WRITER: BECKY SOGLIN
CONTACT: DAVE PEDERSEN
Iowa City IA 52242
(319) 335-8032; fax (319) 384-4638
Release: July 2, 2002
UI study finds some uterine polyps and fibroids can regress on their own
Benign uterine polyps and fibroids occur in many women, especially those
over age 35, and often are surgically removed, particularly if they are causing
abnormal bleeding. However, the natural history of these lesions has not been
studied. Some uterine polyps and fibroids regress on their own without surgery,
according to findings by University of Iowa Health Care investigators.
The researchers found in four of seven women with asymptomatic polyps that
the lesions regressed or went away on their own without treatment. Smaller
growths were more likely than larger growths to spontaneously resolve. The
findings appear in the lead article of the July 1 issue of the journal Obstetrics
"Despite the fact the endometrial polyps are very common, no one had
ever reported on the natural history of these lesions," said Bradley
Van Voorhis, M.D., UI professor of obstetrics and gynecology and the study's
The UI team followed the cases of 64 initially asymptomatic women (average
age 44) over two-and-a-half years to track the development and regression
of uterine abnormalities of polyps, which are benign growths on the tissue
lining the inside of the uterus, and fibroids, also known as leiomyomata,
which are benign tumors in the smooth muscle of the uterus.
The team used saline infusion sonography to monitor the condition of the
women's lesions and thus detect the lesions and record either growth or regression
of the lesions. Saline infusion sonography involves using ultrasound and injecting
fluid into the uterine cavity to better see the polyps and fibroids. Seven
of the 64 women had endometrial polyps at the first examination, and four
of these women had no polyps detected at their second examination. Eleven
of the 64 women had a total of 18 fibroids at the first ultrasound, and among
these 11 women, one had no fibroids at the second examination. The polyps
were more likely than the fibroids to resolve on their own.
"We found in some asymptomatic women that over time the growths no
longer were present," Van Voorhis said. "This natural regression
is something physicians should take into consideration when they might otherwise
recommend surgery to women who have no bleeding or other symptoms. If a small
polyp is asymptomatic, there is no reason to take it out. In addition, our
findings in asymptomatic polyps raise questions about what would happen with
small symptomatic polyps if they were left alone rather than surgically removed."
Typically, the surgical treatment is offered on an outpatient basis and
can involve general anesthesia. Van Voorhis said that fewer surgeries would
mean less expense and time spent by the patient.
"Surgery is effective, but we do wonder how many women would be happy
if their condition was left alone to resolve itself without treatment,"
Van Voorhis said.
In addition to Van Voorhis, UI investigators contributing to the study included
Deborah DeWaay, now a second-year student in the UI Roy J. and Lucille A.
Carver College of Medicine; and UI Department of Obstetrics and Gynecology
faculty members Craig Syrop, M.D., professor; Ingrid Nygaard, M.D., associate
professor; and William Davis, M.D., assistant professor (clinical).
University of Iowa Health Care describes the partnership between the
UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and Clinics
and the patient care, medical education and research programs and services
they provide. Visit UI Health Care online at www.uihealthcare.com.