Symptoms of the formation and treatment of polyps in the uterus: in the endometrium and cervix

Polyps in the uterine cavity, by their nature and formation reasons, differ from similar growths in the cervical canal. Treatment is almost always surgical. Polypous growths occur at any age, even in young men and women in deep menopause. Symptoms of polyps in the uterus can resemble manifestations of a malignant process, so the attitude towards them is serious.

What are

The term "polyps" of the uterus means a wide group of growths in different parts of the genital organs. Depending on the localization, polyps in the uterus are as follows:

• in the uterine cavity - grow from the inner layer, endometrium, so the second name is endometrial polyps;
• in the cervix - can be located both on the surface and deep in the cervical canal;
• in other places- also found in the vagina, vulva.

In the uterine cavity

All polyps that form in the uterine cavity come from the endometrium - the inner lining. Depending on the composition of the tissues of which they are composed, the following types of growths are distinguished.

• Glandular. Sometimes they are called glandular cystic and functional. They are formed from actively dividing glandular cells, therefore they are background states for the development of the oncological process. Glandular polypous growths secrete a special viscous secretion, therefore, more often than others are accompanied by significant clinical manifestations. They can degenerate into adenomatous, with a more malignant course. More often formed in women of reproductive age under the influence of excess estrogenic background, they can go away on their own.
• Fibrous. They are formed from connective tissue cells, therefore, have a denser structure. Often reach large sizes. Fibrous polyps are more characteristic of menopausal women, almost always they have a benign course. They are insensitive to sex hormones, have an inflammatory or dysmetabolic nature.
• Glandular fibrous. They have a mixed structure - they consist of both connective tissue and glandular. Usually, the denser part of the polyp is located closer to the uterine wall, and the "jelly-like" part freely leaves the cavity. During excision of such growths, insufficient excision of just the “leg” will lead to a rapid relapse of the disease.
• Adenomatous. They occupy an intermediate position between the glandular and adenocarcinoma of the uterus (cancer of the uterus). Therefore, the detection of adenomatous polyps is the basis for a detailed examination and more radical treatment.
• Placental Formed in the presence of chorionic or placenta residues in a woman’s uterine cavity. This is possible after childbirth (delayed lobes of the child's place), abortion (surgical, medical, and vacuums), miscarriages, and undeveloped pregnancy.After removal, they do not reappear.

You can also find a division into typical (hyperplastic) and atypical (aplastic) polyps. Such a diagnosis can be established only after histological examination of the material. Atypical have signs that are close to malignant growth, therefore, require serious treatment.

In the cervical canal

In the cervix, polypous growths of two types are possible:

• glandular - covered with cylindrical epithelium;
• epidermized - covered with stratified squamous epithelium;
• decidual - are formed as a reaction to hormonal changes only during gestation.

The growths can be concentrated in the cervical canal (cervical) and on its surface. The sizes are variable - from 1-2 mm to 3-4 cm. By structure they are most often of medium density, less often - cartilaginous or glandular consistency.

Why grow

Polyps occur mainly in women after 35-30 years and in perimenopause, when the menstrual function comes to its end, hormonal disruptions occur. But from this pathology young nulliparous girls, as well as ladies in deep menopause. The main reasons for the formation of polyps in the uterus are as follows.

Hormonal imbalance

Polyps are hormone-dependent formations formed against the background of an excess of estrogen. Only fibrotic occur independently of female sex hormones. Estrogens are responsible for enhancing the division of endometrial cells, and these progestogens “inhibit” these processes. With imbalance, excessive uneven growth of the inner layer of the uterus occurs. Similar fluctuations in estrogen and progestogen levels are observed in the following women:

• overweight;
• withpolycystic ovaries;
• with hypothyroidism;
• after repeated abortions;
• at endometriosis, especially the uterine body (adenomyosis).

Inflammation

It is believed that both endometrial hyperplasia and polypous growths are formed on the "soil" of chronic inflammation. It can be aseptic, for example, against the background of an intrauterine device or after surgical interventions, or bacterial with a latent course. The latter occurs when there is an infection in the genital tract.
It is inflammation that is attributed a significant role in the formation of polyps in menopausal women against the background of already atrophic endometrium and low levels of sex hormones.

Polypous growths of the cervix in most cases occur against the background erosionectopia dysplasia, with cicatricial deformities or with other types of chronic inflammation.

Injuries

Any damage to the endometrium (after abortion, diagnostic curettage, hysteroscopy) leads to the formation of microgranules into which blood cells rush - macrophages, white blood cells, lymphocytes. To restore the structure of tissues, they secrete various growth activators, enzymes. Violations at some stage lead to the formation of polyps.

Endocrine and immune diseases

Metabolic diseases are often accompanied by a tendency to overweight.In addition to this violation of blood supply, tissue nutrition increases the likelihood of inflammation and improper tissue growth. Most often, polypous growths are found in women with the following diseases:

• autoimmune nature;
• thyroid pathology;
• diabetes;
• cardiovascular problems.

How do they manifest

Symptoms of polyps in the uterus depend on their location, size and associated diseases. Often they are a “find” during a routine examination, especially with small sizes. The following complaints also occur.

• Bloody issues. The most common signs of a polyp in the cervix are contact bleeding that occurs immediately after an intimate relationship, as well as incomprehensible pain in the lower abdomen. Polypous growths of the uterine cavity are accompanied by increased menstrual flow, clots may appear. Functional polyps can even “come out” with menstruation without any operation, however, this should not be hoped for. In some cases, a brown daub appears in the middle of the cycle (it is taken for ovulatory discharge), on the eve and after menstruation.
• Pain syndrome. This is an atypical sign for polypous growths. Pain most often occurs with large polyps that protrude into the cervical canal from the cavity. In this case, they intensify during menstruation, can be cramping in nature.
• Infertility. Such formations can cause infertility, reviews of women confirm this.

The causes of infertility are that polyps:

• create a mechanical obstruction - if there is growth in the cervix or inside the uterine cavity at the mouth of the tubes;
• "Work" like an intrauterine device - observed with large dense growths, concentrated in the center of the uterine cavity.

How to quickly identify

Polyps of the cervix can be seen during examination by a gynecologist; in addition, colposcopy is used for detection - examination under magnification. In most cases, polypous growths protrude from the cervical canal and are easily detected.

Do conception and gestation

Given the fact that polyps are formed, including in women of reproductive age, many questions arise about subsequent pregnancies and the possibility of conception. Most often interested in the following.

• Do polyps interfere with pregnancy. Polyps of the cervix and uterine cavity can mechanically prevent the sperm and egg from meeting. In addition, growths in the endometrium will interfere with the normal implantation of the chorion, causing undeveloped pregnancies and miscarriages. Decidual polyps form after conception, do not interfere with gestation, therefore, they are removed only in cases when they constantly bleed or with excessive growth.
• Do I need to delete. Any polyp must be removed on the eve of pregnancy planning, otherwise there may be problems with conception or bearing.
• When can I get pregnant. After the polyp is excised, conservative treatment is prescribed. Usually it includes hormonal, anti-inflammatory drugs. You can plan a pregnancy immediately after completing the full course. On average, after three to six months.
• Is it possible to confuse with the fruit. A polyp can be “masked” under pregnancy only by delaying menstruation. It is extremely rare to confuse a fetal egg for a short time with a polyp inside the uterine cavity. If in doubt, you must perform a test or take a blood test for hCG.

What are dangerous polyps in the uterus

Polyposis on the cervix or in the cavity is dangerous as follows:

• degeneration into cancer - any pathological formation can be malignant even with apparently benign signs;
• bleeding - polyps are easily injured and violate the normal rejection of the endometrium, so there is always a risk of heavy bleeding;
• inflammation - infection of such growths in the cervix or uterine cavity entails acute endometritisadnexitis cervicitis;
• infertility - a fetal egg cannot be implanted into a pathologically altered endometrium.

What to do with them

Any polyp is subject to removal and subsequent histological examination, according to the results of which further therapy is prescribed.

Polyps in the uterus are removed in the following ways:

• in the endometrium - a curettage of the cavity or hysteroscopy is performed with the removal of the polyp in the uterus;
• in the cervical canal - removal is possible during a biopsy (if the polyp is not deep) or during curettage or hysteroscopy; less commonly used radio wave removal, laser, cryodestruction.

Hysteroscopy - the "gold standard"

Hysteroscopy is considered the most acceptable method for the detection and removal of polyps of the endometrium and cervix. During the procedure, a special tool is used - a hysteroscope. It is a tube with conductors - for the supply of lighting, tools. A minor operation is carried out in eight stages.

1. A woman fits in a special chair on her back.
2. An intravenous general anesthesia is performed for 15-20 minutes.
3. A gynecologist inserts mirrors into the vagina and displays the cervix for review.
4. After its expansion, a hysteroscope is inserted into the cervical canal.
5. A “picture” of the uterine lining is displayed on the monitor screen.
6. If necessary, the removal of polyps and other formations, cauterization of the "legs" for the prevention of relapse.
7. Curettage of the walls of the uterine cavity is performed to control, if necessary, a cervical biopsy.
8. All material obtained is sent for histological examination.

The entire hysteroscopy procedure takes about 20 minutes. For another two hours, the woman is under the supervision of medical personnel, after which she can go home and continue taking medication at home if the postoperative period is uneventful. Recommendations after such manipulation are as follows:

• abstain from sexual activity for 10-14 days;
• it is forbidden to use tampons and douching for a month;
• should refuse to visit saunas, baths for a month;
• It is necessary to avoid physical activity for a month.

Conservative treatment

After removing all pathological growths and histological examination, the question of the need for further medication is resolved. Given the fact that polyps are hormone-dependent, hormone therapy is most often used, as can be seen from the table.

Table - Drugs for the treatment of polyps

Prevention

There is no reliable method for preventing the formation of polyps. The following is recommended:

• control body weight;
• avoid intrauterine interventions;
• regularly examined by a gynecologist;
• compensate for all chronic diseases.

Any abnormal growths of the genitals should be treated. The best approach is to remove the polyp in the uterus during hysteroscopy, after which additional hormonal or antibiotic therapy may be needed. Alertness towards polyps is due to the fact that they are background diseases for the development of cancer. Check out in more detail on the Internet what diseases look like in photos and videos.