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Took on and off birth control. Have uterine polyp. D&C and hysteroscopy to be done. Worrisome

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I have a 4cm uterine polyp and am scheduled for a D&C and Hysteroscopy to remove it in two weeks. I am scared to death this could be cancer. Are my worries warranted? I thought polyps were usually the size of a pencil eraser - this is much larger and is causing me heavy bleeding and spotting. 1 year ago my pap came back abnormal, but they told me since I am HPV neg, it was probably due to inflammation and to retest in a year. Now this. During the sonohystogram my Dr. said that my uterine lining looked "nice and thin". Not sure if this matters or not.

I am 40 years old and have 2 young children. My entire life I have had minor gynecological issues (long periods, post-coital bleeding, cervical inflammation) I have a coloscopy and mostly normal pap results. Nothing has ever been found. I had taken birth control on and off for about 10+ years.
Posted Wed, 13 Feb 2013 in Women's Health
Answered by Dr. Timothy Raichle 29 minutes later
Hello I would be happy with you question.

The arguments that this is NOT cancer:
1. Polyps are rarely cancerous
2. Cancer within the uterus is rare at age 41
3. The thin lining is a good sign indicating a low chance of cancer

You are right- they are usually much smaller when found but this is because the abnormal bleeding usually brings them to our attention sooner.

Try not to worry too much, get it removed, and you are going to feel a lot better when this is over !!
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Follow-up: Took on and off birth control. Have uterine polyp. D&C and hysteroscopy to be done. Worrisome 1 hour later
Thank you. I forgot to mention that the polyp looked "sponge-like" on the ultrasound. Is this normal?

Also.... This polyp was found due to an extremely long period (18+ days long), and some abnormal watery orange colored discharge. The Dr. actually saw the polyp descending through my cervix upon examination which lead to the ultrasound followups. Is it typical for a polyp to descend and cause a discharge like that? Since that exam and the follow up appointments I really haven't had that kind of discharge again. The odd discharge is also what has me concerned.

Finally, will the D&C hysteroscopy/polypectomy rid me of the heavy/long/irregular periods?

I appreciate your time.
Answered by Dr. Timothy Raichle 10 hours later
Thank you for the followup - I am sorry for the delay in responding.

The "sponge-like" appearance of the growth in the uterus only means that it is more likely a polyp versus something like a fibroid. This is not a bad sign.

The symptoms that you described are exactly what I would expect for a polyp this size - unpredictable bleeding unrelated to your cycle. And yes, I have seen them on many occasions be a source of a watery-like discharge. This is certainly related to its large size.

And yes, they can descend or even "prolapse" through the cervix. They are often attached to the uterine wall by a long thin stalk.

If all goes well, the polypectomy and D&C will return you to your prior normal periods. I will say, that for the same reason that you might have had irregular or heavy cycles and the development of polyps, this might be a recurrent risk in the future. You should ask the doctor about an "ablation" if you think you are done with child-bearing.

I hope that this helps!!
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