I was just diagnosed with Endometrial polyps, I also have a 3 cm Ovarian (simple) cyst on my left ovary.
They actually found the Polyps during a Endometrial Biopsy which was done due to spotting after intercourse. My pap smears have always come back normal. Does it seem odd that they didn't detect the Polyps during the Transvaginal Ultrasound? Isn't this the way they are normally detected?
My doctor is scheduling me to have a D&C in a few months .. she said there is no rush, but will need to be done to make sure all the Polyps are removed.
I honestly do not think that they can see endometrial polyps while doing an endometrial biopsy. They essentially insert a sort of "straw" into the uterus and they blindly try to get as close to the lining as they can. Then they suction some of the tissue as they twirl the straw around. They take the straw out, cut away the portion that contains the sample and send this off to pathology.
I am quite certain that there are other procedures (hysteroscopy or something that sounds like this) where they can scope the uterus and remove polyps to biopsy them. This is a completely different procedure from what you had and I am almost certain that she could not have removed a section of the polyp to have it biopsied while doing this. I think the reason she said that the polyp was not cancerous is because the endometrial biopsy (ie. the sample of the lining that was taken) came back normal, which is indeed very encouraging.
I also was not aware that a D & C could remove polyps so try and look into this. I was under the impression that a D & C suctioned out the lining of the uterus. I imagine a polyp would have to be "cut" out and the lining cauterized, much like any other polyp (colon, stomach etc..). Usually these other polyps are removed during a colonoscopy (colon) or an endoscopy (stomach) so I imagine that a hysteroscope can also be used to remove polyps in the uterus.
I would seriously advise you to do some research and then speak to your doctor again. You may be able to have the polyp(s) removed and biopsied with a much simpler procedure than a D & C, which requires general anaesthesia (although I am not sure what the scoping procedure requires ... the other scoping procedures require a light sedative and not general anaesthesia). Of course, perhaps your doctor is planning to scope and then to do a D & C, thereby making sure that the spotting is taken care of. You will need to ask her exactly how she plans to remove the polyp(s).
As for polyps being found on ultrasounds, yes they can be found this way but I imagine that sometimes they can be missed as they are not as large as cysts and fibroids. Also, make sure that the polyp is indeed in your uterus and not somewhere else (like the cervical canal) as it is strange that she was able to see it during your in office procedure. Oh and by the way, as far as I know (keep in mind that I am no medical expert so you will need to verify), endometrial polyps are not precursors to cancer like colon polyps are (stomach polyps are not either). However, if you feel that your doctor is performing something that you feel is unnecessary or is telling you things that don't make sense, see about at least getting a second opinion from another specialist.
Take care of yourself and tell us how things are going. I bet you will feel so relieved to get rid of this and go back to your normal lifestyle without having to think about polyps and cysts.
Being the overly curious person that I am, I did a bit of quick research and indeed, a hysteroscope can be used to remove endometrial polyps right in the doctor's office, without the use of general anaesthesia. It is also used to diagnose endometrial polyps and to take endometrial biopsies so I am wondering if your doctor didn't use this procedure to do the biopsy as opposed to the usual "straw" technique that is more common. In this case, I don't know why she would not have simply removed the polyp to have it biopsied at the same time (?). This can be done much like the other scoping procedures that incorporate surgical techniques (removal of colon and stomach polyps). Evidently all that is required is to freeze the cervix with a local anaesthetic and that's it ! After the in office procedure, you get up and walk out of the office and go back to your regular life. Mild cramping is a side effect but I am certain that you can control this with anti inflammatories like Advil or Motrin.
This seems to be a much simpler procedure than checking into the hospital for a D & C so perhaps you should find out about it from your doctor. As far as surgical procedures under G.A. go, a D & C is one of the simplest you can have (it is a day surgery) but an in office procedure without G.A. is even better. Of course you would need to have a doctor that can perform this procedure comfortably so this would have to be discussed with your gyne.
Thank you for your continued help and advice, you have been Great!!!!
Is it possible she didn't even see the polyp when she was doing the biopsy? From what I know she did a Endo Biopsy, just to confirm why I was having the abnormal bleeding. This is when she found the polyps. As you can say, I have major health anxiety, I am always looking on the internet for some answers and most of the time it just scares the h*ll out of me .... everything I read states, "cancer." My mind is all over the place. She said she wanted to do a D&C to make sure all the polyps were taken care of. Does it seems like something is not right here? Should I ask further questions? As always, I'm confused and scared!
I've had uterine polyps removed 4 separate times by D&C and hysteroscopy at the hospital. The only way it was diagnosed was by saline ultrasound. There's no other way to be sure they are there. It doesn't make sense that your doc would have not seen them on the ultrasound. No sense at all. Furthermore, they can only be removed in the doc's office if they are cervical polyps. The endometrial polyps are attached to the uterus and need to be surgically cut out during the hysteroscopy. The technical term for it is a polypectomy. If they just go in and do a blind D&C then they won't get the polyp because the suction will just pass right over the polyp, which is attached to the uterine wall by a stalk and hence needs to be snipped off.
Full general anesthesia is not necessary. I only had general once. The other 3 times I had twilight anesthesia. They kept calling it MAC, which is a medical anagram for something or another. I can't remember what it stands for, but it's just knocking you out enough where you're not really aware of what's going on and you're mostly asleep but there's no tube down your throat and you're breathing on your own.
I'm not sure why your doctor would tell you such weird things but it's not at all my experience and I've had it done so many times, I feel like I'm pretty much an expert at the procedure.
As for the cancer link, that's only an issue when you're post-menopausal. You didn't say whether you are or not, but I'm assuming not? And even then it's not like polyps turn cancerous that often. They're just really annoying and for me cause heavy bleeding and really bad cramps, so that's why I always have them removed.
I have put a call into the doctors office. I feel like I am being a pain in the rear, but something is making me raise a Red Flag..
Is there any specific questions that you can think for me to ask?
I spoke to my GYN again (boy do I feel like a pain in the a$$).. She said what was actually found during the endometrial biopsy were fragments of polyps, which to them lets them know that their are other ones there that need to come out. She mentioned this is a very common thing that they see. Basically she explained the procedure to me, they will be doing a D&C / Hysteroscope. I also confirmed with her that all was normal w/ the biopsy besides that and she said everything look good.
She was very helpful, and told me to call her back anytime if I have any further questions.
I did a little research on my own prior to this, and she just basically confirmed what I read. Transvaginal Ultrasounds have a hard time picking up polyps due to them sometimes being flattened. In order to see them they need to do a special ultrasound .. (Sonohysterogram).
Again, I really appreciate all the advice you all gave me, you are great
Don't you dare feel like a pain in the *** !! Your physician should have explained all of this to you in the first place instead of letting you worry like that. It makes sense that she will be performing a hysteroscopy AND a D & C. The hysteroscopy will take care of any polyps and the the D & C will suction out the lining. As for getting "pieces" of polyps from the endo biopsy ... hmmm ... I am not sure about this.
You may want to ask her if the procedure will be done under general anaesthesia or under sedation. Either is possible. Some gynecologists do perform hysteroscopies in their office but I have it from a very good source that this can be very uncomfortable unless you are at the very least sedated (ie. what the previous post referred to as twilight anaesthesia). This is because the uterus has to be inflated with saline or CO2 in order for the surgeon to work in there. I have a feeling that your doctor will do the procedure under general as many of them are done this way. Ask her, just to be sure. And don't even THINK about being a pain in the butt. It is your body they are working on and you should be kept informed about everything at all times. Would you feel this way if they were working on your car and they told you things that didn't make sense? Your body is much more important so being vigilant is even more essential (you can always buy another car).
Oh and in regards to the internet ... try typing in some benign symptom such as coughing or headache and you will get tons of hits for lung and brain cancer. Most of the time neither coughing nor a headache are related to cancer. Same goes for certain types of polyps and other mostly benign symptoms. Inform yourself, of course, but take the information with a big grain of salt and weigh it accordingly.
Hi, Parker. Try not to worry before you know if you have anything to worry about, but I know this is hard. BTW, how old are you? Are you pre- or post-menopausal?
My take on your situation is that there is a range of things it could be, from simple and totally harmless to serious, as I guess you know now after looking it up. Unless you are in menopause and your cycles have become unpredictable (normal for menopause), any bleeding outside of your normal period is always a cause for concern until it can be thoroughly investigated to find its cause.
From reading and from watching the screen as my doctor was doing my own ultrasounds, my understanding is that they can see polyps on a regular transvaginal ultrasound, but they can't tell much about them. They reminded me of how it looks on a map when there are mountains or rough terrain. Just kinda bumpy and lumpy.
I went to my doctor for something similar back in January. In my case, I had been experiencing spotting after intercourse for some time, years since the very first time it happened, only it used to happen only every once in awhile and it had begun to happen frequently. And my periods seemed to be getting longer and heavier than they were. I am 40 years old and pre-menopausal.
They did a standard workup: a pap, an ultrasound, then an endometrial biopsy, in that order. The pap came back clear. The ultrasound saw some of those bumpy shapes, along with a fibroid. Plus, my endometrial lining was thicker than it should have been. My endometrial biopsy came back clear and I was relieved to not have to think about cancer. But the fact that my endometrial lining was too thick meant I needed to have another procedure to see what that was about.
So I had a D&C under general anesthesia, and they sent the tissue to the lab. My understanding of a D&C is that is involves a lot of scraping down the uterine walls with these specialized tools. They want to take off every bit of the current lining and any polyps without missing anything. Probably some snipping goes on if needed. After having a clear pap and a clear endometrial biopsy, I turned out to have a pre-cancerous condition of the endometrial lining, hyperplasia, complex, with atypia, to be exact. I also had lots of polyp growth. Both of these were why I had been bleeding after intercouse and having heavier periods. This kind of hyperplasia means that I had two choices: to try to keep my uterus and go on progestin therapy to see if that would cause a remission back to a normal lining or to have a hysterectomy, which is the recommended treatment. If the progestin doesn't work, I have to have the hysterectomy anyway, because you can't just leave something that is pre-cancerous in place and hope for the best. I have responded well to the progestin treatment so far, my last D&C looked good. But the crystal ball says there is a hysterectomy in my future, since the treatment is just a temporary fix that might only last a few years.
All that is to say that although I understand that the idea of all these procedures is unwelcome, especially going under anesthesia, have as many of them as the doctor says until they feel certain they know what is happening with you. I was flabbergasted to realize the endometrial biopsy was wrong in my case. But if you think about it, that biopsy is just a sliver (or several slivers) of tissue. What about all that other tissue area that was not sampled?
Be well and be thorough. Here's to good lab results for you, my dear! :-)
I am (will be) 38 in August.
I have another ultrasound scheduled next week as a follow up to my 3cm cyst. At first that is what I thought was causing the bleeding (only after intercourse, and only happened twice). My periods have always been regular, and I haven't noticed a change in them (some were lighter, but I blamed this one stress).
I know I worry to much, I will just have to wait until my next ultrasound and try to speak to the technican and see if she/he has any comments regarding the polyps.
Did they biopsy the polyps and find them to be cancerous ? Or was it the thickened lining that contained the atypical cells ? Thank goodness they caught it in the precancerous stage and that your most recent D & C came out clear. Congratulations on your recent results. I guess you will have to continue to keep an eye on things in the near future. The decision to have a hysterectomy is a difficult one, I am sure.
Parker, if you are going for that ultrasound, you may also want to ask about the thickness of your endometrial lining. Usually they will suspect endometrial hyperplasia if your lining is 1 cm or more in thickness. I remember that I was very concerned about this when I had my irregular bleeding episodes back in my 40th year. However, my doctor told me that when he is doing the endometrial biopsy he can usually tell right away if the lining is too thick as the collection of the sample will be different in each case. He may collect very little, just enough or too much in a very short time. I do not know if this is true or not but the fact that my lining was only about 3 mm (as per the ultrasound) made it unlikely that I had hyperplasia (I also had a uterine fibroid which is still present and very small). When they perform your D & C they will do a pathology of the lining that they remove so this will be a much more thorough investigation than the biopsy (although if atypical cells have spread to encompass the entire uterus, I believe they would be more likely to catch this on the biopsy ... the most common form of uterine cancer moves very slowly, fortunately for us).
Most likely your ovarian cyst will be gone at your ultrasound but they may see another one so be prepared. I was always told by my doctors to have my ultrasounds during my period in order to minimize the number of normal functional cysts that are seen. This seemed to do the trick and only my abnormal cyst was seen during this time (at other times there were always follicles ranging in size from a few mms to approximately 3 cms).