Uterine polyps: do they need surgery?

Not all uterine polyps need to be removed. Here is what they are, when they are removed and how it is done by hysteroscopy, without abdominal incisions.

By Dr. César Cantú · Minimally Invasive Gynecologic Surgeon · Member of the AAGL · Hospital Ángeles Valle Oriente, Monterrey, Mexico · Updated July 2026 · Leer en español

What are uterine polyps?

Uterine (endometrial) polyps are growths of the tissue lining the inside of the uterus. They are common and mostly benign. They can cause abnormal bleeding (between periods, heavier, or after menopause), spotting, and in some cases are associated with difficulty getting pregnant. Many, however, cause no symptoms and are found on ultrasound.

When are they removed?

  • They cause abnormal bleeding or bothersome spotting.
  • They may be affecting fertility or before a fertility treatment.
  • They appear after menopause (studied more carefully).
  • They have features or size that warrant study.

Some small, symptom-free polyps can be monitored. When removed, they are always sent to pathology to confirm they are benign.

How are they removed? Hysteroscopy

Polyps are removed by hysteroscopy (hysteroscopic polypectomy): a thin camera enters through the vagina and cervix into the uterus, with no abdominal incisions. Many cases are resolved on an outpatient basis, with a quick recovery.

Frequently asked questions

Do uterine polyps always need surgery?

Not always. They are removed when they cause bleeding, may affect fertility, appear after menopause or need study. Small, symptom-free polyps can be monitored.

How are they removed?

By hysteroscopy, with no abdominal incisions; many cases are outpatient.

Are they cancer?

Most are benign. A small percentage can have changes, more often after menopause, so they are sent to pathology when removed.

Do they affect pregnancy?

In some cases they can make it harder or cause bleeding; they are sometimes removed before a fertility treatment. Assessed case by case.

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Educational content; it does not replace an individual medical evaluation.