Hysteroscopic Uterine Polyp Removal: precise, incision-free surgery that protects the uterus in Turkey

What exactly is a uterine polyp, and what happens in the womb?

A uterine polyp, or endometrial polyp, is a benign, localised overgrowth of the lining of the womb made of glands, stroma and blood vessels. Polyps are common, found in roughly 6 percent of women before menopause and around 12 percent after it, and they range from a few millimetres to several centimetres. They can cause irregular bleeding and can make it harder for an embryo to implant, which is why they are often discovered during bleeding or fertility investigations. Most polyps are harmless, but because a small proportion can carry pre-cancerous or cancerous change, the removed tissue is always examined.

Is it a polyp or a fibroid — and why does the difference matter?

Polyps and fibroids are often confused, but they are different tissues and the right diagnosis decides the right operation. A polyp is an overgrowth of the lining (endometrium), while a fibroid is a benign muscle tumour of the uterine wall; a fibroid that bulges into the cavity (submucosal) can cause similar bleeding and can also be removed hysteroscopically. Both can affect fertility and both can be addressed through the cervix when they sit inside the cavity, but the technique and planning differ. Telling them apart with ultrasound and hysteroscopy is the first step, because it determines whether a simple polypectomy or a more involved resection is needed.

Source: American College of Obstetricians and Gynecologists (ACOG), abnormal uterine bleeding

Which symptoms point to a uterine polyp?

The most common sign of a uterine polyp is abnormal uterine bleeding, which is why bleeding is the symptom that most often leads to the diagnosis. This can mean heavy periods, bleeding or spotting between periods, irregular cycles or, importantly, any bleeding after menopause. Some women have no symptoms at all and the polyp is found by chance on a scan or during fertility tests, while others notice difficulty conceiving or recurrent miscarriage. Any bleeding after menopause should always be assessed promptly, because it is the symptom most strongly linked to a higher risk of a worrying polyp.

How is a uterine polyp diagnosed?

A uterine polyp is usually first suspected on a transvaginal ultrasound and then confirmed with hysteroscopy, which gives the clearest view. Ultrasound is the first-line test, and adding saline into the cavity (saline infusion sonography) makes a polyp easier to see. Hysteroscopy is superior to the other methods because it shows the number, type and exact location of polyps directly, and it allows the polyp to be removed in the same look (see-and-treat). The definitive diagnosis is always made by examining the removed tissue under the microscope.

Source: Royal College of Obstetricians and Gynaecologists (RCOG), endometrial pathology and hysteroscopy

Can a uterine polyp be cancer?

The great majority of uterine polyps are benign, and the risk of a pre-cancerous or cancerous polyp is low, though it is not zero. In premenopausal women that risk is around 1 percent, rising to roughly 3 to 5 percent after menopause and higher still with post-menopausal bleeding or older age. Larger polyps, obesity, multiple polyps and tamoxifen use also raise the risk a little. This is precisely why we remove and examine the polyp rather than simply watching it when these features are present, so that any abnormal change is caught early.

How does hysteroscopic polyp removal actually work?

Hysteroscopic polypectomy removes the polyp through the natural opening of the cervix, with no cut in the abdomen and no scar. A thin telescope (hysteroscope) is passed into the womb, the cavity is gently expanded with fluid, and the polyp is removed under direct vision with a fine resectoscope or a tissue-removal device while the healthy lining is left intact. The procedure usually takes about 15 to 30 minutes, is done under anaesthesia and is almost always a day case. We use direct-vision removal because it allows the whole polyp to be taken cleanly, which both confirms the diagnosis and lowers the chance of it coming back.

Does every polyp need to be removed, or can some be watched?

Not every polyp has to be removed; the decision depends on symptoms, menopausal status, fertility plans and risk factors. Polyps that cause bleeding, that are linked to difficulty conceiving, or that appear after menopause are usually removed, because they cause problems or carry a higher risk. Small, symptom-free polyps in younger women may sometimes be watched, as a proportion can even regress on their own. We weigh these factors with you and recommend removal when the benefit is clear, rather than treating every polyp the same way.

Source: American Association of Gynecologic Laparoscopists (AAGL), hysteroscopic management of endometrial polyps

Do uterine polyps come back after removal?

Polyps can recur after removal, and how often this happens depends on the type of polyp and how long women are followed. Reported recurrence ranges widely, from a few percent up to around 40 percent over longer follow-up, and it is more likely when there are several polyps or when only part of a polyp is removed. Complete removal under direct vision lowers this risk compared with blind scraping, which is one reason hysteroscopy is preferred. Regular follow-up means that if a polyp does return, it can be found and dealt with early.

Polyps and fertility: can removal help me conceive?

For women whose only fertility obstacle is a polyp, removing it can improve the chance of conceiving and raise pregnancy rates. A polyp can interfere with implantation by bleeding into the cavity or by creating an unfavourable surface for the embryo, and clearing it restores a healthier lining. This is especially relevant before IVF (in vitro fertilisation), where a smooth, polyp-free cavity supports implantation, so we time the procedure and coordinate with the fertility plan. We raise the topic of conception early, so that polyp removal fits naturally into the wider treatment.

Source: European Society of Human Reproduction and Embryology (ESHRE), uterine cavity assessment before treatment

What is our approach to treating uterine polyps?

At the heart of our approach is precision with restraint: removing the polyp completely while protecting the healthy lining, and recommending surgery only when it genuinely helps. We assess each woman as a whole — her bleeding, her menopausal status, her fertility plans and any risk factors — and decide together whether to remove or to watch. Where removal is right, we prefer direct-vision hysteroscopic polypectomy so the polyp is taken cleanly and sent for examination, and for women trying to conceive we time it to support the fertility plan. As Associate Professor Dr. Cengiz Andan and our team, we believe that carrying the whole process through with one responsible surgeon makes a real difference to both trust and outcome.

Why does experience matter even in a "minor" procedure?

Although hysteroscopic polyp removal is a minor, incision-free procedure, the surgeon's experience still shapes how cleanly and safely it is done. Complete removal under direct vision lowers the chance of recurrence, while a careful technique reduces the small risks of this surgery, such as uterine perforation or cervical injury. The 18 years of experience of Associate Professor Dr. Cengiz Andan, with more than 2,000 laparoscopic and hysteroscopic procedures, reflects a high case volume in minimally invasive surgery, and the overall complication rate is kept low, around 2 percent. Even so, we want to be clear that every procedure carries some risk and that results can vary from person to person.

How does recovery and the return home work?

Recovery after hysteroscopic polyp removal is quick, because there is no abdominal wound and the procedure is a day case. Most women go home the same day, have only mild cramping and light spotting for a few days, and return to a normal routine within a day or two. As there is no abdominal incision, a flight home is usually possible within a few days, confirmed at the check-up. Complications are rare, but if a problem arises after you return we remain reachable, coordinate with your doctor at home, and handle the histology, report and follow-up remotely, and your operation note is prepared so you can give it to your own doctor.

Treatment in Europe or in Turkey — what is the difference?

For hysteroscopic polyp removal the difference between Europe and Turkey is not quality but access and cost. The same minimally invasive technique and the same international guidelines are followed in both; the gap comes from the exchange rate and lower operating costs, which lower the price rather than the standard. For many women an added difference is being able to complete the whole process quickly and with one and the same surgeon, instead of waiting weeks or months for a hysteroscopy slot.

How does the treatment process, accommodation and follow-up work from abroad?

For patients coming from abroad, the process begins with a digital assessment before travel and is completed with a short stay in Turkey. You first share your imaging (ultrasound) and reports, and discuss the treatment plan and approximate cost in an online pre-consultation. Because polyp removal is a day-case procedure, a stay of about 3–5 days in Turkey is usually enough, covering the assessment, the procedure and the first check-up. A flight home is usually possible within a few days, as there is no abdominal wound, and your histology result is shared with you and your own doctor once it is ready.