Hysteroscopic polyp removal is a surgical procedure in which polyps located within the uterine cavity (endometrium) are directly visualized with a camera and removed under direct vision.
This method is performed via the vaginal route without any external incisions, allowing detailed evaluation of the uterine cavity and targeted removal of polyps. The ability to perform both diagnosis and treatment in the same session has made hysteroscopy one of the most commonly preferred techniques today.
Uterine polyps are benign tissue overgrowths that develop from the endometrial lining. They may be single or multiple, and their size can range from a few millimeters to several centimeters. Although they are usually benign, they may cause clinical problems such as abnormal uterine bleeding, menstrual irregularities, and infertility. In rare cases, precancerous cellular changes may be detected within some polyps.
Hysteroscopic polyp removal is commonly indicated in cases of menstrual irregularities, heavy or intermenstrual bleeding, recurrent miscarriages, and unexplained infertility. It is also an important diagnostic and therapeutic method for women experiencing postmenopausal bleeding. Surgery performed under direct visualization reduces diagnostic errors and helps preserve healthy uterine tissue.
Polyps are small growths that are generally benign tumors and can develop in various parts of the body. The uterine cavity is one of these locations. Uterine polyps originate from the endometrial lining of the uterus and grow into the uterine cavity. Although the exact cause of uterine polyp formation is not fully understood, they are known to be associated with estrogen secretion. Increased estrogen levels in the body may contribute to the development of polyps.
Polyps can occur at any age. While they may be seen in younger women, they are more commonly detected during the postmenopausal period.
Uterine polyps may interfere with conception and increase the risk of miscarriage during pregnancy. Therefore, in couples undergoing infertility treatment or IVF, if a uterine polyp is detected during uterine evaluation, it is usually removed via hysteroscopy before treatment. In many cases, polyps are discovered incidentally during routine gynecological examinations.
Before starting polyp treatment, polyps must first be detected and diagnosed. The most commonly used method for evaluating and diagnosing polyps is transvaginal ultrasound. However, because the anterior and posterior walls of the uterus may be in close contact, transvaginal ultrasound alone may sometimes be insufficient for an accurate diagnosis. In such cases, the SIS (Saline Infusion Sonography) method is performed. During this procedure, sterile saline is infused into the uterine cavity through a thin catheter, and the uterine cavity is visualized with ultrasound.
Hysteroscopy is a highly effective and successful method used both for the diagnosis and removal of polyps. The procedure is performed using a thin hysteroscope with a diameter of approximately 4–5.5 mm. The hysteroscope is inserted through the cervix to examine the uterine cavity. Visualization is achieved via a camera located at the tip of the hysteroscope. Polyps identified during imaging are then removed and treated using the same hysteroscopic device.
Polyps removed by hysteroscopy are sent for pathological examination. Treated polyps may recur over time; therefore, it is not possible to specify a definite timeframe for recurrence.
Before starting hysteroscopic polyp treatment, the patient should be adequately informed. This helps eliminate stress and anxiety caused by uncertainty and allows the procedure to be performed more comfortably.
If there are any specific steps, restrictions, or precautions to be followed during the hysteroscopic polyp removal process, these will be explained in detail by your physician.
Prof. Dr. Nilgün TurhanGynecology, Obstetrics and IVF Treatment Specialist
PROF. DR. NILGÜN TURHAN
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