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Friday, July 25, 2014
Is endometrial ablation needed for a polyp?
I have been having very heavy periods, with clotted blood discharge, and my doctor has determined I have an Endometrial Polyp. She has recommended the removal of the polyp (Hysteroscopy w/D&C) and an Endometrial Ablation, since I am over 40 and do not plan on having any more children. Other tests for Adenomyosis were negative. How likely is it that the removal of the polyp by Hysterscopy alone will lessen the heavy bleeding? Or is the Emdometrial Ablation necessary? I am concerned about the risks associated with Endometrial Ablation (i.e. making it more difficult to screen for cancer in the future, scarring, etc.). Thank you.
An endometrial polyp will usually cause not only heavy bleeding, but more likely irregular bleeding. If a polyp has been confirmed with a special ultrasound or office biopsy, it is certainly reasonable to only have the polyp removed along with a D&C and forgo the ablation. If the bleeding remains heavy, then you could consider other options like ablation. Heavy bleeding that is not due to anatomic causes (once the polyp is removed) can be managed medically with hormonal regulation to prevent the lining from growing too thick and leading to heavy bleeding.
You could discuss this with your doctor and ask him/her if there is any reason that you couldn't proceed in this manner.
Thomas A deHoop, MD
Formerly Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
No longer associated