Treatment of endometrial polyps

  Small asymptomatic endometrial polyps can be followed up regularly. For larger (>1 cm) and symptomatic polyps (such as irregular vaginal bleeding, infertility, excessive menstruation, chronic pelvic pain, etc.), surgical treatment should be performed. The rate of polyp malignancy in patients of reproductive age is 4.8%, which can increase to 10.0% after menopause. Therefore, hysteroscopic polypectomy should be actively performed for endometrial polyps during menopause once they are detected.  The principle of endometrial polyp treatment is to remove polyps, eliminate symptoms and reduce recurrence. Conventional hemostasis and medication are often ineffective in the treatment of endometrial polyps, and scraping has been used in the past with a high recurrence rate. Because it is difficult to scrape the polyp roots located in the basal layer of endometrium, and it is not easy to scrape the bottom and horn of the uterus with a scraper to ensure the complete removal of polyps, which leads to clinical symptoms and recurrence soon after surgery.  With the development of hysteroscopic technology, the level of diagnosis and treatment of endometrial polyps has been greatly improved. Because endometrial polyps are limited endometrial lesions, mainly solitary, with an average diameter of 0.5-2 cm, the above characteristics make them suitable for hysteroscopic removal. Hysteroscopic removal of polyps is the preferred treatment for endometrial polyps because of its accurate positioning, limited surgical scope, less damage to the endometrium, preservation of organ functions, less bleeding, shorter operative time, and faster recovery than other surgical procedures. In addition, hysteroscopic removal of polyps in infertile patients increases the pregnancy rate and live birth rate without increasing the postoperative miscarriage rate.