Uterine polyps are quite common. They're soft red fleshy tumours of the endometrium (the lining of the uterus or womb).

They vary in size from 1cm - when they contain only endometrial tissue - to 5cm. Larger polyps often contain not just endometrial cells, but also muscular and fibrous tissue from deeper in the wall of the womb.

Polyps are prone to bleeding. Bleeding between periods is often the first clue to their existence.

Polyps may lie flat against the inside of the womb or be pedunculated, which means they form on the end of a 'stalk' of flesh.

Pedunculated polyps sometimes hang down through the cervix, where they may become trapped, cutting off the blood supply (known as strangulation). In this case they may bleed profusely and be painful.

Treatment

Surgery is usually recommended for polyps, for several reasons:

• To establish the diagnosis - this is usually done by curettage (scraping out the womb) and examining the tissue in a laboratory. Larger polyps may be missed. Other diagnostic techniques include hysteroscopy (where a thin telescopic device enables the surgeon to look inside the womb) or a hysterogram (a special x-ray of inside the womb).
• To rule out malignant cancer - most polyps are benign (they grow only locally), but it's essential tissue is removed (a biopsy) to make sure it's not malignant.
• To cure irregular bleeding, by removing the polyp.
• To try to improve fertility. Polyps may interfere with implantation of a fertilised egg in the lining of the womb, so they're often removed to try to improve the chances of conceiving.

While polyps can occasionally be biopsied under local anaesthetic, most surgeons recommend that they're examined and treated under general anaesthetic, especially if a curettage is to be performed as this procdure can be uncomfortable.

If you're worried about a general anaesthetic, ask whether the biopsy can be carried out under epidural. However, a general anaesthetic may be better especially as, with modern anaesthetic drugs, recovery is very swift.