Types of uterine polyps
In gynecology, polyps in the uterine cavity are distinguished ( endometrial polyps
) and
cervical polyps
.
If after childbirth part of the placenta remains in the uterus, it grows to its surface and forms another type - placental polyp
.
Uterine polyps are usually found in women who have given birth; The likelihood of the disease is greatest between the ages of 40 and 50 years. However, recently, uterine polyps are increasingly being detected at a younger age, including before the first birth.
Depending on the structure of the tissue from which the polyp was formed, there are:
- glandular polyps
, in the structure of which glands predominate over connective tissue; - fibrous polyps
, consisting of dense connective tissue with occasional inclusions of glands; - glandular fibrous polyps
, which are an intermediate option; - adenomatous polyps
, characterized by an altered structure of glandular tissue.
Glandular polyps are more often found in young women, and fibrous and adenomatous in women after 40 years of age (menopause). Adenomatous polyps are regarded as a precancerous disease.
Endometrial hyperplasia
Let's consider one of the most common pathologies of the uterine cavity - endometrial hyperplasia.
Endometrial hyperplasia is a process characterized by inadequate and non-invasive proliferation (growth) of endometrial glands with varying quality of the underlying stroma. Recently, great importance in the development of this process has been attached to inadequate excessive growth of blood vessels, i.e. excessive angiogenesis. In the future, when creating drugs that can block these processes, i.e. have antiangiogenic properties, endometrial hyperplasia and treatment will be a very easy task for the doctor.
Uterine polyps and pregnancy
Small polyps do not interfere with conception, the implantation of the egg on the uterine wall, and the development of the fetus. However, sometimes it is the polyp that causes infertility. Therefore, when planning a pregnancy, it is advisable to make sure that there are no endometrial and cervical polyps. But if pregnancy has already occurred, cervical polyps are usually not removed.
Removal of the polyp, in turn, also does not prevent subsequent pregnancy.
Causes of uterine polyps
Modern medicine does not yet have complete knowledge of the mechanism of polyp formation. The main reason that causes the formation of polyps is considered to be hormonal disorders.
(progesterone deficiency and excess estrogen). Estrogens stimulate the growth of the endometrium, the inner layer of mucous membrane lining the uterus.
The following factors also have a significant impact on the formation of polyps:
- chronic cervical erosion;
- chronic inflammation of the genital organs, including sexually transmitted infections;
- injuries to the uterine cavity resulting from abortions, diagnostic curettages and the use of an intrauterine device;
- miscarriages, fragments of the placenta remaining after childbirth, complications during childbirth (for example, bleeding);
- endocrine diseases (diabetes mellitus, obesity, thyroid diseases);
- reduced immunity.
Anatomical certificate
The endometrium is the inner mucous membrane of the uterus, lining its muscular layer; it consists of glandular tissue and stroma - the base tissue. The endometrium is a hormone-dependent tissue and its structure changes in accordance with a woman’s menstrual cycle.
The main function of the endometrium in a woman’s reproductive system is the successful implantation of an embryo, because in order to carry a pregnancy, it must attach itself to the endometrial wall. Therefore, endometrial pathologies often lead to infertility, in which implantation and successful gestation of the embryo become impossible. But pathology is different, and before making a diagnosis of infertility, a specialist diagnoses a specific disease. There may be several of them.
Symptoms of uterine polyps
Small uterine polyps, as a rule, do not cause any concern. But they can increase and reach quite large sizes - up to 3 cm or more. In this case, the following symptoms are possible:
Menstrual irregularities
Uterine polyps can cause irregularities in the monthly cycle: menstruation may become irregular, of varying duration and intensity.
Bleeding outside the cycle
One of the signs of a uterine polyp may be bleeding outside the cycle (usually a few days after the end of menstruation).
Bleeding after intercourse
There may be slight bleeding after sexual intercourse.
Painful intercourse
There may be pain or discomfort during intercourse (typical of cervical polyps).
Discharge from the genital tract
Leucorrhoea (discharge from the genital tract) may appear.
More about the symptom
Preparation
Preparation for hysteroscopy is similar to other surgical interventions in gynecology. First, an examination and, if necessary, certain treatment are carried out. The following tests are performed:
- General blood and urine analysis.
- Coagulogram.
- Blood type and Rh factor.
- Vaginal smear for flora.
- ECG.
- Test for STIs.
- Tests for HIV and parenteral hepatitis.
Hysteroscopy is planned at the beginning of the menstrual cycle (before day 10), since endometrial tumors are clearly visible during this period.
Immediately before surgery, it is recommended to follow these rules:
- Two days before hysteroscopy, avoid sexual contact.
- On the day of the operation, take a shower and then put on underwear made from natural fabrics.
- Remove jewelry and contact lenses.
- Immediately before entering the operating room, empty your bladder.
- Do not eat for at least 6 hours before anesthesia.
Methods for diagnosing uterine polyps
If symptoms appear, you should consult a gynecologist. Cervical polyps are detected and diagnosed during a gynecological examination. Diagnosis of uterine body polyps is made on the basis of ultrasound data (ultrasound examination of the pelvic organs) and hysteroscopy.
Timely completion of a screening (preventive) gynecological examination, including pelvic ultrasound, makes it possible to detect and take under medical control even small polyps of the uterine body, which usually do not manifest themselves as symptoms. Gynecologists at the Family Doctor recommend undergoing such an examination annually, even if you have no complaints.
Ultrasound of the pelvic organs
Ultrasound of the pelvic organs allows you to detect polyps in the uterine cavity, clarify their number and location. Upon examination, growths of the mucous membrane are clearly visible, having a homogeneous structure.
More information about the diagnostic method
Hysteroscopy
Hysteroscopy is the most accurate method for diagnosing the disease. The method involves inserting special endoscopic equipment into the uterus - a hysteroscope, with which the doctor can examine the situation visually. Hysteroscopy allows you to distinguish single polyps from those growing in dense groups. The color of the polyp is determined.
During the hysteroscopic examination, a biopsy can be performed (biological material is taken for subsequent histological analysis), and small polyps can also be removed.
More information about the diagnostic method
Sign up for diagnostics To accurately diagnose the disease, make an appointment with specialists from the Family Doctor network.
Basic recovery recommendations
- If an antibiotic is prescribed, take it for as long as your doctor recommends.
- To relieve pain after hysteroscopy, you can take antispasmodics or analgesics.
- Avoid sexual intercourse and heavy physical activity until the bleeding stops, but not less than 10 days.
- Perform hygiene measures in the shower. Taking a bath is not recommended.
- Toilet your genitals as needed, but at least 2 times a day.
- During the recovery period, it is not recommended to use tampons and menstrual cups; discharge should come out of the vagina freely.
Most women generally feel satisfactory after therapeutic hysteroscopy. The main complaints are nagging pain in the lower abdomen and weakness. The full recovery period takes about two weeks. However, if complications develop - fever, heavy bleeding, foul-smelling discharge, you should immediately consult a doctor.
Treatment methods for uterine polyps
Polyps should not be left without medical supervision. At the site where the polyp is attached, blood circulation is often disrupted and hemorrhage is possible. This can lead to cell death and become the beginning of an inflammatory process. When placed in a certain location, polyps can cause infertility. But the greatest danger is the possibility of the polyp degenerating into a malignant tumor.
It is very important to identify polyps in a timely manner and consult a qualified gynecologist who will help you decide whether the polyp should be removed or not.
Hormone therapy
Since polyps are formed, as a rule, against the background of altered hormonal levels, an important component of the course of treatment is hormonal therapy. Such treatment allows you to stop the growth of the polyp, as well as reduce the risk of re-formation of the polyp if it is removed.
Removal of uterine polyps
Gynecologists at the Family Doctor recommend removing polyps only in justified cases - depending on their size and location, as well as taking into account the age and condition of the patient.
Removal of polyps is carried out on an outpatient basis, if necessary - on a hospital basis. We use modern equipment for radio wave surgery - Surgitron. It is possible to remove a cervical polyp with a laser.
Make an appointment Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.
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Types of hysteroscopy
There are diagnostic or surgical hysteroscopy. Diagnostic involves only examining the endometrium and endocervix for the presence of pathologies. The study is performed on an outpatient basis and does not require serious anesthesia (local anesthesia and sedation are sufficient) and a long recovery period. Therefore, it was called office hysteroscopy. Based on its results, the doctor draws up a plan for further management of the patient.
Surgical hysteroscopy allows for diagnosis and immediate treatment of identified pathologies. It is performed in an operating room and requires full anesthesia. The procedure is prescribed either when the diagnosis has already been established, or when the likelihood of detecting a pathology is extremely high.
We specialize in surgical hysteroscopy because we believe that invasive diagnostic techniques can be successfully replaced by safer tests. This will help make the correct diagnosis without the risk of surgical complications.
