cervical polyps - is to grow into the cavity of the cervical canal, the formation of which is due to excessive proliferation of local unchanged mucosa.Cervical polyps of different sizes, the inner and outer structure and consistency.Polyps arranged in groups or individually, are considered to be a common condition among women who have overcome forty years abroad, but they can also be diagnosed in all age groups and in pregnant women.
The cervix is the lower divisions of the uterus that connects its cavity with the vagina.With the city's only available its lower, vaginal part of.
surface of the cervix is formed by several layers of squamous cells, giving it a pale pink color.
reported uterine cavity with the vagina through the cervical canal.Its appearance resembles the spindle and the inner surface is formed by columnar epithelium, forming numerous folds.Directly under the epithelial layer are many glands that produce the cervical mucus.
At the beginning of the cervi
inner jaws located at the point where communication with the cervical canal of the uterus cavity.Features of the structure of the cervix with cervical mucus provides a protective function, protecting the uterus against unwanted pathogens.
cervix contains a plurality of elastic muscle and collagen fibers that allow the neck to stretch considerably during childbirth.All the structural elements of the cervix have increased sensitivity to cyclical hormonal changes a woman's body, so the appearance of polyps in the cervix linked to hormonal causes.
Dimensions cervical polyps vary considerably from very small (a few millimeters) to large (several centimeters).They can be placed on the expression "leg" or "sit" on a broad basis.Small, individual polyps do not have clinical symptoms and may appear random finding during examination of the patient.
cervical polyp is usually formed at the back or slightly above the external os of the cervix, so poorly rendered during a routine inspection.However, if a polyp has a fairly long leg, he can speak from external os into the lumen of the vagina, and it is easy to detect during an inspection in the mirror.Individual cervical polyps often across multiple.
internal structure similar to the structure of the polyp mucosa cervical canal, but different quantitative ratio of structural elements.The composition may be in the cervical polyp connective tissue, fibrous, glandular elements, but their number and the ratio are not all equally polyps.Polyp with more fibrous stroma has a denser texture than educated mostly glandular elements.Soft polyps often injured and bleeding.Bleeding is the most common symptom of cervical polyp.
Sometimes large cervical polyps can cause infertility, and vice versa - hormonal disorders in women with infertility can trigger the formation of polyps.
Accurate cause of cervical polyps is unknown.They are classified as benign.Malignant transformation is unlikely, but possible.Therefore, any cervical polyp be removed.The only method of elimination with cervical polyps is surgical removal.Cervical polyp removal procedure is not difficult.Unfortunately, even the most skillfully executed cervical polyp removal procedure does not preclude the recurrence of the disease.
To prevent a recurrence is necessary to eliminate the adverse triggers and restore normal hormonal balance.
patients should pay attention to the use of the term cervical polyp of the cervix instead of "cervical polyp."The term "cervical" refers only to the cervix, and "cervical polyp" refers to the precise location of the polyp.This means that cervical polyp of the cervix is the wrong wording.Correct diagnosis sounds like "cervical polyp."
reasons polyp cervical
The immediate reasons for the formation of cervical polyps can not be called, but there are a number of predisposing factors, the combination of which can cause the appearance of polyps:
- the cervix often polyps are formed after mechanical damage to the cervix during abortion or diagnosticmanipulation (hysteroscopy, diagnostic curettage, etc.).Cervical polyps can develop after traumatic manipulation during labor (breaks, forceps, manual examination of the uterus), when the healing of damaged tissues takes place correctly: in the specific area of the cervix begins overgrowth "new" tissues, and form a polyp of the cervix.
- cervical polyps often appear against a background of structural disease of the cervix - ectopia, pseudo, leukoplakia and others.
- play an important role in the origin of polyps assigned chronic infectious and inflammatory diseases (cervicitis, colpitis, endometritis and so the case).The inflammatory process affects the function of the glands, causing damage to the epithelium and distorts tissue regeneration.
- specific inflammatory processes of the genitals (gonorrhea, trichomoniasis, chlamydia and others) lead to reduced local immunity, changes in the composition and quantity of cervical mucus and epithelial proliferation of the cervical canal, thereby causing the formation of polyps.
- A large number of occurrences of cervical polyps among patients with ovarian dysfunction, uterine fibroids, endometriosis and endometrial hyperplasia indicates a possible hormonal nature of the disease.Excessive production of estrogen increases the thickness of the mucous membrane of the cervical canal and the appearance of polyps.
- physiological hormonal changes during pregnancy and menopause can cause the formation of polyps of the cervix.
- Dysbacteriosis vagina can serve as a background for the development of cervical polyp.Fluctuations in vaginal pH and changes in its normal flora leading to excessive reproduction of opportunistic and / or pathogenic microbes.Formed inflammation and, consequently, can form cervical polyp.
- Patients with polyps of the uterus (the endometrium) can be diagnosed and cervical polyps, as a consequence of a single pathological process in the uterus.
- Abnormalities in the psycho-emotional sphere (prolonged stress) could be the starting point in the development of cervical polyp.
- unfavorable background for the formation of polyps in the cervix are endocrine and metabolic disorders (diabetes, thyroid disease, obesity).
Sometimes, cervical polyps are diagnosed in women who do not have the above factors.
Symptoms of cervical polyp
clinical manifestations of cervical polyp determine its structure, size and location."Sit" small polyps often do not manifest themselves.
Some patients with cervical polyps complain of abnormal discharge (leucorrhoea) mucous character.Polyps large irritate nerve endings of the cervical canal and provoke increased mucus secretion.Also, large polyps can significantly change the (narrow) the diameter of the cervical canal, creating conditions for inflammation focal or diffuse.Character cables after joining a secondary infection can be changed - they become purulent or seropurulent.
cervical polyps contain large amounts of blood vessels.When using vaginal swabs during intimacy of a pelvic exam or a surface of the polyp protruding into the vagina due to the long leg, easily injured, and cause contact bleeding.Intermenstrual spotting appear in patients in case of inflammation or necrosis in a polyp.
Occasionally cervical polyps large provoke pain in the lower abdomen and / or lower back.
large polyps can cause infertility: a large number of cervical mucus in the narrowed channel creates a mechanical barrier to the penetration of sperm into the uterus.However, most often the cause of infertility is not a polyp, and related inflammatory and / or hormonal dysfunction.
In most cases, symptoms of cervical polyp detected with the general gynecological examination.Often polyps in the external os well visualized with the naked eye.Advantageously
cervical polyps remain small (up to 0.4 cm in diameter), oval or circular shape.There are atypical forms of petals or cluster.Polyps smooth surface and texture depends on the composition: the more fibrous tissue is contained in a polyp, so it is denser.
Painting polyp depends on the type of fabric forming: stratified squamous epithelium gives polyp whitish appearance, and shine through the cylindrical cover of the blood vessels in his stained dark pink color.The appearance of the surface of the polyp bluish color indicates poor circulation (torsion legs polyp, trauma).
Every second patient of childbearing period cervical polyps combined with ectopia (pseudo), by visual inspection, they may be difficult to visualize.
After examination for diagnosis is carried out colposcopy, which allows you to determine the exact location of the polyp, the size and composition of the epithelium covering the surface.During colposcopy diagnosed background diseases of the cervix - ectopia, leukoplakia and others.The method allows to determine invisible during normal inspections small polyps of the cervix.
Often polyps are areas of necrosis or inflammation, such changes depend on whether the polyp extends beyond the external os.
Ultrasonography vaginal sensor can detect polyps of all sizes, not only in the cervix, but also in its cavity.During the study, specifies the location, number, size and structure of the polyps.In parallel, co-morbidities are diagnosed uterine - fibroids, adenomyosis, endometriosis, and others.
origin of cervical polyps can be accurately established only with the help of histological examination, which is carried out after the removal of a polyp.
in cell composition polyps are divided into:
- glandular cervical polyp .It consists of a large amount of stroma and randomly arranged glands.Not more than 1 cm in size. The young women glandular cervical polyp is diagnosed more often.
- Fibrous polyp cervical .Formed by proliferation of fibrous elements and practically free of iron.It features a higher density.More common in the elderly.Fibrous and glandular cervical polyp different amounts of iron.
- fibrous glandular cervical polyp .In addition to the elements of connective tissue is composed of glandular structures.Often large sizes (up to 2.5 cm).
These histological examination is crucial when choosing a treatment strategy.
In order to determine the presence of pathological changes in the thickness of the cervical canal for histological examination is taken not only the polyp, but also the surrounding tissue obtained during dilatation and curettage endocervix.
often in women with cervical polyps and polyps are in the womb, as well as uterine or endometrial hyperplasia, carried out extensive diagnostics via hysteroscopy.
Differential diagnosis of cervical polyps is performed to eliminate the cysts of the cervix, endometrial polyps or submucosal fibroids projecting beyond the cervical canal.
cervical polyps during pregnancy
sometimes (22%), signs of cervical polyps found in a pregnant woman.Typically, planning pregnancy, a woman undergoes a full inspection and eliminate all unwanted changes (including polyps) before conception.However, sometimes small asymptomatic cervical polyps are detected only during the ultrasound examination of a pregnant woman.Some patients consciously refuse treatment of cervical polyps and pregnant, knowing about his illness.
polyps during pregnancy is not always the same origin and structure.In some cases, pregnancy can cause the appearance of so-called decidual polyp.Polyps pregnant women develop from placenta or chorionic tissue (decidua tissue).Under the influence of the physiological hormonal changes occur in all pregnant growth of the inner lining of the cervical canal.In some the process is intense, and at others it occurs more smoothly.Chorionic tissue is undergoing similar changes, and excessive growth, it falls into the cervical canal, forming polypoid growths that can not be called true polyps of the cervix.Decidua pseudopolyps in fact is not a disease and does not require special treatment, if not manifest themselves during pregnancy.After birth, they are on their own, once stabilized hormones.A feature of decidual polyps is the excessive vascularization, so they are easily injured, followed by infection and bleeding.To avoid undesirable symptoms expectant mother should limit physical activity and observe sexual rest.No harm to health of mother and child does not cause decidual polyp.
Sometimes pregnant women meet the true polyps with decidualization.They are formed in contact with the fabric of a true polyp chorionic cells.They persist after birth and shall be removed.
Regardless of the situation, the combination of pregnancy and cervical polyps is not catastrophic.The vast majority of all cervical polyps do not interfere with the normal development of the pregnancy, but their presence is still fraught with the risk of adverse events.
cervical polyps can provoke inflammation of the vagina and cervix.A pregnant may appear profuse discharge from the genital tract.When you join secondary pathogenic inflammation, discharge could be pus-like.In the context of reducing the body's defenses against the background of pregnancy is safe for the fetus inflammation, so needed anti-inflammatory therapy.Systemic antibacterial drugs can harm the baby, so the treatment is carried out strictly on the testimony.
Pain pulling character in the lower abdomen with a combination of polyps of the cervix and pregnancy deserves special attention.Sometimes large polyps irritate the cervical canal, causing reflex uterine contractions.In this case, there is a risk of early spontaneous abortion.
If a polyp is located on a long stalk and extends beyond the cervix, it can be injured and inflamed, causing spotting, which should be distinguished from those of threatened miscarriage.
In rare cases, when there are serious complications (leg twisting the polyp, necrosis or bleeding), polyp of the cervix during pregnancy still have to be removed.
described potential cases are very rare.Normally, pregnancy and childbirth in women with cervical polyp pass without complications.However, after birth is recommended in such patients undergo a full examination and eliminate the polyp.