Uterine polyps are relatively common growths that can develop within the female reproductive tract. While medical intervention is the standard path for removal, the body sometimes initiates a process to detach and expel these growths spontaneously. This spontaneous event is not a reliable form of resolution and requires careful medical investigation. This article explains the biological nature of these growths, the mechanics behind their expulsion, and the necessary steps for medical follow-up.
Defining Uterine Polyps
Uterine polyps, also known as endometrial polyps, are overgrowths of the tissue lining the inside of the uterus (the endometrium). These growths consist of stroma, glands, and blood vessels, often forming a soft, fleshy texture. They attach to the uterine wall either by a broad base (sessile) or by a thin stalk (pedicle or pedunculated attachment).
The size of polyps varies widely, from a few millimeters to several centimeters. While they are overwhelmingly benign (noncancerous), their presence can trigger disruptive symptoms. The most common sign is abnormal uterine bleeding, which manifests as spotting between periods, heavy flows, or bleeding following menopause.
The Mechanics of Passing Uterine Tissue
A uterine or cervical polyp can spontaneously detach and be expelled from the body. This process is often triggered by the uterus treating the polyp as a foreign object within its cavity. The uterine muscle initiates contractions to push the growth out through the cervical canal.
For a polyp to be expelled, it typically needs a slender, stalk-like attachment. As the uterus contracts, the pedunculated polyp is forced toward the cervix, a process sometimes called prolapse. The constant tugging and pressure can cause the thin pedicle to become elongated or twisted, a condition known as torsion. This twisting compromises the blood supply, leading to tissue death (infarction), which allows the growth to detach completely.
The expelled tissue is distinct from a typical blood clot; it may appear fleshy, pinkish-white, or a darker red or brown due to compromised blood flow. Individuals often describe the passed tissue as feeling more substantial or solid than menstrual clotting. While expulsion may provide immediate relief from symptoms, this spontaneous event is not a guaranteed mechanism for complete resolution.
Medical Consultation and Management
Seeking immediate medical evaluation is necessary if an individual passes a polyp or any unexpected tissue. This evaluation confirms the nature of the passed tissue and ensures no fragments remain within the uterine cavity. A physician must also rule out more serious conditions and confirm that the entire growth has been expelled.
Diagnostic evaluation typically begins with a transvaginal ultrasound, which uses sound waves to image the uterus and its lining. A more detailed examination often involves Saline Infusion Sonography (sonohysterography). This procedure introduces sterile saline into the uterine cavity to distend it, allowing clearer visualization of any remaining growths. The gold standard for both diagnosis and treatment is hysteroscopy, which involves inserting a thin, lighted scope through the cervix to visually inspect the uterine cavity.
If a polyp is identified, the standard treatment is a surgical procedure called a polypectomy, usually performed during a hysteroscopy. The removed tissue is sent for pathological examination under a microscope. This step is a safeguard to confirm the benign nature of the growth and to detect the rare possibility of precancerous or malignant cells, particularly in postmenopausal individuals.