Hysteroscopic Polypectomy
Incisionless removal of endometrial polyps with a camera-guided technique to treat bleeding, spotting, or fertility concerns.
Hysteroscopic polypectomy removes one or more endometrial polyps using a slender camera (hysteroscope) passed through the cervix. A saline solution gently opens the uterine cavity so we can see and precisely remove polyps with micro-instruments or a tissue removal device. There are no abdominal incisions, recovery is typically quick, and the tissue is sent to pathology to confirm the diagnosis.
Fast Facts About Hysteroscopic Polypectomy
No abdominal incisions; all instruments pass through the cervix
Treats abnormal bleeding, intermenstrual spotting, and some infertility cases
Most procedures take 10–30 minutes; many go home the same day
Cramping and light spotting are common for a few days
Removed tissue is sent to pathology for confirmation
Who It May Help
- Heavy or irregular periods, or bleeding between periods
- Postmenopausal bleeding with suspected polyps
- Infertility or recurrent implantation failure where a cavity lesion is found
- Ultrasound or sonohysterogram showing a focal intrauterine mass
- Anemia or quality-of-life impacts related to bleeding
How It Works
After cervical preparation and anesthesia selection, a small hysteroscope is advanced through the cervix while saline distends the uterine cavity. Under direct vision, a resection loop or mechanical tissue removal device excises each polyp at its base to minimize recurrence. The cavity is re-inspected to ensure a smooth lining before completing the procedure.
Candidacy & Alternatives
Good candidates have symptoms or imaging consistent with polyps. We may defer or treat infection first if present. Alternatives include observation for small, asymptomatic polyps, medical therapy to control bleeding, or dilation and curettage (D&C) with or without imaging guidance. However, hysteroscopic removal provides direct visualization and targeted excision, which improves accuracy and reduces missed lesions.
Hysteroscopic Polypectomy vs. Other Approaches
Hysteroscopic Polypectomy
- Direct visualization of the uterine cavity
- Targeted removal at the polyp base
- Outpatient with quick recovery
- Lower chance of missing focal lesions
D&C (Blind Curettage)
- Scrapes the lining without direct view
- May miss small or focal polyps
- Sometimes used when hysteroscopy is not available
- Can be combined with imaging for guidance
Medical/Expectant
- Non-procedural option for mild symptoms
- Does not provide tissue diagnosis
- Symptoms may persist or recur
- Follow-up imaging often required
What to Expect
Plan for a short visit to the surgery center or office, depending on anesthesia. You may feel cramping similar to menstrual cramps for 24–48 hours and have light spotting for a few days. Most people return to desk work within 1–2 days. Avoid intercourse, tampons, swimming, and hot tubs until cleared—often about 3–7 days depending on bleeding and comfort.
Safety & Considerations
Common effects include brief cramping and light bleeding. Uncommon risks include infection, heavier bleeding, fluid imbalance, vasovagal symptoms, or uterine perforation. We review medications (including anticoagulants) and allergy history, and we tailor anesthesia choice to your needs. Pathology results guide follow-up and rule out atypia or malignancy, which is uncommon but more relevant after menopause.
Before Your Visit
- ✓Share recent ultrasounds or sonohysterogram results
- ✓Ask whether to pause anticoagulants or certain supplements
- ✓Arrange a ride home if sedation is planned
- ✓Use pads, not tampons, after the procedure until spotting stops
- ✓Call us if fever, severe pain, or heavy bleeding occurs
Frequently Asked Questions
1Do polyps always need to be removed?
Not always. Small, asymptomatic polyps may be observed. We recommend removal when bleeding, infertility, or concerning imaging features are present, or after menopause when pathology is more informative.
2Will removal help with fertility?
For some patients, clearing a focal cavity lesion may improve implantation and pregnancy rates. Your overall fertility plan considers age, hormones, tubes, semen factors, and other findings.
3Is anesthesia required?
Options range from local and oral medications to IV sedation or light general anesthesia, depending on your comfort, anatomy, and whether additional steps are planned.
4How long is recovery?
Most people resume normal activities within 1–2 days. Cramping typically resolves within 24–48 hours, and spotting tapers over several days.
5What do pathology results mean?
Most polyps are benign. Pathology confirms the diagnosis and checks for atypia. Results usually return within 1–2 weeks and guide any further care.
6Can polyps come back?
Recurrence can occur, especially with risk factors like estrogen exposure. If symptoms return, we re-evaluate with ultrasound and discuss prevention or repeat treatment if needed.
Ready for Precise, Incisionless Polyp Removal?
We'll confirm the diagnosis, remove the polyp under direct visualization, and provide clear aftercare so you can get back to feeling well quickly.
Book an Appointment