A uterine polypectomy is a procedure to remove polyps from the inner lining of your uterus. These polyps are small, usually noncancerous growths that attach to the uterine wall and can cause heavy periods, irregular bleeding, or fertility problems. The procedure is most commonly performed using a hysteroscope, a thin camera inserted through the vagina and cervix, which lets a surgeon see and remove the polyps without any external incisions.
Why the Procedure Is Done
The most common reason for a uterine polypectomy is abnormal bleeding: periods that are heavier than usual, bleeding between periods, or unexpected bleeding after menopause. Polyps can also interfere with getting pregnant by disrupting how an embryo implants in the uterine lining. In some cases, polyps are discovered during a routine ultrasound even when they aren’t causing symptoms.
There’s also a cancer screening reason. Among postmenopausal women, roughly 8% of endometrial polyps turn out to be premalignant or malignant. The average age for these cases is around 65, compared to 60 for women with benign polyps. Once a polyp is removed, it gets sent to a lab for microscopic examination. If cancer cells are found, your doctor will discuss next steps for evaluation and treatment. For premenopausal women, the risk of malignancy is considerably lower, but removal still allows for a definitive diagnosis.
How the Procedure Works
A uterine polypectomy is typically performed as an outpatient procedure, meaning you go home the same day. The surgeon inserts a hysteroscope through your cervix into the uterus. Fluid is used to gently expand the uterine cavity so the camera has a clear view. Once the polyp is located, it’s removed using one of two main techniques.
The first is electrosurgical resection, where a small heated loop cuts the polyp away from the uterine wall, and the tissue is then retrieved from the cavity. The second is mechanical morcellation, which uses a disposable cutting device that simultaneously cuts and suctions the polyp tissue out. Both approaches are effective, and the choice often depends on the size and number of polyps along with the surgeon’s preference.
Ideally, the procedure is scheduled in the first seven days after your period ends, when the uterine lining is thinnest and polyps are easiest to see. If your periods are irregular, you may need to take a hormonal medication daily until your appointment. If you haven’t previously delivered a baby vaginally, you’ll likely be given a prescription for a cervical softening medication to take the night before.
What Recovery Looks Like
Recovery from a hysteroscopic polypectomy is significantly faster than from major gynecologic surgery. Most women can return to desk work and light daily activities within a few days. You can expect some mild cramping and light spotting for a week or two afterward. Strenuous exercise and heavy lifting are generally best avoided for one to two weeks, though your surgeon will give you specific guidance based on what was done.
Restrictions on sexual intercourse vary, but most providers recommend waiting at least one to two weeks. If the procedure was more extensive or involved additional work inside the uterus, that window may be longer.
Risks and Complications
Hysteroscopic polypectomy is considered a low-risk procedure. A large prospective study found an overall complication rate of just under 1%. The most commonly reported issues are bleeding (about 2.4% of cases), uterine perforation (0.8 to 1.5%), and cervical laceration (1 to 11%, mostly minor). Fluid overload, a rare complication from the liquid used to expand the uterus, occurs in fewer than 5% of cases. Infection is possible but uncommon.
Most of these complications are caught and managed during the procedure itself. Uterine perforation, for instance, sounds alarming but is typically small and heals on its own without further surgery.
How Well It Works for Bleeding
Polypectomy successfully removes the polyps in the vast majority of cases, and about 85% of women report being satisfied with the procedure. However, resolving the bleeding isn’t always as straightforward as removing the growth. In one study tracking outcomes over time, 38% of women experienced recurrence or persistence of at least one bleeding symptom after successful polyp removal. About 16% eventually needed a second surgery.
This doesn’t mean the polypectomy failed. It means that for some women, the polyps were only part of what was driving abnormal bleeding. Hormonal factors, other uterine conditions, or new polyp growth can all play a role. If bleeding persists after removal, additional treatments may be considered.
Impact on Fertility
For women trying to conceive, removing uterine polyps can meaningfully improve pregnancy rates. In a study comparing hysteroscopic polypectomy to a simpler scraping technique (curettage), women who had the hysteroscopic approach achieved a 68% pregnancy rate after their first embryo transfer, compared to 51% in the curettage group. After a second transfer, the gap remained: 80% versus 68%.
Live birth rates were also significantly higher in the hysteroscopic group, with no difference in miscarriage rates between the two approaches. These findings suggest that not only does polyp removal help, but how the polyp is removed matters. The more precise hysteroscopic method, which allows direct visualization, appears to better restore the uterine environment for implantation.
Polyp Recurrence After Removal
One of the most common questions after a polypectomy is whether the polyps will come back. The short answer: they can. Recurrence rates depend heavily on how long you’re being followed. At one to two years, studies report recurrence rates of roughly 13 to 25%. Over longer periods, recurrence climbs substantially, with one study finding a rate of 56% at five years.
The technique used for removal doesn’t appear to make much difference in recurrence. What matters more is time and individual risk factors. If you’ve had polyps once, periodic monitoring with ultrasound is a reasonable approach, especially if symptoms return. A second polypectomy, if needed, carries the same low risk profile as the first.