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Fibroids and polyps

Fibroids are benign muscle growths on the smooth muscle fibres in the wall of the uterus. They do not grow into healthy tissue and generally do not cause any physical problems. A capsule often appears around fibroids so, if necessary, they can be surgically peeled out of the healthy tissue without complications.

A distinction is made between the location of the fibroids:

  • Subserous fibroids: they are located on the outside of the uterus and are covered with peritoneum (serosa). In extreme cases they can be stalked.
  • Intramural fibroids: these are located in the uterine wall
  • Submucosal fibroids: are located just below the lining inside the uterus
  • Pedunculated submucosal fibroids lie in the uterine cavity and are often mistaken for polyps.

Careful ultrasound of the uterus is required before any fertility treatment. Not only are fibroids detected or excluded, but other changes may also be diagnosed (e.g. adenomyosis or malformations of the uterus). The decision as to whether and when to treat fibroids is made by the specialist for each patient individually.

Sometimes fibroids can cause pain, uncomfortable pressure on the bladder resulting in a frequent urge to urinate, prolonged menstrual periods or intermenstrual bleeding. Less often, affected women report constipation, lower back pain or discomfort during sexual intercourse. Unfortunately, such symptoms are often recognised as fibroids very late.

Polyps are almost always benign tissue changes in the body that can develop on the mucous membranes. Polyps can also arise singly or several times in the uterine cavity in a relatively short time. Polyps often go unnoticed by the woman, but there may be increased menstrual bleeding or pain during menstruation. Polyps can often be quickly identified through precise ultrasounds. Signs of polyps could also include increased discharge and bleeding after intercourse. This is the case when the polyp protrudes from the cervix.

In cases of infertility or if polyps cause discomfort, they can be removed as part of a uterine endoscopy. Especially in patients with infertility, it is important that polyps do not interfere with the implantation of the embryo in the uterine cavity.