Cervical polyps are benign tumors located on the walls of the cervical canal.
Polypous growths can be the result of prolonged inflammation occurring in the pelvic organs and accompanied by stagnation of blood in the cervical canal. However, the disease is also hormone-dependent, so the imbalance of estrogen in the female body can lead to the development of polyposis, endometriosis, myomatosis and other dangerous gynecological diseases.
Polyps - smooth rounded or papillary (finger-shaped) growths. They can be located on a broad base or thin leg, and may consist of glandular epithelium or connective tissue structures. But there are also mixed types of cervical polyps, which are formed from both types of tissues at the same time.
They can be single and multiple, large and small. The treatment is chosen individually, based on the patient's history and the characteristics of the course of cervical polyposis.
The exact causes of the formation of polyps of the cervix to date have not been established. But doctors identify certain factors that can provoke this process. Polyposis may develop in the background:
- chronic inflammatory processes in the pelvic organs;
- hormonal disorders;
- cervical injuries.
In parallel, gynecologists identify certain risk groups that include women:
- during menopause;
- those who have had sexually transmitted diseases;
- suffering from diabetes.
Pregnancy is also a kind of factor predisposing to the development of cervical polyposis.
Chronic infectious-inflammatory processes
The formation of cervical polyps may be due to the following infectious-inflammatory processes occurring in a chronic form:
- cervicitis, the provocateurs of which most often act as ureaplasmosis or chlamydia;
- human papillomavirus (cervical papillomatosis).
Such pathological processes violate the integrity of the epithelium, impair tissue regeneration and gland function.
Hormonal disorders can occur under different circumstances, but their main cause is impaired ovarian activity. As a consequence, there is a sharp increase in estrogen with a concomitant decrease in progesterone levels. Against this background, the cervical mucosa thickens, which is why polyps are formed. In parallel, a decrease in the amount of progesterone leads to the formation of cysts in the glandular tissues.
Abortions, invasive diagnostic or therapeutic measures, mechanical damage to the mucous membranes of the cervix during intercourse - all of these factors can lead to the formation of polyps. Sexually transmitted diseases are also able to provoke the development of this pathology due to impaired regeneration processes.
Symptoms of polyposis
With small polyps and small numbers of women, as a rule, do not feel any discomfort or other symptoms. But if torsion of the tumor neoplasm occurs, its damage or loss in the vagina, the first warning signs appear in the form of:
- pain syndrome;
- intermenstrual bloody vaginal discharge;
- discomfort in the lower abdomen (during intercourse and not only).
If the polyposis is accompanied by pathologies resulting from hormonal disorders and hyperplasia of the mucous membrane, then the woman will experience symptoms such as menstrual disorders and pulling, cramping pain in the lower abdomen and lower back. In case of cervicitis and infectious diseases of the genital organs, vaginal secretions appear - purulent, mucous, with an unpleasant odor and different intensity.
How does cervical polyp affect pregnancy?
If a woman managed to get pregnant with polyposis of the cervix, the disease will not affect the pregnancy of the fetus. With a small size of tumors, treatment is carried out after delivery. But if the polyps are multiple and large, the doctor may prescribe a removal within the first 13 weeks of the gestational period.
Polyps can prevent pregnancy in the following circumstances:
- Disordered hormonal background. In this situation, an increased level of estrogen is determined, under the influence of which thickening and growth of the uterine mucosa occurs. As the estrogens are elevated, the concentration of progesterone responsible for the onset of pregnancy is reduced. Such disorders lead to disruption of the menstrual cycle and ovulation, therefore, fertilization of the egg is much more difficult. Therefore, in case of polyposis of the cervix, a woman is recommended to undergo treatment for a start, and only then plan a pregnancy.
- Large sizes of polyps. Such tumors prevent sperm from entering the egg. This is another reason to remove polyps before planning a pregnancy.
Timely identified and removed polyps do not cause any harm to women's health. But the lack of therapy for a long time can cause the degeneration of growths into a cancer.
In addition, uterine cervix polyposis can cause:
- severe anemia caused by large blood loss;
- infringement of growths by the walls of the cervical canal (it is only possible to get rid of this effect by surgery);
- aggravation of hormonal imbalance;
- secondary infertility;
- high risk of spontaneous abortion in the early stages.
The most dangerous consequence of polyposis is the malignancy of tumors, since in such circumstances not only the tumor is removed, but also the body of the uterus.
To confirm or refute the diagnosis, conduct:
- Gynecological examination using special mirrors. Thanks to this method, the state of the cervix is visually evaluated, and the neoplasms present are studied. But this becomes possible only if they are located outside or at a short distance from the entrance to the cervical canal.
- Ultrasound of the pelvic organs with vascular Doppler and ultrasound echoscopy of polypous growths. Using this method, you can determine the location, structure and size of polyps on the uterine walls.
- Colposcopy. The procedure is performed using a colposcope, and makes it possible to assess the state of the cervical tissues and polypous growths. During this examination, it is also possible to take tissues for biopsy.
- Hysteroscopy. This method is based on the introduction into the cervical canal of a special instrument with a camera at the end, thanks to which you can thoroughly examine the state of the uterine cervix.
- General clinical blood and urine tests.
- Blood test for hormones.
- Pap smear on cytology.
- Biochemical blood tests.
- Blood tests for tumor markers are specific proteins produced in the presence of cancer. If you suspect polyposis, as well as to exclude the presence of a malignant tumor on the cervix, tests for the tumor marker CA-15-30 are performed.
However, tumor markers can only indicate the presence of oncological processes in the body. The final diagnosis based on the results obtained is not made.
How to treat cervical polyp without surgery
Conservative therapy for cervical polyposis is possible, but not always applicable. It is important to understand that drug treatment does not remove the tumor, but only prevents its further growth, removes the symptoms. To this end, resorted to the appointment:
- hormonal drugs;
- anti-inflammatory drugs.
For polyps, an integrated therapeutic approach is important. The treatment regimen is developed individually.
Hormonal treatment is effective in case of imbalance of female sex hormones. Combined oral contraceptives or progestogens are used.
Hormones contribute to:
- cessation of polyp growth;
- reducing the risk of malignancy of tumors;
- stopping or reducing the intensity of vaginal discharge;
- normalization of the menstrual cycle;
- reduce the likelihood of uterine bleeding;
- reduce pain.
In no case can one take hormone preparations for the treatment of cervical polyposis. Types of drugs are selected taking into account the specifics of a particular situation, the results of blood tests for hormones, by which their exact levels in the body are determined.
What is the difference between COC and gestagen?
- Combined oral contraceptives are prescribed to balance estrogen and progesterone levels. Such medicines contain estrogen and progesterone. They are assigned to patients of reproductive age with polyps formed from glandular or glandular fibrous tissues. Usually, in this pathology, women are recommended to undergo a course of hormone therapy based on the use of Regulon, Yarina, Janine, and their analogues. Start drinking tablets should be from the first day of the menstrual cycle. Treatment should be continued for 3 weeks, after which a week-long pause should be made. During this period, menstruation occurs, and after it ends, you can resume taking the prescribed combined contraceptive. Therapy lasts from 3 to 6 months, but the doctor may set other terms.
- Progestin The drugs in this group are based on the content of progesterone. They help eliminate bleeding and normalize the activity of the endocrine system. The most commonly prescribed medications are: Norkolut, Utrozhestan, Duphaston, and their analogues. These drugs are recommended to take from 11 to 25 days of the menstrual cycle for 10 days. The dosage is determined individually, the duration of treatment is from 3 to 9 months.
Antibacterial drugs are selected depending on which infectious disease caused the formation of polyps:
- When chlamydia is administered antibiotics tetracycline or macrolide series.
- In mycoplasmosis, tetracyclines or fluoroquinolones are used.
- With trichomoniasis, nitromidazole medications are used.
- In gonorrhea, fluoroquinolones and cephalosporins will be effective.
- In the treatment of ureaplasmosis, cervicitis and adnexitis used macrolides, tetracyclines, fluoroquinolones.
Preparations of this group in uterine cervical polyposis are effective in the presence of adnexitis, cervicitis, endometritis and other inflammatory diseases. As a rule, nonsteroidal drugs based on ketoprofen, ibuprofen and diclofenac are prescribed. They are recommended to be taken together with antibiotics. They relieve pain, inflammation, reduce body temperature.
The only way to completely get rid of the pathology is surgical removal of a polyp of the cervix:
- electric wire.
The main methods are the removal of polypous tumors:
- Polypectomy. Unscrewing of tumors is carried out with single polyps and their sizes up to 3 cm in diameter. To begin with, the leg of the growth is unscrewed, after which the mucous membrane is scraped and the polyposal bed is cauterized.
- Hysteroscopy. This is a diagnostic and therapeutic manipulation at the same time. During this intervention, the doctor cuts a polypous bed on the inner uterine layer.
- Diathermocoagulation. During this manipulation, the polyp is excised with an electric knife. But such treatment is fraught with the formation of a scar and a trace on the uterine cervix, which can later cause ruptures during labor.
- Treatment with liquid nitrogen. Cryotherapy is carried out with polyps of small sizes. It is performed on the 8th - 10th day of the menstrual cycle. After processing the growth of liquid nitrogen at low temperatures, it dies.
- Lasercogulation. The procedure is based on the burning of a polyp using a laser beam. After the procedure, there are no scars or scars. Moreover, laser coagulation is a completely bloodless manipulation.
After removing a cervical polyp
If during surgery or hardware treatment not all the polyp tissues were removed, then a new growth of the pathological neoplasm may start from the remaining leg. In addition, it is sometimes possible for the patient to receive thermal burns, the development of stenosis or the formation of strictures of the uterine cervix. All of these conditions and disorders are complications of surgical interventions.
Perhaps the appearance of mucous or bloody vaginal discharge, as well as pain in the lower abdomen after 2 - 3 weeks after surgery. These symptoms usually disappear quickly and do not require treatment. But if necessary, a woman can take an anesthetic drug - Drotaverinum, Ibuprofen or No-silo (as a substitute for Drotaverinum).
For 14 days after discharge from the hospital you should not:
- conduct vaginal douching;
- have sex;
- take drugs containing acetylsalicylic acid;
- to refuse to visit the sauna and bath, and to prefer bathing to a shower;
- use hygienic tampons (you can use only pads);
- do sports, perform intense exercise.
Folk remedies in the treatment of cervical polyps
Folk remedies for cervical polyposis are not particularly effective, and in no way affect either the cause of the disease or the areas of altered tissues. In addition, this disease is fraught with the development of cancer, so you should not risk and decide on such therapy.
The danger of self-treatment using methods of alternative medicine lies in the fact that most of the prescriptions are associated with the introduction of intravaginal tampons, or with syringing medicinal solutions or decoctions. Such rash actions can lead to serious complications.
With cervical polyposis, nothing can be done without prior consultation with the oncogynecologist. In some cases, permissible use of decoctions or infusions of medicinal plants is allowed, but strictly according to the scheme developed by the doctor. For this, the patient may need additional phytotherapist consultation.
To prevent the formation of cervical polyps should:
- avoid stressful situations and depressive episodes;
- annually undergo preventive examinations at the gynecologist;
- eliminate bad habits;
- monitor glucose indicators in diabetic polyposis etiology;
- timely identify and treat infectious diseases of the genital organs and other diseases of the reproductive system in the form of erosion, pseudo-erosion, etc .;
- avoid casual sex;
- use barrier contraception;
- take oral contraceptives exclusively for the purpose of the gynecologist.
With the timely start of therapy in 100% of cases it is possible to achieve complete recovery. Polyposis recurrences are observed in 10% of situations.
The highest risk of re-development of the disease is with adenomatous tumors, so a woman should be regularly monitored by a gynecologist. The prognosis directly depends on the size and number of polyps, as well as on how accurately the patient fulfills all the prescriptions given by her doctor.