Polypectomy (Removal of Polyps)

What is polypectomy? 

Polypectomy is a minimally invasive procedure used to remove uterine or cervical polyps—small, finger‑like growths that arise from the lining of the uterus (endometrial polyps) or the cervix. Typically benign, these polyps can nonetheless cause symptoms such as irregular or heavy menstrual bleeding, spotting after intercourse, postmenopausal bleeding, or even contribute to fertility difficulties. 

During a hysteroscopic polypectomy, a thin, lighted telescope (hysteroscope) is passed through the cervix into the uterine cavity, which helps with direct visualisation and removal of the polyp with specialised instruments and without incisions. Meanwhile, cervical polyps, often visible during a routine pelvic exam, can usually be grasped and removed quickly in the clinic. 

Once excised, the tissue is sent for histopathological analysis to check for any abnormal or precancerous changes. The procedure is generally safe, performed as a day‑case, with most women resuming normal activities within a day or two. 

How does polypectomy work?

Polypectomy is a simple and effective way to remove abnormal tissue growths from the uterus or cervix. The method used depends on the size and location of the polyp, but most procedures are quick, minimally invasive, and do not require any cuts or stitches.

For uterine polyps — Removal using hysteroscopy

Uterine polyps are usually removed during a hysteroscopy. A thin, lighted telescope (hysteroscope) is gently inserted through the cervix to visualise the inside of the uterus. Once the polyp is located, it is removed using specialised tools such as scissors, graspers, or a wire loop that uses mild electric current. This allows precise removal with minimal discomfort.

For cervical polyps — in-clinic removal (for most)

Cervical polyps are often small and visible during a pelvic examination. They can usually be removed in the clinic using simple forceps, without the need for anaesthesia or special equipment. The procedure is quick and rarely causes more than mild cramping or spotting.

Occasionally the polyps may be large or located deep within the cervical canal necessitating removal under anesthesia. 

After removal — Tissue analysis

The removed polyp is always sent to the lab for histopathological testing to check for any abnormal or precancerous changes. This ensures that any necessary follow-up treatment can be provided promptly if needed. Most women recover quickly after a polypectomy and can resume normal activities within a day or two.

Why is a polypectomy performed? 

Polypectomy is done to address both symptoms and potential health risks associated with uterine or cervical polyps. These growths may seem harmless, but they can lead to discomfort or complications if left untreated. Common reasons for performing a polypectomy include:

• Irregular or heavy menstrual bleeding
• Spotting between periods or after intercourse
• Postmenopausal bleeding
• Difficulty getting pregnant
• Presence of polyps seen during a scan or examination
• To rule out precancerous or cancerous changes through lab testing
• Recurring polyps causing repeated symptoms

What conditions can be diagnosed or treated by a polypectomy?

Polypectomy plays both a diagnostic and therapeutic role in managing several gynaecological conditions. By removing polyps from the uterus or cervix, doctors can relieve symptoms and assess whether any underlying issues need further treatment. Conditions commonly diagnosed or treated with polypectomy include:

• Endometrial polyps — these are benign growths on the lining of the uterus that can cause heavy periods, irregular bleeding, or spotting between cycles. Polypectomy helps remove the source of bleeding and allows lab analysis to rule out abnormal changes.

• Cervical polyps — small growths that develop on the cervix, often detected during a routine pelvic exam. They may cause light bleeding or discharge and can be removed easily in the clinic.

• Abnormal uterine bleeding — unexplained or heavy bleeding may be due to polyps or other changes in the endometrium. Removing the polyps helps relieve symptoms and clarify the cause.

• Postmenopausal bleeding — any bleeding after menopause requires investigation. Polyps are a common cause, and removing them allows proper diagnosis and peace of mind.

• Subfertility or difficulty conceiving — polyps in the uterine cavity can interfere with embryo implantation. Removing them may improve the chances of pregnancy, especially before IVF.

• Precancerous changes — although most polyps are benign, some may contain atypical or precancerous cells. Polypectomy ensures the tissue is tested and, if needed, further treatment can be planned early.

What are the benefits of polypectomy? 

Polypectomy offers both diagnostic clarity and symptom relief, making it a valuable procedure in gynaecological care. Benefits include:

• Relief from irregular or heavy menstrual bleeding
• Reduction in postcoital or postmenopausal spotting
• Improved chances of conception in women with fertility issues
• Removal of potentially precancerous growths before they progress
• Minimal recovery time with a quick return to daily activities
• Clear diagnosis through lab testing of the removed polyp

Are there any side effects of polypectomy? 

Polypectomy is generally a safe procedure, but like any medical treatment, there may be mild side effects. Most women recover quickly with minimal issues. Possible side effects include:

• Light vaginal bleeding or spotting for a few days
• Mild cramping or discomfort, similar to period pain
• Watery discharge for a short time after the procedure
• Temporary bloating or abdominal pressure

Serious complications are rare, but if there is heavy bleeding, fever, or severe pain, it’s important to seek medical attention.

How to prepare myself for a polypectomy? 

Preparing for a polypectomy is usually straightforward and doesn’t require extensive steps. Your doctor will guide you based on whether the procedure is done in-clinic or under light anaesthesia. Here are some general tips:

• Follow fasting instructions – if the procedure involves sedation or anaesthesia, you may be asked not to eat or drink for a few hours beforehand.

• Inform your doctor of any medications – let your doctor know if you are taking blood thinners, aspirin, or any supplements, as you may need to pause them temporarily.

• Schedule around your period – polypectomy is often scheduled when you are not menstruating to allow better visibility and comfort.

• Arrange for transport – if sedation is used, you will need someone to drive you home afterwards.

• Wear comfortable clothing – opt for loose, easy-to-remove clothing on the day of the procedure.

• Ask questions – do not hesitate to clarify any concerns you have with your doctor beforehand, so you feel fully informed and at ease.

What happens during the polypectomy procedure? 

Polypectomy for gynaecological conditions is usually performed during a hysteroscopy or as an in-clinic procedure, depending on the location of the polyp. Here’s what typically happens:

• Sedation or local anaesthesia — you may be given sedation or general anaesthetic during the procedure.

• Insertion of the hysteroscope — a thin, tube with a camera (hysteroscope) is gently passed through the vagina and cervix into the uterus to locate the polyp.

• Polyp removal — once the polyp is visualised, it is removed using appropriate instruments based on its location. Cervical polyps are typically removed in the clinic using forceps, often by gently twisting them off at the base. For uterine polyps, removal is done during hysteroscopy using fine scissors, graspers, or a wire loop. In some cases, a hysteroscopic morcellator may be used to shave and suction out the polyp, especially if it is larger or broad-based.

• Tissue retrieval and inspection — the removed polyp is collected and sent to the lab for analysis. The doctor will also check the area for bleeding or any complications before completing the procedure.

What happens after a polypectomy? 

After a polypectomy, you may experience mild cramping or light spotting for a few days, which is normal. The removed polyp is sent to the lab for histological analysis to check for any abnormal or precancerous cells. Your doctor will follow up with the results and discuss if any further treatment is needed. Most women recover quickly and can resume normal activities within a short time, though it is advised to avoid sexual intercourse or using tampons for a few days to allow the area to heal.

Summary 

Polypectomy is a safe and straightforward procedure used to remove polyps from the uterus or cervix—growths that, while usually benign, can cause symptoms such as irregular bleeding, spotting, or fertility issues. Depending on the location and size of the polyp, removal may be done in the clinic using forceps or through a hysteroscopy using specialised instruments. 

The procedure typically involves minimal discomfort, with most women recovering quickly and resuming daily activities within a day or two. The removed tissue is always sent for lab testing to ensure there are no abnormal or precancerous changes. 

If you are experiencing unusual bleeding, postmenopausal spotting, or difficulty conceiving, schedule a consultation with Holistic Gynaecology & Fertility to assess whether a polypectomy is right for you.

Frequently Asked Questions (FAQs) 

Patient Information Leaflet: The Impact of Diet and Lifestyle on Endometrial Polyps and Fibroids

Understanding Endometrial Polyps and Fibroids

Endometrial polyps and fibroids are predominantly benign growths in of the uterus.

Polyps are growth of the inner lining (endometrium) of the uterus and fibroids are growths of the muscle wall of the uterus.

While they are usually not cancerous, they can lead to symptoms such as heavy menstrual bleeding, intermenstrual bleeding, pelvic pain, and fertility issues.

The human body has two main female hormones estrogen and progesterone. Estrogen results in growth of fibroids and polyps. Certain foods are estrogen dominant or rich in estrogen and taking these foods can result in development or worsening of these gynecological conditions.

Hence diet and lifestyle choices can significantly impact the development and management of these conditions.

The Role of Diet and Lifestyle

1. Dietary Influences:
   • Healthy Diet: A balanced diet rich in whole foods, fruits, vegetables, lean proteins, and healthy fats can help regulate hormone levels and reduce inflammation.
   • Cruciferous Vegetables: Foods like broccoli, cauliflower, kale, and Brussels sprouts contain compounds known as glucosinolates, which help balance estrogen levels and support liver detoxification.
   • DIM (Diindolylmethane): Found in cruciferous vegetables, DIM may help metabolize estrogen effectively, potentially reducing the risk of polyps and fibroid growth.
   • Fiber-Rich Foods: Whole grains, legumes, fruits, and vegetables can help maintain a healthy weight and improve hormonal balance.
     
2. Foods to Include:
   • Cruciferous Vegetables: Broccoli, cauliflower, cabbage, Brussels sprouts.
   • Fruits: Berries, apples, oranges, and melon for their antioxidants and fiber.
   • Healthy Fats: Avocados, nuts, seeds, and olive oil for hormone regulation.
   • Lean Proteins: Poultry, fish, and plant-based proteins to support overall health.
   • Spices: Turmeric and ginger for their anti-inflammatory properties.
     
3. Foods to Avoid:
   • Estrogenic Foods: Limit foods that are high in estrogen, such as soy products (tofu, soy milk) and flaxseeds, as they can mimic estrogen in the body.
   • Phytoestrogens: Foods containing phytoestrogens like red clover and licorice root should be consumed with caution.
   • Processed Foods: Sugary snacks, fast food, and processed meats are rich in carbohydrates - these coupled with a sedentary lifestyle can lead to weight gain, which is indirectly related to estrogen dominance, and a higher chance of developing endometrial polyps.
   • Meat or dairy with added hormones- so either stop eating OR, ONLY consume organic meat and dairy products
     
     
     

Impact of Chemicals in Plastics

1. BPA (Bisphenol A): This chemical is commonly found in many plastics and has been linked to hormonal disruptions. BPA can mimic estrogen in the body, potentially contributing to the growth of endometrial polyps and fibroids. So disposable plastics should not be used to store food and ordering-in food should be minimized (as all ordered food comes in disposable plastics).
   
2. Other Chemicals: Phthalates and parabens, found in personal care products and food packaging, can also disrupt hormonal balance. Reducing exposure to these chemicals is beneficial for hormonal health.
   

Lifestyle Considerations

1. Maintain a Healthy Weight: Excess body fat can produce additional estrogen, exacerbating the growth of polyps and fibroids. Aim for a balanced diet and regular physical activity.
   
2. Regular Exercise: Engaging in regular physical activity can help maintain a healthy weight and regulate hormone levels.
   
3. Limit Alcohol and Caffeine: Excessive consumption of alcohol and caffeine can affect hormone metabolism. It is advisable to limit their intake to support hormonal balance.
   
4. Stress Management: Chronic stress can lead to hormonal imbalance. Practices such as yoga, meditation, and deep-breathing exercises can help manage stress effectively.
   

Conclusion

Your diet and lifestyle play a crucial role in managing endometrial polyps and fibroids. Incorporating nutrient-dense foods, particularly cruciferous vegetables and foods that support hormone balance, while avoiding estrogenic foods and harmful chemicals, can help in maintaining optimal health. Always consult your healthcare provider for personalized advice tailored to your specific conditions.