Polyp of the cervical canal among all gynecological diseases is the most common pathology.
This is a common benign formation, found in 23% in women with existing diseases of the genital area and in 68% - in combination with other diseases of the uterus with appendages.
Polyp of the cervical canal is an enhanced proliferation of normal cervical epithelium. It is found at any age, but most often they are diagnosed in women over the age of 40 years.
Cervical Canal Polyp - Causes
Despite the high prevalence of the polyp of the cervical canal, the causes of its occurrence are not completely clear. It is believed that the most likely of these are genital inflammation and hormonal changes. A combination of them is also possible.
Common causes of polyps include:
1. The presence of inflammation of the uterus, vagina, cervix.
2. Injuries, childbirth, abortion, destructive methods of treatment.
3. STIs, incl. chronic sluggish infections, as well as genital tract inflammation caused by conditionally pathogenic microflora in combination with a decrease in the normal number of lactobacilli.
4. A decrease in the quantity and quality of lactobacilli leads to a decrease in the formation of hydrogen peroxide in which they participate, which causes a decrease in the protective function of mucus. An imbalance of immunoglobulins G, M, A develops: their number increases, but the level of secretory immunoglobulin decreases sharply.
Polyp of the cervical canal - signs
With the development of a polyp of the cervical canal, the signs of this neoplasm, which can include structure, size, quantity and localization, determine the clinical picture and the features of the course of this pathology.
A cervical canal polyp is a benign mass.
Its signs are:
• growth in the lumen of the cervical canal;
• localization in the depth of the external pharynx of the cervix;
• fibrous tissue at its base, covered with cervical epithelium;
• blood vessels in the polyp tissue: the smaller the vessels, the paler the polyp;
• density, depending on the amount of connective tissue: the more fibrous cells in the composition, the denser the polyp;
• sizes from 2 mm to 40 mm, although it rarely reaches such gigantic volumes, mainly polyps are found in height up to several millimeters;
• the presence of a leg: if it is long, the polyp protrudes into the lumen of the vagina and is clearly visible during a gynecological examination.
The following types of polyps are distinguished depending on the histological structure:
• glandular;
• fibrous;
• glandular - fibrous;
• adenomatous.
A polyp can be single or multiple. If multiple polyps are detected, they must be removed promptly, as they increase the risk of cancer degeneration.
A single polyp of the cervical canal of signs and a bright clinical picture with small sizes may not show and in most cases is asymptomatic. It is detected as a find during examination or examination conducted for another reason.
In cases of damage, infection, ulceration or inflammation of the polyp, the following symptoms occur:
• spotting after a gynecological examination, intimacy or as a result of using hygienic tampons;
• bleeding between menstruation - this occurs in case of inflammation or necrosis of the formation; if its integrity is not broken - there will be no bleeding;
• leucorrhea of a mucous - purulent nature - more often occurs with large polyposis;
• pulling pains - occur with a large polyp due to the inability to properly close the cervical pharynx;
• copious mucous discharge - associated with the pressure of the polyp on the mucous glands of the cervix.
Cervical Canal Polyp - Treatment
Despite the fact that the polyp is a benign formation, under certain conditions its malignancy can occur. Therefore, it is considered a precancerous form of the disease of the female genital organs. Depending on the structure of the detected polyp of the cervical canal, treatment can be conservative or with the use of surgical intervention.
1. Glandular polyp - the least dangerous form, it is most easily amenable to drug therapy. It is mainly formed in young women of childbearing age.
2. Fibrous - It is distinguished by high density, because it consists of fibrous tissue, in this regard it is well located on ultrasound, it is a cancer hazard. Therefore, it is necessary to remove the formation with subsequent hormonal treatment. Mostly women suffer after 50 years. In young people it is extremely rare.
3. Ferruginous - fibrous - The most common benign formation, consists of connective tissue and glandular cells, is subject to surgical treatment.
4. Adenomatous cervical polyp - the most dangerous form, requires immediate excision and in the future - prolonged therapy due to high oncogenicity.
Thus, conservative hormone therapy is indicated only in the presence of glandular formation. In other cases, if a fibrous, glandular - fibrous, or adenomatous polyp of the cervical canal is detected, the treatment consists in urgent or planned excision of the proliferation with further adequate taking the following groups of drugs:
• hormones;
• anti-inflammatory drugs;
• local immunostimulants.
Before radical treatment, a course of antibiotic therapy is carried out to exclude the spread of the infectious process after surgery.
The method of surgical treatment is selected individually, depending on the structure, size, localization of the polyp. The following types of surgical intervention are used:
• curettage of the cervical canal;
• targeted hysteroscopy;
• hauling the legs of the polyp;
• cryodestruction;
• moxibustion;
• conization of the cervix;
• amputation.
When prescribing treatment, first of all, the data of histological examination, the multiplicity of growths, the age of the patient are taken into account.
1. Scraping carried out with the simultaneous growth of multiple polyps in the cervical canal and the uterine cavity itself. The likelihood of relapse with this method of treatment is very high, so after the operation, cauterization of the polyp bed is performed.
2. Aiming hysteroscopy represents the "twisting" of the polyp. The risk of relapse is low, manipulation is less traumatic than curettage with cauterization.
3. Polyp leg constriction it is used if the polyp on the leg is located next to the external pharynx and is clearly visible during a gynecological examination. It consists in laying a catgut suture, which leads to the clamping of the vessels that feed the polyp, its further necrosis and rejection.
4. Cryodestruction - the most painless and less traumatic manipulation, the operation takes several minutes in time, and liquid nitrogen is used during its operation. For a certain period after manipulation (in each case - individually), fluid is released from the genital tract. An intimate relationship during this period is not recommended.
5. Moxibustion - different methods are used: electrocoagulation, laser excision, radiofrequency ablation.
6. Conization is a very traumatic method of conical excision of a polyp with adjacent tissues of the cervical canal. Used for relapses of multiple polyps.
7. Amputation is the most radical method, performed when atypical cells are detected in a histological section. The method of treatment of the elderly, because after such an operation, the birth of a child is naturally impossible.
Cervical Canal Polyp - Prevention
In order to avoid the formation of a polyp of the cervical canal, prevention, which consists in following simple rules, must always be strictly observed. Measures that can prevent the appearance of a neoplasm of the cervix include:
• observance of intimate hygiene;
• immediate appeal to a gynecologist at the first manifestations of discomfort, pain, intermenstrual bleeding, leucorrhoea;
• timely treatment of inflammatory gynecological diseases;
• the use of various convenient methods of contraception to avoid injury to the cervix as a result of abortion;
• passing once every six months preventive examinations by a gynecologist.
