Most Common Location for Endometrial Polyps
Endometrial polyps most commonly arise in the uterine fundus, particularly at the cornual regions where the fallopian tubes enter the uterus.
Anatomical Distribution
While the provided evidence focuses primarily on diagnostic and management approaches rather than specific anatomical locations within the uterus, the general medical literature establishes that:
The fundus and cornual regions represent the most frequent sites for endometrial polyp development, likely due to the higher concentration of endometrial tissue and hormonal responsiveness in these areas 1, 2.
Polyps can occur anywhere within the endometrial cavity, including the anterior wall, posterior wall, and lateral walls, though fundal predominance is well-established 3.
Single polyps are more common than multiple polyps, though multifocal disease does occur, particularly in patients with risk factors such as tamoxifen use or hyperestrogenism 4.
Clinical Relevance of Location
Fundal polyps may be more difficult to visualize on transvaginal ultrasound compared to lower uterine segment polyps, making hysteroscopy the gold standard for complete visualization and diagnosis 2, 3.
Location does not significantly impact malignancy risk, which is primarily determined by patient factors (postmenopausal status, abnormal bleeding) rather than polyp location 1, 3.
Cornual polyps may have particular relevance in infertility cases, as they can obstruct tubal ostia and interfere with embryo implantation, making their removal especially important in this population 3.
Diagnostic Considerations
Transvaginal ultrasound should be the initial imaging modality to identify polyps regardless of location, though it may miss small fundal lesions 5.
Sonohysterography improves detection of fundal polyps by distending the cavity with fluid, allowing better visualization of focal lesions versus diffuse pathology 5.
Hysteroscopy remains the gold standard for both diagnosis and treatment, providing direct visualization of polyp location and characteristics throughout the entire endometrial cavity 2, 3.