Polyp of the cervix/cervical canal: the removal, treatment
Polyp of the cervix is a fairly common pathology in gynecological practice. Such formation can be diagnosed almost in every five women undergoing routine gynecological examination. Leaking often asymptomatic, they do not cause anxiety in the patient and may be discovered accidentally, but in almost all cases, in addition to a polyp, there is another diseases of the female reproductive system.
A polyp is an outgrowth of the mucous membrane of the cervix, a favorite of which is the localization of the cervical canal leading from the vagina into the uterus. The basis of the polyp is a glandular or connective tissue, it is supplied by vessels that nourish it and ensure growth. It is believed that the malignancy is not more than 1% of such entities, but the risk is still there, so tactics against the always radical polyp – removal.
Among patients is dominated by women Mature, premenopausal, or have already entered into menopause. Quite often, the polyps are diagnosed in women with a large number of births in the past, which probably indicates the role of injury of the cervix. The proportion of polyps among all benign processes account for up to 25%, and together with other lesions polyps refers to the processes that can serve as backdrop for cancer, so regardless of the woman’s age and type of polyp you always need the constant supervision of a specialist, even after treatment.
A separate group formations are the so-called decidual polyp in pregnant women which cause reasonable concern to the expectant mother, because they can influence the course of pregnancy.
Causes and types of cervical polyps
Causes of cervical polyps is not exactly formulated, but it is known that the important role played by the state of microflora of the genital tract, the presence of infectious lesions, overall health and lifestyle. So, the most frequent polyps are detected when:
- Cervicitis of different nature.
- Hormonal disorders.
- Traumatic injuries of the cervix.
- Chronic stress and failure of the immune system of women.
Predisposing factors can be considered the age of 40, overweight, concomitant endocrine pathology (diabetes, for example) and other changes in the reproductive system and obstructed labor in the past.
Cervicitis is an inflammatory process in the cervix, which can be primarily infectious agents – human papillomavirus and herpes simplex, yeast-like fungi of the genus Candida (thrush), Gardnerella (bacterial vaginosis), Ureaplasma, Mycoplasma, etc, virtually all pathogens of sexually transmitted infections. In some cases the reason for this inflammation becomes banal flora (staphylo — or streptococci), which can live in the cervix in women with weakened immune systems. The condition of chronic cervicitis may be supported by the imbalance of female sex hormones, and the presence of the polyp will only exacerbate inflammation, causing irritation of the mucosa and increased secretion of mucus, which provides a perfect backdrop for the growth of microbes.
Hormonal disorders are frequent for women after 40 years, when well-established menopause has not yet arrived, and the fluctuations in estrogen levels provoke excessive multiplication of cells of the cervical canal. This fact can be explained by the predominance among female patients women of Mature age.
Injuries of the cervix, accompanied by tears of the mucosa, result in a change in the normal ratio cell layers, especially in the area of junction of the glandular and squamous epithelium covering the cervix outside. In the process of healing grows connective tissue, scars are formed. Against this background there are frequent and secondary inflammatory processes. Cervical injury is most likely in childbirth, abortion, diagnostic curettage, hysteroscopy.
The role of stress and immune disorders, although a clear relationship with the occurrence of polyps is difficult to determine. In the presence of such risk factors hormonal changes, inflammation and reproduction of microbes increases, and therefore creates fertile ground for hyperplastic processes of the mucous membrane.
Polyp of the cervix – the process is multifactorial and the causes are often common with other diseases of the female genital organs, it is not surprising that such education occur in 2/3 of women along with uterine fibroids, endometriosis, cystic changes of the ovaries, endometrial polyps, pseudo cervix.
The polyp of the cervical canal is the most commonly diagnosed localization similar formations of the cervix, although not exclude the possibility of their growth on the outer part of the cervix, which, however, is much rarer.
The basis of the polyp is a glandular epithelium, due to the reproduction of cells which is the growth of education. With increasing size, the polyp can «hang» through the external uterine throat in the vagina, then it can be seen with a normal examination by a gynecologist.
Externally, the polyp is a protrusion of the mucous membrane of round or oval shape, the broad base or a thin stalk, red or pinkish color. When blood circulation in the polyp (for example, when torsion of its vascular pedicle), the color changes to purple, or maroon. The more connective tissue is contained in the polyp, so it is denser. Sizes rarely exceed 3-4 cm, usually a polyp is detected at an earlier stage of its development.
Microscopically the polyp resembles a fragment of a mucosa of the cervical canal, but with more developed subject of connective tissue layer and epithelial proliferating epithelium, the blood supply is well developed, due to that there is nutrition education.
Conclusions histological study after removal of a polyp, you can see the different options that reflect the essence of the process, and the likelihood of recurrence or malignancy. Depending on the structure, decided to allocate:
Glandular and glandular-fibrous polyps represent a neoplasm with a well-developed epithelial cell component with a certain amount of connective tissue stroma. These polyps are diagnosed more often in young women or with hormonal disturbances in premenopausal women when estrogen levels are still high. Their structure is very similar to the mucosa of the cervical canal, therefore, if the vascular pedicle was not seen by histology, the diagnosis of a polyp may be in doubt.
The fibrous polyp is dense, it is based on the connective tissue, glandular epithelium covers mainly outside. The presence of such polyps usually reflects a fading of the hormonal function or the menopause. These polyps have a greater risk of becoming malignant and therefore require special control and adenomatous resembling a benign glandular tumor (adenoma). Sometimes the polyp is equipped with such a number of vessels that called angiomatous or vascular.
Decidual polyp and pregnancy
The expectant mother, anxiously awaiting the birth of a baby, very worried about a pregnancy, so any changes in the reproductive system cause well-founded concern. Polyps «not bypassed» and this category of women. When pregnancy occurs a very special kind of entities – decidual polyp, which represents not that other, as the growth of decidual tissue, which turns the mucosa of the uterus during pregnancy.
Powerful hormonal changes that occur after conception, causes growth of the endometrium, which will then serve as a bed for the embryo and the source of his power. Excessive amount of decidual tissue may lead to its protrusion into the cervical canal, and then it creates the appearance polosnogo education. In fact, it is not actually a polyp, since deprived of the vascular pedicle (pseudopolyps), but can give a lot of problems for the future mother.
As the fabric formed of the chorion is rich in blood vessels, any irritation, be it a medical examination or physical activity that can cause bleeding, which can not scare the mother. In addition, such a polyp may be infected, and then the inflammation and microorganisms can penetrate into the uterus, where the growth of the embryo.
Coming from a doctor with this conclusion, do not panic, because decidual polyp most often detected at the beginning of his appearance, of course, subject to regular visits to the obstetrician-gynecologist. Given the possible consequences (risk of miscarriage, inflammation, bleeding), doctors prefer to get rid of pseudopolyps before the end of pregnancy to ensure the safe formation of the fetus and childbirth afterwards.
Symptoms of cervical polyps
Symptoms of cervical polyps are not specific, and, given that this pathology is often combined with other changes of the uterus, and a polyp suspected through clinical signs is not easy. On the other hand, any alarming symptoms or unusual changes in the reproductive system needs to bring a woman to a doctor who’ll diagnose you.
Signs of a polyp of the cervix are:
- Bleeding from the genital tract outside of menstruation, during menopause, after sexual intercourse or diagnostic procedures;
- Abundant uterine bleeding, prolonged menses with blood clots;
- Lower abdominal pain at rest, during the intercourse;
- Copious white or gray from the vagina.
The majority of small polyps are asymptomatic, but signs of their presence can be associated with secondary inflammation, penetration of micro-organisms, injury polyp, ulceration.
Decidual polyps in pregnant women can cause not only bleeding, but also increased tone of the uterus in the early stages, irritating the nerve endings of the cervical canal. The risk of abortion substantially increases.
Mistakenly believe that infertility or menstrual irregularities associated with the appearance of a polyp. On the contrary, the polyp appears when the hormonal background and other processes that lead, in particular, and infertility.
Diagnosis of cervical polyps
The appearance of the above symptoms, and more often during routine visits to the antenatal clinic, the doctor diagnoses a polyp of the cervix after inspection in the mirror. To confirm the diagnosis and establish the type of neoplasm are:
Inspection mirrors allows you to see a polyp of large size or one that acts in the lumen of the vagina through the external uterine throat. Supplement examination by colposcopy and cervicoscopy allows us to consider education with the increase, establish its precise localization and suggest.
Ultrasound examination of the pelvic organs it is necessary to clarify the size and localization of the polyp, and in some cases may require the introduction of saline solution into the uterus to distinguish endocervical polyp growths from the mucous membrane of the uterine cavity.
Separate diagnostic curettage aimed at obtaining fragments of the mucous membrane of the cervical canal and of the polyp, followed by histological examination to accurately determine the structure of the polyp and the possibility of malignant transformation.
After the biopsy and diagnosis of polyp of the cervical canal becomes the only possible the removal of tumors, but if the pathological process is accompanied by severe inflammation, especially of an infectious nature, it is necessary to conduct a bacteriological culture or PCR to clarify the nature of the pathogen. After careful treatment of infectious cervicitis will be possible with radical resection of the polyp.
Treatment of cervical polyps
In the presence of a polyp, every woman cares about, first and foremost, how to cure it so that to avoid recurrence and malignant tumors. Many have heard about the «open» traumatic operations, which have recently been used in gynecology for the treatment of such tumors.
Today, medicine has a range of gentle and minimally invasive treatments that do not require stay in hospital and is quite comfortable for patients, so afraid of the treatment is not exactly necessary.
For effective treatment medical doctors try to apply modern techniques to get rid of the polyp without disrupting the structure of the cervix and the risk of infertility or pregnancy loss in young female patients. Often these operations can be carried out even in conditions of female consultation and without hospitalization of the woman, and the effects and beauty effect for the cervix will be favourable.
A surgical operation to remove a polyp involves exposure of the cervix with the help of mirrors, after which the polyp is captured by the clamp, and Unscrew his leg. After removal of the education the doctor takes a scraping of the cervical canal to the fragments of the legs of the polyp was not left in the cavity. If ultrasound were found changes in the endometrium, the operation to remove a polyp is supplemented by hysteroscopy and curettage of the mucosa of the uterine cavity. After all the manipulations, the resulting material is sent for histological examination.
During pregnancy remove polyps larger than 1 cm, or in cases where they are accompanied by bleeding, infection or signs of malignancy.
Complications after treatment a polyp might be a recurrence if incompletely removed his foot, inflammation, scars and adhesions in the cervical canal and even burns to the careless burning the growth of tumors. To avoid such consequences is largely allows the use of modern, gentle techniques, as well as early detection of polyps and proper preparation for its removal (antibacterial therapy, etc.).
Among the modern minimally invasive techniques of treatment of cervical polyps deserve special attention laser removal and the use of radio-frequency knife.
Laser treatment is considered a minimally invasive technique, allowing you to quickly and effectively get rid of the polyp in a short period of time. The operation can be carried out in conditions of female consultation. The benefits of laser treatment is considered as minor trauma to surrounding tissues and minimal risk of scarring, so the removal of a polyp particularly suitable for nulliparous women.
Radiono, widely used in medicine for the removal of various tumors and pathological processes, finds its application in gynecology, showing high efficacy, safety, and good cosmetic result. Such exposure is performed using apparatus Surgitron, the undoubted benefits which believe:
- Impact purely on pathologically changed tissue;
- No bleeding and risk of infection;
- The lack of scarring after surgery;
- Painless procedure and high speed of its implementation;
- Fast healing of the mucosa in the area of influence of radio waves.
Of course, in each case, removal of the polyp and the amount of intervention required is determined by the doctor depending on the size and type of tumor, the status of other departments of the reproductive system in women of her age, probable pregnancy in the future. Nulliparous patients is preferable to use minimally invasive procedures that are not followed by scarring and deformity of the cervix, predisposing to pregnancy loss and the threat of interruption.
After removal of a polyp of the cervical channel is assigned antibacterial drugs for the prevention of infectious-inflammatory complications anti-inflammatory drugs, if necessary — hormones to correct hormonal background. In most cases, the recovery period is quick and easy, does not require the presence of the patient in the hospital and not affecting her lifestyle, except that it is recommended to respect the calm, avoid physical overload and sexual intercourse for 4-6 weeks after the procedure.
Polyp of the cervix – pathology very common, so panic with this diagnosis do not need, especially because the risk of its transition in cervical cancer is quite low. In order to prevent such a woman is enough to live a healthy lifestyle, regular checkups even in the absence of any complaints or symptoms of the disease, but if there is another pathology of the sexual sphere, it is necessary to treat it in a timely manner. Modern, gentle, yet highly effective methods of treatment allow to get rid of the polyp with minimal risk of complications and recurrence.