infertility. The endometrial polyps cannot be seen or touched through gynecological examination, so why do we need gynecological examination? The purpose of gynecological examination is to rule out abnormal bleeding from other causes such as vaginal, cervical and uterine, such as cervicitis, cervical cancer, etc. If a patient has abnormal uterine bleeding and endometrial polyps are suspected, the first thing the doctor recommends is an ultrasound examination. ultrasound often indicates thickened endometrium with uneven echogenicity, sometimes described as hypoechoic or strongly echogenic masses in the uterine cavity. Since the endometrium varies with the menstrual cycle in non-menopausal patients, it is advisable to repeat the ultrasound examination after menstruation to help differentiate between polypoid endometrium and endometrial polyps. 86% of the sensitivity and 75% of the specificity of ultrasound in diagnosing endometrial polyps cannot be confirmed, and because of this, hysteroscopy is the next mandatory test when ultrasound suggests endometrial polyps. Hysteroscopy can not only observe the situation in the uterine cavity under direct vision, with or without endometrial polyps, but also perform surgery to remove them. Hysteroscopy is an important method to diagnose endometrial polyps, with a positive rate of up to 97%, even so, hysteroscopy still cannot confirm the diagnosis, and the final diagnosis and determine whether it is benign or malignant requires pathological examination of the excised tissue. Second, how to treat endometrial polyps? Hysteroscopic surgery is the gold standard of treatment. Before the invention of hysteroscopy, endometrial polyps were mainly removed by curettage, but the success rate was very low, with a sensitivity of 8-46%, which sometimes resulted in polyps that were broken and could not be diagnosed pathologically. Some patients continued to bleed after surgery and eventually had to have their uterus surgically removed to relieve the bleeding. Nowadays, hysteroscopic endometrial polyp electrosurgery is the gold standard of treatment, which can diagnose the presence of endometrial polyps in the uterine cavity by examination and can also be easily removed. The procedure is minimally invasive, easy to perform, accurate and has better therapeutic effects than hysterectomy. The timing of hysteroscopic endometrial polypectomy is better for women with fertility requirements after menstruation, when the endometrium is thinner, the hysteroscopic examination is clear, the diagnosis is clear and the operation is easier. After the operation, it helps to improve the patient’s symptoms of abnormal uterine bleeding and helps to conceive. There is no time limit for postmenopausal patients with abnormal uterine bleeding, and the operation helps to exclude malignant tumors. However, for elderly people who have been menopausal for many years, the risk of hysteroscopic surgery is the atrophy of the uterus and cervix after menopause, or even cervical adhesion, which prevents the hysteroscope from entering the uterine cavity and leads to failure of the operation, or because of the small volume of the uterine cavity, it is easy to bleed from uterine perforation and cervical laceration and damage to the bladder, intestinal canal and other surrounding organs during the dilation and operation.