Endometrial Polyps Diagnosis

Endometrial polyps are benign overgrowths of the uterine lining and are common. They lie within the space of the uterine cavity and are usually identified with hysterosalpingogram (HSG) or a saline sonohysterogram (SIS). Hysterosalpingography (HSG) is an x-ray study used as an initial screening study to evaluate the uterine cavity and tubal patency, whether the fallopian tubes are patent (open) or not. Many patients have this study performed in the beginning of their infertility evaluation. The HSG is very helpful in diagnosing polyps.

The saline sonohysterogram (SIS) is a study in which sterile saline is placed into the uterine cavity with a catheter and a transvaginal ultrasound is performed. The saline produces a contrast media in order to visualize polyps accurately.

Treatment for Uterine Polyps

A hysteroscopy will be done to remove polyps. This procedure can be done in the office under light anesthesia. The procedure involves introducing a specialized camera, called a hysterscope, into the uterine cavity. Attached to the camera is a surgical instrument, which will allow your physician to remove your polyps.

The vast majority of endometrial polyps are benign, although some may be precancerous. Precancerous polyps account for less than 1% of uterine polyp.

The effect of endometrial polyps on fertility is not clear, but fertility specialists assume that large ones may have an effect like that of an intrauterine contraceptive device, so big polyps are often removed to treat infertility and before attempting any fertility treatments.

Find more information in the Fertility Library.

Hysteroscopy

Procedure Overview

What is a hysteroscopy?

Hysteroscopy is the visual examination of the canal of the cervix and interior of the uterus using a thin, lighted, flexible tube called a hysteroscope. The device is inserted through the vagina.

Hysteroscopy may be used for both diagnostic and therapeutic purposes. The hysteroscope allows for easy visual access to the interior of the cervix and uterus to assess the lining of these structures. Therapeutic maneuvers, such as taking a tissue sample (biopsy), removal of polyps or fibroid tumors, or preventing bleeding with cautery (destruction of tissue by electric current, freezing, heat, or chemicals) may be performed during a hysteroscopy procedure.

Diagnostic hysteroscopy may be performed in a doctor's office or in an outpatient facility with local or no anesthesia required. More invasive therapeutic hysteroscopy procedures may be performed in the operating room under local, regional, or general anesthesia.

Because the doctor is able to see the interior of the cervix and uterus during the procedure, diagnostic hysteroscopy has become a more common procedure than dilation and curettage (D & C), which is performed without endoscopic visualization.

Other related procedures that may be used to evaluate problems of the female pelvic organs include D & C, cervical biopsy, colposcopy, endometrial biopsy, laparoscopy, Pap test, and pelvic ultrasound. Please see these procedures for additional information.

What are female pelvic organs?

The organs and structures of the female pelvis are:

  • Endometrium. This is the lining of the uterus.

  • Uterus (also called the womb). The uterus is a hollow, pear-shaped organ located in a woman's lower abdomen, between the bladder and the rectum. The uterus sheds its lining each month during menstruation, unless a fertilized egg (ovum) becomes implanted and pregnancy follows.

  • Ovaries. Two female reproductive organs located in the pelvis in which egg cells (ova) develop and are stored, and where the female sex hormones estrogen and progesterone are produced.

  • Cervix. The lower, narrow part of the uterus located between the bladder and the rectum, forming a canal that opens into the vagina, which leads to the outside of the body.

  • Vagina (also called the birth canal). The passageway through which fluid passes out of the body during menstrual periods. The vagina connects the cervix and the vulva (the external genitalia).

  • Vulva. The external portion of the female genital organs.

  • Fallopian tubes. Two thin tubes that extend from each side of the uterus, toward the ovaries, as a passageway for eggs and sperm.

Reasons for the procedure

Hysteroscopy may be performed in women who have an abnormal Pap test, abnormal uterine bleeding, or postmenopausal bleeding. It may be used to help diagnose causes of infertility or repeated miscarriages. Hysteroscopy may also be used to evaluate uterine adhesions (Asherman's syndrome), polyps, and fibroids, and to locate and remove displaced intrauterine devices (IUDs). Hysteroscopy is also used to place small inserts in the fallopian tubes that are a permanent method of birth control.

Therapeutically, hysteroscopy may be used to help correct uterine problems. For example, small adhesions, polyps, or fibroids may be removed through the hysteroscope, often eliminating the need for open abdominal surgery. Endometrial biopsy or ablation (removal of the endometrial lining) may be performed via hysteroscopy. The term "operative hysteroscopy" may be used in these situations.

Hysteroscopy cannot be performed during pregnancy.

There may be other reasons for your doctor to recommend a hysteroscopy.

Risks of the procedure

As with any surgical procedure, complications may occur. Some possible complications of hysteroscopy may include, but are not limited to, the following:

  • Infection

  • Bleeding

  • Pelvic inflammatory disease

  • Perforation of the uterus (rare) or damage to the cervix 

  • Complications from fluid or gas used to expand the uterus

You may experience slight vaginal bleeding and cramps for a day or two after the procedure.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Certain factors or conditions may interfere with a hysteroscopy. These factors include, but are not limited to, the following:

  • Pelvic inflammatory disease

  • Vaginal discharge

  • Inflamed cervix

  • Distended bladder

Before the procedure

  • Your doctor will explain the hysteroscopy procedure to you and offer you the opportunity to ask any questions that you might have.

  • You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if something is not clear.

  • For certain more invasive hysteroscopy procedures: In addition to a complete medical history, your doctor may perform a complete physical examination to ensure you are in good health before undergoing the procedure. You may undergo blood tests or other diagnostic tests.

  • Depending on the type of procedure to be performed, you may be asked to fast before the procedure if you are to receive local or general anesthesia. The procedure may be performed with local or regional anesthesia or without anesthesia depending on what other procedures are to be performed at the same time.

  • If you are pregnant or suspect that you may be pregnant, you should notify your health care provider.

  • Notify your doctor if you are sensitive to or are allergic to any medications, iodine, latex, tape, and anesthetic agents (local and general).

  • Notify your doctor of all medications (prescription and over-the-counter) and herbal supplements that you are taking.

  • Notify your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.

  • Depending on the procedure to be performed, you may receive a sedative prior to the procedure to help you relax. Because the sedative may make you drowsy, you will need to arrange for someone to drive you home.

  • You will be scheduled to undergo the procedure after menstrual bleeding has ended and before ovulation. This allows better visualization of the uterus and avoids damaging a newly formed pregnancy.

  • Dress in clothes that permit access to the area or that are easily removed.

  • Based on your medical condition, your doctor may request other specific preparation.

During the procedure

A hysteroscopy may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor's practices.

Generally, a hysteroscopy follows this process:

  1. You will be asked to remove clothing and will be given a gown to wear.

  2. You will be asked to empty your bladder prior to the procedure.

  3. An intravenous (IV) line may be inserted in your arm or hand.

  4. You will be positioned on an operating table, lying on your back with your feet in stirrups.

  5. The vaginal area will be cleansed with an antiseptic solution.

  6. The cervix may be dilated prior to the insertion of the hysteroscope.

  7. The hysteroscope will be inserted into the vagina, through the cervix, and into the uterus.

  8. A liquid or gas will be injected through the hysteroscope to expand the uterus, allowing for better visualization.

  9. The wall of the uterus will be examined for abnormalities. Photographs or video documentation may be made. Biopsy specimens may be taken.

  10. If a procedure, such as fibroid removal, is to be performed, instruments will be inserted through the hysteroscope.

  11. For more detailed or complicated procedures, a laparoscope (a type of endoscope inserted through the abdomen) may be used to view the outside of the uterus simultaneously.

  12. When the procedure is completed, the hysteroscope will be removed.

After the procedure

Your recovery process will vary depending on the type of anesthesia that is given. If general anesthesia or a sedative was used, your blood pressure, pulse, and breathing will be monitored until they are stable and you are alert. When stable, you will be discharged to your home. Hysteroscopy is usually performed on an outpatient basis.

Otherwise, there is generally no special type of care following a hysteroscopy.

You may experience cramping and vaginal bleeding for a day or two after the procedure. Report fever, severe abdominal pain, or heavy vaginal bleeding or discharge.

You may experience flatulence (gas in the digestive tract) and pains resulting from the gas administered during the procedure for about 24 hours. You may feel pain in your upper abdomen and shoulder.

Take a pain reliever for soreness as recommended by your doctor. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.

You may be instructed to avoid vaginal douching and sexual intercourse for two weeks after the procedure, or for an alternate period of time recommended by your doctor.

Other activities and normal diet may be resumed unless your doctor advises you differently.

Your doctor may give you additional or alternate instructions after the procedure depending on your particular situation.

Online resources

The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your doctor. Please consult your health care provider with any questions or concerns you may have regarding your condition.

This page contains links to other websites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we do not control or endorse the information presented on these websites, nor do these sites endorse the information contained here.

American Cancer Society

American Congress of Obstetricians and Gynecologists

American College of Surgeons

American Society for Reproductive Medicine

National Cancer Institute (NCI)

National Institutes of Health (NIH)

National Library of Medicine

National Women's Health Information Center

Douglas T. Carrell, Ph.D., H.C.L.D.

Doug Carrell received his Ph.D. degree in reproductive physiology from the University of Utah in 1995, after receiving a M.S. degree in cellular and developmental biology from Brigham Young University. Dr. Carrell has worked in the area of research and treatment of human infertility for 30 years. Dr. Carrell is ... Read More

Specialties:

Andrology, In Vitro Fertilization, Reproductive Endocrinology & Infertility

Locations:

Andrology & IVF Laboratories (801) 581-3740

Specialties:

Reproductive Endocrinology & Infertility

Locations:

Utah Center for Reproductive Medicine (801) 581-3834

James M. Hotaling, M.D., FECSM

Dr. Hotaling has significant training in both the clinical aspects of male fertility and genetic epidemiology and he is currently the only fellowship trained male infertility/andrology expert in Utah. He completed a 6 year residency in urology at the University of Washington, elected to pursue a year of sub-sp... Read More

Specialties:

Andrology, General Urology, Men's Health, Reproductive Endocrinology & Infertility, Urology

Locations:

Utah Center for Reproductive Medicine (801) 587-1454

Erica B. Johnstone, M.D.

Erica B. Johnstone, M.D., M.H.S., is a gynecologist and reproductive endocrinologist in the Division of Reproductive Endocrinology and Infertility. Dr. Johnstone clinical interests include reproductive endocrine disorders and all types of infertility, and she also works with hormonal disorders in children and ad... Read More

Specialties:

In Vitro Fertilization, Menopause, Reproductive Endocrinology & Infertility

Locations:

Centerville Health Center
Madsen Health Center
South Jordan Health Center (801) 581-3834
Utah Center for Reproductive Medicine (801) 581-3834

William R. Keye, M.D.

William R. Keye, M.D., is a board-certified physician specializing in obstetrics and gynecology, as well as reproductive endocrinology and infertility. He received his medical degree from the University of Minnesota, and was an original member of the University of Utah’s I.V.F.(in vitro fertilization) team. He s... Read More

Specialties:

Reproductive Endocrinology & Infertility

Locations:

Redstone Health Center (801) 581-3834
South Jordan Health Center (801) 581-3834
Utah Center for Reproductive Medicine (801) 581-3834

Specialties:

Reproductive Endocrinology & Infertility

Locations:

A location has not yet been added by this physician.

Andrew K. Moore, M.D.

As a sixth-generation resident of Utah Valley, Dr. Moore is pleased to bring the University of Utah’s world-class reproductive medicine closer to home for Utah Valley and southern Salt Lake county residents. He has office hourse daily in Orem, and also each week in South Jordan. During his first year of practi... Read More

Specialties:

Endometriosis, In Vitro Fertilization, Minimally Invasive Pelvic Surgery, Pelvic Pain, Polycystic Ovary Syndrome, Recurrent Miscarriage, Reproductive Endocrinology & Infertility, Robotic Surgery, Tubal Ligation Reversal

Locations:

Parkway Health Center (801) 581-3834
Utah Center for Reproductive Medicine (801) 581-3834
Utah Valley Regional Medical Center (801) 581-3834

C. Matthew Peterson, M.D.

Matthew Peterson, M.D., is a Reproductive Endocrinologist in the University of Utah Department of Obstetrics and Gynecology. Dr. Peterson received his undergraduate degree, magna cum laude from Brigham Young University in 1977 and his M.D. from the University of Utah in 1981. His residency training in obstetrics... Read More

Specialties:

Adolescent Gynecology, Endometriosis, Gynecological Surgery, Gynecology, In Vitro Fertilization, Minimally Invasive Pelvic Surgery, Pediatric Gynecology, Polycystic Ovary Syndrome, Reproductive Endocrinology & Infertility, Tubal Ligation Reversal, Women's Genetic Counseling

Locations:

Centerville Health Center (801) 581-3834
Parkway Health Center (801) 581-3834
South Jordan Health Center (801) 581-3834
University Hospital (801) 581-3834
Utah Center for Reproductive Medicine (801) 581-3834

Reproductive Medicine services are available at the Utah Center for Reproductive Medicine as well as multiple locations through out the state of Utah, including Centerville, Orem, South Jordan and Park City. Our reproductive endocrinologists offer a wide range of services including:

  • Infertility counseling
  • Infertility monitoring and treatment
  • IUD insertion and removal
  • Annual gynecological exams
  • Endocrinology
  • Diagnosis and treatment of polycystic ovary syndrome
  • In vitro fertilization
  • Treatment of endometriosis
  • Pediatric and adolescent gynecology services

Our highly trained reproductive endocrinology specialists are experts in both the treatment and research of infertility and our clinic consistently boasts one of the highest success rates in the nation.

Neighborhood Health Center Locations:

Utah Center for Reproductive Medicine 675 Arapeen Way, Suite 205
Salt Lake City, Utah 84108-1237
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University of Utah Health Care
Centerville Health Center
26 South Main
Centerville, Utah 84014
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Dixie Regional Medical Center 544 South 300 East
St. George, UT 84770
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McKay Dee Hospital 4401 Harrison Blvd.
Ogden, UT 84403
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University of Utah Health Care
Redstone Health Center
1743 W. Redstone Center Drive, #115
Park City, Utah 84098
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University of Utah Health Care
South Jordan Health Center
1091 W. South Jordan Parkway, Suite 500
South Jordan, 84095
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Utah Valley Regional Medical Center
Woman’s and Children’s Clinic
1034 N 500 W
Provo, Utah 84604
  • FAZST
    Keywords: Fertility, reproductive medicine, pregnancy outcomes, folic acid and zinc supplementation trial, semen quality, infertility
    Status: Recruiting
  • MORENDO
    Keywords: Endometriosis
    Status: Active, not recruiting
  • Healthy Conceptions for Couples Intervention Pilot Study
    Keywords: Infertility, Obesity, polycystic ovarian syndrome, emotionally focused therapy, weight loss
    Status: Recruiting