Uzm. Dr. Ertan Özen
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- 36+years exp.
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Gynaecological Procedures
Hysteroscopic polypectomy
What a hysteroscopic polypectomy is, how an endometrial or cervical polyp is removed through the cervix with a camera, when removal is advised and when watching is reasonable, how it compares with blind curettage, approximate costs in Turkey against the UK, US and Germany, recovery, effect on bleeding and fertility, risks and how to check a clinic.
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Prof. Dr. Zehra Neşe Kavak
GynaecologyVerified
- 36+years exp.
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What is hysteroscopic polypectomy and how is a uterine polyp removed?
Hysteroscopic polypectomy is the removal of a polyp from the lining of the womb (endometrial polyp) or the cervical canal using a hysteroscope, a thin telescope passed through the vagina and cervix. No cut is made in the abdomen. Saline is run through the scope to open the cavity, so the surgeon can see the polyp on a screen and take it out under direct vision with fine scissors, a loop that cuts and seals with electrical energy, or a small mechanical shaver that cuts and suctions the tissue. The removed tissue is sent to a laboratory for examination. Many gynaecology departments in Turkey carry out hysteroscopic polypectomy as a day-case procedure.
Polyps are soft overgrowths of the endometrium. They are usually benign, but they can cause bleeding between periods, heavy periods and, in some women, difficulty conceiving. This guide covers when removal is advised and when watching is reasonable, what the operation involves, what it costs in Turkey compared with the UK, US and Germany, how long recovery takes and what to ask a clinic. For the wider picture see our gynaecology treatments in Turkey.
Do I need a polyp removed, or can it be left?
Not every polyp has to come out. Small polyps found by chance in a woman with no symptoms who is still having periods sometimes disappear on their own, and some doctors suggest watching them with a repeat scan. Removal is usually advised when a polyp causes bleeding between periods or heavy periods, when you have bleeding after the menopause, when the polyp is large, when you are trying to conceive or about to start fertility treatment, or when the scan appearance is uncertain. Bleeding after the menopause always needs investigation, and the NHS advises seeing a doctor promptly if it happens.
A very small number of polyps contain abnormal cells, and this is more likely after the menopause. That is why the tissue is always examined after removal and why taking out the whole polyp, not just sampling it, is the standard aim.
How is the procedure done, step by step?
The steps are similar in every hospital, although the setting varies.
- Anaesthesia. A polyp can be removed in a clinic with a narrow hysteroscope and little or no anaesthetic (a "see and treat" approach), or in an operating theatre with sedation or a short general anaesthetic when the polyp is large, the cervix is tight or you prefer to be asleep.
- Access. The cervix is gently opened to the width of the instrument and saline distends the womb.
- Removal. The polyp is cut at its base with scissors, a bipolar loop or a mechanical morcellating system, then taken out. Removing it at the base matters because snipping only the top leaves tissue that regrows.
- Check. The cavity is looked at again for further polyps or fibroids, and the tissue goes for histology.
The operation usually takes 10 to 30 minutes. Most women go home the same day after a short rest.
Hysteroscopic polypectomy cost in Turkey compared with the UK, US and Germany
The figures are approximate ranges for a day-case operation including the hospital stay of a few hours, not hospital quotes. Each hospital confirms its own price in writing after reviewing your scan report.
| Country | Approximate cost range |
|---|---|
| Turkey | €700 – €2,500 |
| United Kingdom | €1,500 – €4,500 |
| United States | €3,000 – €9,000 |
| Germany | €1,500 – €4,000 |
The price moves with the type of anaesthesia, whether the surgeon works in an office setting or a theatre, the size and number of polyps, whether a fibroid or scar tissue is removed in the same sitting and the cost of histology. A package normally covers the consultation and ultrasound, the operation, the anaesthetist, the laboratory report and a follow-up check; ask for these items listed. If a stay of a few days is planned, accommodation and transfers are priced separately in most programmes.
Hysteroscopic polypectomy, D&C or watchful waiting?
Blind dilatation and curettage (D&C) scrapes the lining without seeing inside, and polyps are easily missed or only partly removed. Professional guidance, including from the Royal College of Obstetricians and Gynaecologists, favours looking directly with a hysteroscope for this reason. The choice among the options looks like this.
| Approach | Suited to | Typical limits |
|---|---|---|
| Clinic (see and treat) hysteroscopic polypectomy | Small and medium polyps, tolerant patients | Can be uncomfortable; large polyps may need theatre |
| Theatre hysteroscopic polypectomy | Large or multiple polyps, tight cervix, anxious patients | Needs sedation or general anaesthetic |
| D&C (blind) | Rarely used for polyps now | Polyps can be missed or left in part |
| Watchful waiting | Small polyps with no symptoms before the menopause | No treatment of the polyp; needs repeat scans |
If a scan shows a fibroid pressing into the cavity as well, the same hysteroscopic approach is used for hysteroscopic myomectomy, and a uterine septum is dealt with by hysteroscopic septoplasty.
Does removing a polyp improve bleeding and fertility?
For abnormal bleeding the evidence is straightforward: polyps are a recognised cause, and removing them stops or reduces the bleeding in most women whose symptoms came from the polyp. Bleeding can still continue if another cause is present, such as hormonal imbalance, fibroids or adenomyosis, so a clear diagnosis before surgery matters.
For fertility the picture is more careful. Polyps can interfere with implantation, and some trials suggest that removing a polyp before intrauterine insemination raises pregnancy rates, while data before IVF are less clear. Fertility societies in Europe and the US generally advise removing polyps found in women who are trying to conceive. Removal is not a fertility treatment in its own right, and your doctor should treat it as one part of your overall plan.
Who is a good candidate, and who should wait?
Good candidates are women with a polyp confirmed on ultrasound or saline sonography who have symptoms, are trying to conceive, are postmenopausal with bleeding, or have a large polyp. The operation is delayed if you are pregnant, have a pelvic infection, or are bleeding heavily at that moment, because the view inside the womb will be poor. It is best timed for just after a period, when the lining is thin. Women who take blood thinners or have a bleeding disorder need a plan from their own doctor first. Cervical or uterine cancer, if suspected on scan or biopsy, needs a different pathway from a simple polypectomy.
Hysteroscopic polypectomy recovery: what to expect
Most women feel period-like cramps for a day, and spotting or light bleeding can last up to two weeks. Simple painkillers are usually enough. You can walk and do light work the next day, and most people return to a desk job within one to three days. Avoid tampons, sex, swimming and baths for about two weeks, or as the surgeon advises, to lower the risk of infection. Call the clinic if you have fever, heavy bleeding that soaks a pad an hour, severe pain or foul-smelling discharge. A follow-up appointment reviews the histology result, usually within one to two weeks.
If you travel for the procedure, a stay of two to three nights is typical: one day for assessment, the operation, and a final check before flying. Short flights are generally allowed once the surgeon has seen you.
What can go wrong, and can the polyp come back?
Hysteroscopic polypectomy has a low complication rate, but no operation is without risk. Possible problems include bleeding, infection, injury to the cervix, a small hole in the wall of the womb (perforation) and, rarely, an overload of the fluid used to distend the cavity. Perforation is more likely with a narrow or scarred cervix, and surgeons reduce the risk by working under vision and limiting fluid. Polyps can recur, especially in women with a tendency to form them, so ongoing symptoms after removal should be reported rather than waited out. The NHS and RCOG patient leaflets describe these risks in plain terms and are worth reading before you decide.
How to choose a gynaecologist and hospital, and what to ask
Look for a gynaecologist who performs hysteroscopic surgery regularly, a licensed hospital with an anaesthetist and a pathology laboratory, and a plan for who reviews your histology result once you are home. Red flags include a diagnosis made without any scan, offers of surgery with no review of your records, no named surgeon, a fixed price quoted without seeing your report and pressure to book quickly. Read how our process works and send your scan report through the free quote page; the hospital reviews it and sends a written plan and price.
Questions worth asking:
- Will the polyp be removed at its base, and by which technique?
- Will it be done awake in a clinic or under anaesthesia in theatre?
- Is histology included, and how will I receive the result?
- What happens if a fibroid or septum is found during the procedure?
- How many nights should I stay, and who answers calls after I fly home?
Hospitals with Gynaecology in Turkey
Frequently asked questions
It is the removal of a uterine or cervical polyp with a hysteroscope, a thin camera passed through the cervix. The surgeon sees the polyp on a screen and removes it with scissors, a loop or a shaver, without any abdominal cut.
Not always. Small polyps without symptoms before the menopause are sometimes watched. Removal is usually advised for bleeding, postmenopausal bleeding, large polyps or when you are trying to conceive.
Approximate ranges are €700 to €2,500 in Turkey against about €1,500 to €4,500 in the UK. The price depends on the anaesthesia, polyp size and whether histology and follow-up are included.
The cervix is gently opened, so cramps like period pain are common. It can be done with sedation or a short general anaesthetic if you prefer to be asleep, and simple painkillers are usually enough afterwards.
Most women return to light activity the next day and to work within one to three days. Light bleeding or spotting may last up to two weeks, during which tampons and sex are normally avoided.
Yes, polyps can recur, particularly in women who tend to form them. If bleeding returns, report it to your gynaecologist rather than waiting, so that a scan can check the cavity again.
Polyps can interfere with implantation, and some trials suggest removal before insemination improves pregnancy rates. It is one part of a fertility plan, not a treatment on its own.
Hysteroscopic removal lets the surgeon see and remove the whole polyp, while blind D&C can miss it or remove only part. Professional guidance therefore prefers the hysteroscopic method.
Yes. The removed tissue is sent to a laboratory. Abnormal cells are uncommon, but they are more likely after the menopause, which is why histology is part of every polypectomy.
Two to three nights is typical: assessment, the operation and a final check before the flight. The surgeon should confirm you are fit to fly, usually a day after the procedure.
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