cervical polyp - this excessive proliferation of unchanged focal epithelial cervical canal as a benign outgrowth of origin.Cervical polyps are always grow into the cavity of the cervical canal.They are not a rare disease of the cervix (20-25%), recorded at any age, even during pregnancy, but most of them are from abroad have overcome forty patients.
cervical polyps are different in different shapes and structure, can grow on thin "legs" or have a dense, broad base, they are single or form groups.The size of the polyps is also ambiguous: small polyps of several millimeters often "live" in the cervical canal are asymptomatic for many years, and the largest (a few centimeters) blocks a cervical canal.The reasons for
nolipov cervical thoroughly understood.They are expected to appear, with the participation of hormonal dysfunction, local inflammation, or tissue injury previously transferred cervix.Almost always, the presence of polyps in the cervix accompanied by the presence o
Cervical Canal is inside the cervix.Its inner surface is lined with a cylindrical shape having epithelial cells and submucosa glands are many active.Cervical glands produce a protective mucous secretion, which fills cervical canal like a cork.
inner surface of the cervical canal forms numerous folds, causing it becomes like a spindle.At the beginning of the channel (at the base of the cervix) has a constriction - the outer mouth.In the area of external os stratified epithelium surface of the cervix becomes columnar epithelium of the cervical canal, this place is called a "zone of transformation".
At the point where the cervical canal is connected with the cavity of the uterus, is the second restriction - internal os.Both the constriction formed of dense connective tissue and function as a kind of safety "valve" that prevents the spread of infection.
cervical polyps are formed deep in the external os, middle or top of the endocervical.If they have a long leg, it can act in the lumen of the vagina and visualized by simple inspection.Cervical polyp surface may be covered by columnar epithelium, as the surface of the channel itself, or cells of stratified squamous epithelium similar to the vaginal mucosa.
When forming cervical polyp grows into a large number of blood vessels, so in response to even a small risk of harm to the polyp begins to bleed.
have cervical polyps specific symptoms are not observed.Small polyps, especially not having long legs, can not manifest itself clinically and found by chance.Larger polyps may be accompanied by slight spotting.
polyp cervix during pregnancy - not uncommon (22%).As a rule, they are small, do not manifest themselves clinically and diagnosed by chance during an ultrasound.The presence of small polyps in the canal of the cervix in pregnant women does not require immediate attention because they do not threaten pregnancy.After delivery, the patient need to undergo a second thorough examination to clarify the causes of cervical polyp and undergo the necessary treatment.
diagnosis of polyps of the cervical canal consists of a pelvic exam, a colposcopy, ultrasound scanning using a vaginal probe.
all polyps surgically removed cervical canal.The final verdict is issued Diagnostic Laboratory on the basis of histological study of tissues after polyp removal.
Surgery for cervical polyp ensure full recovery can not.After surgical removal of cervical polyps may recur (12-15%).Therefore, in the postoperative treatment program includes measures for the prevention of recurrence.
Causes cervical polyp
impossible to pinpoint the reasons for which the cervix is required to form polyps, but their development is always accompanied by one of the precipitating factors, or a combination thereof.
provokes polyp conditions are often:
- Mechanical damage lining the cervical canal epithelium during abortions, diagnostic curettage, hysteroscopy, aspiration biopsy, uterine sounding, improper administration of the intrauterine device and such manipulations.
cervical canal also can be injured by extensive generic discontinuities or obstetric manipulation (manual examination of the uterus to remove a piece of the placenta is not separated, forceps and the like).
Obviously, the healing process is accompanied by excessive growth of the "new" mucous cells in the lesion.For the formation of polyps is not necessarily a lot of damage, sometimes it develops in the area of microtrauma.
- occurs on the surface of the cervix structural changes.Often polyps of the cervical canal combined with erosions (true and false), leukoplakia and related pathologies.
- Specific infectious inflammation in the area of the external genitalia.Genital infections (gonorrhea, trichomoniasis, chlamydia, and the like) after the defeat of the vaginal epithelium in the background of reduced local immunity able to climb into the cervical canal, which alter the composition of cervical mucus and provoke local inflammation.Against the background of inflammatory edema of the epithelium of the cervical canal becomes friable and easily vulnerable.In response to the inflammatory damage to the cervical epithelium begins to over-proliferate, forming a polyp.
- Chronic nonspecific inflammation in the vaginal epithelium (vaginitis, vulvovaginitis), cervix (endocervicitis, cervicitis) or uterus (endometritis, endomyometritis).
- Thrust disbiotic processes in the vagina.Long-existing violations of the normal composition of the vaginal flora and pH fluctuations lead to the creation of favorable conditions for vaginal colonization by opportunistic microorganisms capable of provoking inflammation.
- Ovarian dysfunction.The largest number of cases, the appearance of polyps in the cervical canal is registered among patients with dyshormonal pathologies: endometriosis, uterine fibroids, endometrial polyps, hyperplasia of the endometrium.Obviously, excessive influence of estrogen stimulates the growth of abnormal cervical epithelium.
Sometimes the ovaries are not the cause of hormonal dysfunction.It can provoke strong emotional stress (stress, fatigue), or endocrine diseases (diabetes, obesity, thyroid dysfunction).
- Physiological reasons.Polyp of cervix during pregnancy is formed according to physiological reasons, when excessive growth of normal cells triggers hormonal changes.A similar cause of cervical polyps at menopause.
the above reasons do not always encourage the growth of polyps in the cervical canal poppies.Sometimes, cervical polyps occur in the cervical canal for unknown reasons.
Symptoms of cervical polyp
Most cervical polyps do not cause adverse subjective sensations.Polyps are small, especially "sit" on a broad basis, may be asymptomatic for a long time in the cervical canal and diagnosed by chance.
clinical picture of cervical polyps is associated with the development of complications.Most complicated pedunculated polyps, particularly partly projecting beyond the surface of the external os of the cervix.When the surface of the polyp injured, in contact with him there neobilnye spotting.This happens when you use vaginal tampons, gynecological examination, intimacy or douching.
intermenstrual spotting for uncomplicated cervical polyps are not peculiar.But they can appear when a polyp is complicated by necrosis or inflammation.
mucous or mucopurulent leucorrhea accompanied by the presence of cervical polyps in the case of an infectious inflammation.It develops more frequently with large polyps, which are significantly narrow the lumen of the cervix, as well as create favorable conditions for the inflammation.Location
large polyp in the area of the external os prevents him from properly closed, causing a nagging pain.All other existing symptoms (severe pain, menstrual disorders, etc.) caused by concomitant diseases (myoma, genital inflammation, endometriosis, and the like).
have attained large polyps can be accompanied by copious mucous secretions from the constant pressure on the cervical cancer.
most cervical polyps are localized and leg closer to the outer zevu.Therefore, their diagnosis during a gynecological examination no difficulties because they are visualized in the lumen of the cervical canal to the naked eye.
The size and shape of the polyps of the cervical canal is a great variety.Most often they do not exceed the size of half a centimeter, oval or round (mushroom or leaf-less), have a long leg, allowing droop into the vagina, and a smooth surface.
present in the stroma of the polyp blood vessels are visible through the columnar epithelium covering the polyp, and give it a dark pink color.Less often, when their surface is covered by flat stratified epithelium, polyps appear whitish.Dark, bluish, tint becomes a polyp in the event of it circulation (torsion legs, trauma).
Consistency polyp is determined by the presence in them of fibrous tissue, the more it in the polyps, so it is denser.
After inspection of the cervix for further diagnosis all patients need to colposcopy.The method allows a closer look at a polyp, to determine the structure and the structure of covering his cell.
structure of cervical polyp may specify only the histological examination, which necessarily takes place after surgical removal of a polyp.
According cell of cervical polyps are classified into:
- glandular cervical polyp.Rarely is larger than 1 cm. Most often appears in young women.Its structure is dominated by chaotically arranged gland.
- Fibrous polyp cervical canal.It appears mostly in old age.Advantageously composed of dense fibrous stroma, glands and contains almost no.
fibrosing and glandular cervical polyp differ only in the ratio of glandular and dense connective tissue.The glandular structure polyp makes it softer.Fibrous cervical polyp is more density.
- glandular-fibrous, mixed, cervical polyp.It has equivalent ratio of glandular and fibrous structures.Mixed polyps often grow large (2.5-3 cm).
Selecting treatment strategies depends on the structure of the polyp, it is the same in most situations indicating its origin.
high position polyps of the cervical canal can not be seen during colposcopic examination or investigation, but they can be clearly seen on ultrasound scan with a vaginal probe.In the presence of cervical polyp lumen is deformed, and the polyps themselves look as different density parietal a homogeneous structure.
Additional diagnostic measures are carried out in case of a combination of polyps of the cervical canal with other gynecological diseases.
Sometimes patients with polyps incorrect formulate his diagnosis.For example, they may say - "polyp cervix of the uterus."Cervical channel refers exclusively to the cervix, and use the expression "cervix uteri" correctly.Therefore, the phrase "cervical uterine polyp" should be replaced by "cervical polyp 'or' cervical polyp."
Treatment of cervical polyp
Eliminate cervical polyp is non-operational by the impossible, so they are exposed to surgical removal.However, there are situations where small cervical polyps without accompanying complications treated conservatively with anti-inflammatory drugs.Indeed, against the backdrop of such treatment polyps can significantly decrease in size or disappear altogether.Such situations occur when a polyp is true for cervical growths accepted the inner surface of the cervical canal inflammatory origin (pseudopolyps).
When the size of the polyp after anti-inflammatory treatment are reduced, which means that surrounding it eliminated the inflammation, and the polyp is in the cervical canal and must be removed surgically.
Pre preoperative preparation is required only in the case of the accompanying inflammation of the vagina and cervix.A polyp is removed after a course of antibiotic therapy in the presence of the normal analysis.
cervical polyp removal operation agree with the menstrual cycle of the patient.Usually it is administered in the first two weeks after the next menstruation.
There are several methods of surgical treatment of cervical polyp, but the ultimate goal is always its removal followed by histological study.To determine whether there are structural abnormalities in the tissues surrounding the polyp, it explores not only the polyp tissue, and mucous land on which he grew up.
After removing the polyp cervical patient should be supervised.The decision on further medical tactics adopted after histological conclusion.After removing the glandular cervical polyp is no special treatment after the operation is not carried out.Emerging in the cervical canal fibrotic polyps in postmenopausal women have a small risk of malignancy (malignancy), so they can not be left without due attention.
Mixed, fibrous glandular cervical polyps are often accompanied by hormonal dysfunction, which can trigger a relapse.To cervical polyp has not grown again, make adequate correction of existing hormonal disorders.
In situations where a patient refuses to remove a polyp from the cervical canal, have to resort to medical treatment.Hormones and antibiotics eliminate the negative symptoms and help stop the further growth of polyps of the cervical canal, but are not able to eliminate them.
specific methods of relapse prevention cervical polyp does not exist today.The only effective method is considered to be the elimination of the factors precipitating a relapse.It is necessary to maintain the normal hormonal function in a timely manner to treat inflammation of the genitals, eliminate endocrine disorders, to avoid abortion.
removal of polyps of the cervical canal
procedure is the surgical removal of cervical polyps (polypectomy) requires hospitalization of the patient.It is carried out under mandatory adequate anesthesia.
When a polyp is located on the long leg, it just spun, and then eliminate the bleeding at the point of attachment.
Regardless of the surgical technique, after the removal of a polyp produced scraping the entire cavity of the cervical canal.Scraping removes the opportunity to leave a small amount of cells from which a polyp to grow again, and also allows you to explore the "background" in which it was formed.
remove polyps of the cervical canal is possible by several methods:
- Diathermocoagulation.Special electric "knife" cervical polyp is excised.