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Cervical polyp

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Cervical polyp
Other names: Endocervical polyp; polyp of cervix uteri
Drawing of a cervical polyp
SpecialtyGynecology
SymptomsNone, vaginal bleeding after sex, vaginal discharge[1]
ComplicationsInfertility[2]
Usual onset>40-years old[1]
TypesEndocervical, ectocervical[2]
CausesUnknown[1]
Risk factorsPrior births or sexually transmitted infections[2]
Diagnostic methodSpeculum examination, histological examination[2]
Differential diagnosisFibroids, cervical cancer, endometrial polyp, cervical ectropion, endometriosis[2]
TreatmentNone, removal[2]
FrequencyCommon[1]

A cervical polyp is a growth attached to the inside of the cervical canal, part of the uterus.[1] It generally does not result in symptoms; though, may occasionally present with vaginal bleeding after sex or vaginal discharge.[1] Rare complications may include infertility and they may be associated with endometrial polyps.[2]

The cause is not known.[1] Risk factors include multiple prior births or sexually transmitted infections.[2] They tend to occur as single growth and are less than a centimeter in size; though may rarely be much larger.[1][2] Their color may vary from grey to red.[2] Most are not serious; thought, 0.2% to 1.5% are precancerous or cancerous, which mostly occur after menopause.[2] Diagnosis is generally suspected based on speculum examination and confirmed by histological examination.[2]

In those without symptoms specific treatment may not be required.[2] If there are concerns of cancer or symptom removal is recommended.[2] Occasionally this can be achieved by twisting it with ring forceps.[2] Long-term outcomes are generally good.[3] They may reoccur after removal.[2] Cervical polyps are common, affecting 2 to 5 % of women.[2] They mostly occur in those older than 40-years.[1]

Signs and symptoms

Cervical polyps often show no symptoms.[1] Where there are symptoms, they include intermenstrual bleeding, abnormally heavy menstrual bleeding (menorrhagia), vaginal bleeding in post-menopausal women, bleeding after sex and thick white vaginal or yellowish discharge (leukorrhoea).[4][5][6]

Cause

The cause of cervical polyps is uncertain.[1] They may also occur as a result of raised levels of estrogen or clogged cervical blood vessels.[4]

Diagnosis

Histopathology of endocervical polyp: With endocervical epithelium and glands (mucinous columnar linings), edematous stroma and clear congestion. H&E stain.

Cervical polyps can be seen during a pelvic examination as cherry-red or greyish-white projections from the cervical canal.[2] Diagnosis can be confirmed by a cervical biopsy which will reveal the nature of the cells present.[4]

Structure

Cervical polyps are finger-like growths, generally less than 1 cm in diameter.[1] They are generally bright red in colour, with a spongy texture.[7] They may be attached to the cervix by a stalk (pedunculated) and occasionally prolapse into the vagina where they can be mistaken for endometrial polyps or submucosal fibroids.[5]

Treatment

Cervical polyps can be removed using ring forceps.[8] They can also be removed by tying surgical string around the polyp and cutting it off.[4] The remaining base of the polyp can then be removed using a laser or by cauterisation.[4] If the polyp is infected, an antibiotic may be prescribed.[4]

Prognosis

99% of cervical polyps will remain benign and 1% will at some point show neoplastic change.[9] Cervical polyps are unlikely to regrow.[4]

Epidemiology

Cervical polyps are most common after age 40-years.[1] They are rare in pre-menstrual girls and uncommon in post-menopausal women.[6]

See also

References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 WHO Classification of Tumours Editorial Board, ed. (2020). "6. Tumours of the uterine cervix: cervical polyp". Female genital tumours: WHO Classification of Tumours. Vol. 4 (5th ed.). Lyon (France): International Agency for Research on Cancer. p. 352. ISBN 978-92-832-4504-9. Archived from the original on 2022-06-17. Retrieved 2022-08-03.
  2. 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 Alkilani, Yara G.; Apodaca-Ramos, Irasema (2022). "Cervical Polyps". StatPearls. StatPearls Publishing. Archived from the original on 2022-08-03. Retrieved 2022-08-03.
  3. "Cervical Polyps". Harvard Health. 11 February 2019. Archived from the original on 4 December 2023. Retrieved 24 August 2024.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 4.6 Smith, Melanie N. (2006-05-10). "Cervical polyps". MEDLINE. Archived from the original on 2007-10-26. Retrieved 2007-11-05.
  5. 5.0 5.1 Bates, Jane (1997). Practical Gynaecological Ultrasound. Cambridge University Press. p. 77. ISBN 1-900151-51-0. Archived from the original on 2022-04-22. Retrieved 2022-07-20.
  6. 6.0 6.1 Bosze, Peter; David M. Luesley (2004). Eagc Course Book on Colposcopy. Informa Health Care. p. 66. ISBN 963-00-7356-0. Archived from the original on 2022-04-07. Retrieved 2022-07-20.
  7. Zuber, Thomas J.; E. J. Mayeaux (2004). Atlas of Primary Care Procedures. Lippincott Williams & Wilkins. pp. 254–256. ISBN 0-7817-3905-5. Archived from the original on 2017-04-22. Retrieved 2022-07-20.
  8. Moore, Anne (2001-09-20). "How Should I Treat Postcoital Bleeding in a Premenopausal Patient?". Medscape.com. Archived from the original on 2003-12-14. Retrieved 2007-10-21.
  9. Tillman, Elizabeth. "Short Instructor Materials" (PDF). Centers for Disease Control and Prevention. Archived from the original on 2006-04-23. Retrieved 2007-10-21.{{cite web}}: CS1 maint: bot: original URL status unknown (link)

External links

Classification
External resources