Should surgery be performed if endometrial polyps are found during gynecological examination?

Whether surgery is necessary for endometrial polyps discovered during gynecological examinations depends on the size of the polyps, symptoms, and the patient's fertility needs. Most asymptomatic small polyps may not require surgery temporarily, while those with a diameter exceeding 10 millimeters, accompanied by abnormal bleeding or infertility are usually recommended for surgical removal. Endometrial polyps with smaller volumes may have no obvious symptoms and are only incidentally discovered during physical examinations. These types of polyps grow slowly and have a low probability of malignancy, and their changes can be monitored through regular ultrasound. For menopausal women, as estrogen levels decrease, some polyps may naturally shrink. Medications such as progesterone capsules and dexamethasone tablets are commonly used in clinical practice to regulate hormone levels and inhibit polyp growth. If polyps enlarge or symptoms such as increased menstrual flow or prolonged menstruation occur during follow-up, surgical indications need to be reassessed. Patients with abnormal uterine bleeding, infertility, or recurrent miscarriage, even if the polyps are small, should consider surgery. Hysteroscopic polypectomy is the preferred treatment method, which can accurately locate and completely remove the lesion, and perform pathological examination to exclude malignancy. Short term use of levonorgestrel intrauterine sustained-release system may be used after surgery to prevent recurrence. Newly developed endometrial polyps in postmenopausal women, or polyps with abundant blood flow and irregular morphology indicated by ultrasound, are recommended to undergo surgery as soon as possible to clarify their nature.

After surgery, it is necessary to keep the perineum clean, avoid baths and sexual activity for one month, and follow medical advice to use antibiotics such as cefixime dispersible tablets to prevent infection. Daily intake of high estrogen foods should be reduced, weight should be controlled within the normal range, and gynecological ultrasound should be reviewed annually. Pregnant women are advised to try to conceive three menstrual cycles after surgery. If they also have endocrine disorders such as polycystic ovary syndrome, they need to be treated simultaneously.