Why do polyps grow in the womb and do they need surgery?

Zhimei recently received such a user message:

@ Flying Fish: Hello Sister, can you do a phase of the content of uterine polyps, ah, recently to go to the test, HPV and TCT are no problem, but the doctor said that there are uterine polyps, need outpatient surgery, so scared! Why did you grow this?

Today, Zhimei will give you a good talk about uterine polyps.

"Polyps" are actually benign vegetations that grow on the surface of the mucous membrane. It may grow on the mucous membranes such as the nasal cavity, gastrointestinal tract, and gallbladder.

The polyps of the uterus are divided into "cervical polyps" and "endometrial polyps" according to the place of growth.

If the uterus is likened to a house, this is what the polyp looks like in the room, that is, the endometrial polyp:

This is what the polyp looks like on the nagato, which is the cervical polyp:

Although they are brothers, these two polyps are not much the same in terms of examination, symptoms, and treatment.

[Cervical polyps]: As the name suggests, it is succulent that grows on the cervix, and is also clinically known as "cervical vegetation". Usually single, but also can be multiple, red, soft and brittle texture, tongue-shaped, may have a peduncle.

Three questions about the soul of cervical polyps:

1. How did it come about?

The cause of cervical polyps is unclear. The current mainstream view is that it is due to chronic inflammatory stimulation of the cervical canal. Sometimes estrogen can also be behind it [1].

2. How to find out?

Most cervical polyps can be without any symptoms and are examined by a doctor during a gynecological physical examination.

Reports often describe it as follows: "A pink polypoly-like vegetation the size of a soybean can be seen at the mouth of the cervix" or "a pink tongue-like vegetation can be seen in the cervix"...

A small number of people are found after presentations for bleeding and abnormal vaginal discharge.

haemorrhage:

Polyps are generally rich in small blood vessels, so bleeding is mostly due to touch or friction (intercourse bleeding), usually bright red, or dripping when wiped with a paper towel.

Abnormal vaginal discharge

Polyps may be mainly caused by inflammation and may therefore be accompanied by abnormalities in vaginal discharge, such as increased discharge, odor, bloody streaks, or brownish color.

3. What to do?

If the polyp is eligible for any of the following conditions, a small outpatient procedure is required to remove it [1].

Symptomatic (as with atrial bleeding, excessive vaginal discharge)

Greater than ≥3 cm

Looks "ugly" (doctor suspects viciousness)

Cervical polypectomy is generally relatively simple and can usually be done in a gynecological clinic. However, cervical precancerous screening is usually required before resection to rule out cancerous changes.

Although the malignancy rate of polyps is extremely low, pathological examination is required after resection to confirm whether it is benign.

"Endometrial polyps", also known as uterine polyps, are protrusions formed from the surface of the endometrium from the surface of the endometrium by excessive hyperplasia of the endometrial glands and interstitium. May be single or multiple, and may occur in any part of the uterine cavity.

It can occur at any age in adult women, and the prevalence is significantly higher in postmenopausal women than in premenopausal women.

Three questions about the soul of endometrial polyps:

Endocrine factors

It is often closely related to excessive estrogen levels. Consumption of health supplements containing estrogen, hormone supplementation therapy, etc. may increase estrogen levels.

Inflammatory factors

Long-term gynecological inflammatory stimulation, intrauterine foreign body (birth control ring) stimulation, childbirth, miscarriage, gynecological surgical procedures, etc. may cause the occurrence of endometrial polyps.

other

Age, obesity, and diabetes are also high-risk factors for endometrial polyps [3].

Unlike the big brothers of cervical polyps, endometrial polyps mostly have symptoms:

Irregular bleeding

Approximately 70% to 90% of patients with endometrial polyps experience abnormal uterine bleeding, including intermenstrual bleeding, prolonged menstruation, or irregular bleeding. Postmenopausal bleeding may occur in postmenopausal women [3].

infertile

The presence of endometrial polyps is detected by gynecological ultrasound or hysteroscopy due to prolonged unsuccessful pregnancy preparation [2].

(Source: Network)

There are symptoms

The polyps should be removed surgically. Hysteroscopic-guided polypotomy is usually performed.

It is a minimally invasive procedure that requires general anesthesia and usually requires hospitalization.

asymptomatic

Polyps under 1 cm can be observed and followed up if they have no symptoms, and there is a 27% chance that they will disappear naturally within 1 year.

If the polyp is large or partially in the cervical canal, it is easy to cause secondary infection, necrosis, and cause foul-smelling bloody secretions. Surgical removal is recommended[3].

After women of childbearing age have found endometrial polyps, if they are prepared for childbirth, even if there are no symptoms, it is generally recommended to remove the polyps and then try to conceive, which can improve the chances of conception.

Postmenopausal discovery

The risk of malignancy in postmenopausal women is relatively high, and once the polyps are found, they should be treated surgically as soon as possible, and pathological examination should be carried out to determine the diagnosis of benign and malignant disease.

Well, after seeing so much, I hope that everyone is no longer afraid of the extra "meat" on the womb! If the sisters around you have the same confusion, quickly forward this article to her!

Reviewer

Ou Jilan | Chief Physician of the Department of Obstetrics and Gynecology, Ningbo First Hospital

bibliography

[1] Benign cervical lesions and congenital anomalies of the cervix,Marc R Laufer, MD, UpToDate, Inc.(last updated: May 28, 2020).

[2] Endometrial polyps,Elizabeth A Stewart, MD,UpToDate, Inc.(last updated: Mar 25, 2020.)

Xie Xing,Kong Beihua,Duan Tao. Journal of Obstetrics and Gynecology (9th Edition).Beijing:People's Medical Publishing House,2018.]

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