Cervical polyp

Proven content

A cervical polyp is formed by the growth of the epithelium and the tissues that line the cavity and canal of the cervix. Structures in the form of polyps under the microscope are in the form of dilated gland ducts around which there are cells of the glandular epithelium, connective tissue and blood vessels. Polyps can be pedunculated, i.e. have a cervix and protrude into the lumen of the cervical cavity or canal, or adhere closely to the tissues from which they originate.

Characteristics of cervical polyps

Cervical polyps usually affect women between 30 and 50 years of age and are most often located in the cervix. These are delicate structures (elongated bumps) that come out of the pedicels attached to the surface of the cervix. In the uterine cavity, they mostly occur in women during menopause. We can divide polyps into cervical (located in the cervix) and endometrial (located in the uterine cavity). The cause of this ailment is currently not fully known. There is talk of a role for estradiol (the female hormone) and its over-synthesis which causes the mucosa to grow. Although polyps are usually benign in nature, sometimes neoplasms may develop on their basis (this is most common in perimenopausal women). There are precancerous forms of polyps and neoplasms that take the form of polyps, so it is so important to perform a cytological examination as soon as possible if disturbing changes are detected and their appropriate treatment.

Cervical polyp – causes

The cause of cervical polyps has not been specifically identified. However, it is assumed that their formation and growth is favored by disturbances in the level of hormones, and more precisely, excess estradiol, which is responsible for stimulating the growth of the epithelium and glands lining the uterus, and too low progesterone levels. Chronic inflammation of the cervix, uterus and vagina, as well as overflow of blood vessels also contribute to the formation of polyps.

Cervical polyps are a very common condition diagnosed in a gynecological office. Women most often report pain in the lower abdomen and bleeding after intercourse and in the middle of the menstrual cycle, as well as more or less heavy bleeding. These symptoms usually appear in premenopausal women and, unfortunately, can become a direct cause of infertility. Fortunately, only in a few cases do these structures develop into a tumor. Polyps, without giving any signals, can accompany patients for many years.

Symptoms of cervical polyps

Usually, cervical polyps (as mentioned earlier) do not give any symptoms for many years and are diagnosed at random during a routine gynecological examination. Polyps can lead to pain in the lower abdomen as a consequence of the contractile activity of the uterus trying to get rid of the polyp. They can sometimes cause longer and heavy periods, or bleeding between periods. Women often visit the gynecologist because of the so-called contact spotting, i.e. spotting after intercourse – during penetration, a partner’s member may disturb the delicate structure of a well-vascularized polyp of the cervix and cause slight spotting or bleeding. They can also appear after a gynecological examination. If bleeding is profuse and not self-limiting, medical attention is urgent.

Other symptoms that suggest the presence of polyps are:

1. recurrent miscarriages (usually seen with endometrial polyps);
2. often recurring inflammation of the genital tract;
3. trouble getting pregnant;
4. vaginal discharge of a purulent or bloody nature;
5. a large amount of mucous discharge.

Some of the symptoms that appear may indicate the presence of cancer. Removing a polyp significantly lowers the risk of cancer.

How to recognize a cervical polyp?

If the polyp grows into the lumen of the cervical canal, it can be detected during a routine gynecological examination. Then it is diagnosed with the use of a speculum, which allows the cervix to be visualized. Pedunculated polyps, which have a specific shape, are the easiest to notice. It is sometimes difficult to determine their origin, as they can grow in the body and cavity of the uterus. The best diagnostic methods to recognize both small and large polyps are:

1. Pap smear test – to detect abnormal cells in the polyp structure;
2. Transvaginal ultrasound;
3. histopathological examination (aimed at finding neoplastic features in the taken sample);
4. colposcopy (consisting in careful observation of the genital tract with a colposcope);
5. hysteroscopy (examination consisting in observation of the body and the uterine cavity with an endoscope).

Treatment of cervical polyps

Cervical polyps (even asymptomatic ones) are removed in women who plan to have children in the future or for whom hormonal treatment is indicated (exogenous estradiol may cause further growth of polyps).

The location of the polyps significantly influences the further treatment procedure. Blockage of the entrance to the cervical canal or the mouth of the fallopian tubes by a polyp may be the main cause of problems with becoming pregnant and your doctor may recommend that you have it removed immediately.

Cervical polyps are usually removed on an outpatient basis – ablation (turning) or in a hospital setting – hysteroscopy (uterine polyps) or abrasion (polyps of the cervical canal).

1. Ablation is a procedure that involves uncovering the cervix with the help of dedicated eyeglasses, and then inserting an appropriate instrument into the cervical canal and twisting the polyp. In some centers, abrasion, i.e. diagnostic curettage of the cervical canal, is performed as standard. The doctor slides a small spoon into the cervical canal, then moves it back and forth several times (often called “scraping”) to collect material for histopathological examination. If the uterine endometrium does not show any changes before the ultrasound examination, then in the case of nulliparous women, some doctors withdraw from diagnostic abrasion of the uterine cavity.
2. Hysteroscopy is a surgical procedure performed using intravenous anesthesia. If the procedure is not complicated (e.g. bleeding), most women leave the hospital home the next day.

Further treatment of cervical polyps depends on the result of the histopathological examination.

Do you know that:

Cervical polyps diagnosed in pregnant women often do not require any treatment. If the Pap smear test is normal, removal is not recommended. The polyp may evacuate spontaneously during childbirth.

What’s the prognosis?

Cervical polyp has a good prognosis and is considered benign if the examined structure does not show neoplastic or precancerous features. In most cases, polyps are benign lesions and their removal is tantamount to complete recovery. The situation becomes more complicated when neoplastic cells or even a slight dysplasia are diagnosed in the polyp’s fabric. Then, diagnostics should be extended, the patient should be provided with specialist gynecological and oncological care and appropriate treatment against cancer should be implemented.

Read also: Cervical and endometrial polyps

Text: lek. med. Matylda Mazur

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