Polyp of the cervical canal: basic questions about the need and methods of its removal. Consequences after removal of a cervical canal polyp

Polyp of the cervical canal– this is an excessive focal proliferation of unchanged epithelium of the cervical canal in the form of a growth of benign origin. Cervical polyps always grow into the cavity of the cervical canal. They are not a rare pathology of the cervix (20-25%), they are registered at any age, even during pregnancy, but more often they are found in patients who have overcome the forty-year mark.

Polyps of the cervical canal have different shapes and structures; they can grow on a thin “pedicle” or have a dense, wide base; they can be solitary or form groups. The size of the polyps is also ambiguous: small polyps of a few millimeters often “live” in the cervical canal asymptomatically for many years, and the largest (several centimeters) block the lumen of the cervical canal.

The reasons for the formation of nolips in the cervical canal have not been thoroughly studied. It is assumed that they appear with the participation of hormonal dysfunction, local inflammatory process or previous trauma to the cervical tissue. Almost always, the presence of polyps in the cervix is accompanied by the presence of some gynecological disease (in 70%), and in healthy patients they are detected much less frequently.

The cervical canal is located inside the cervix. Its inner surface is lined with cylindrical epithelial cells, and the submucosal layer contains many active glands. The glands produce a protective cervical mucous secretion that fills the cervical canal like a plug.

The inner surface of the cervical canal forms numerous folds, making it look like a spindle. At the beginning of the canal (at the base of the cervix) there is a narrowing - the external os. In the zone of the external pharynx, the stratified epithelium of the surface of the cervix passes into the columnar epithelium of the cervical canal; this place is called the “transformation zone.”

In the place where the cervical canal connects to the uterine cavity, there is a second narrowing - the internal os. Both narrowings are formed from dense connective tissue and act as a kind of protective “damper” that prevents the spread of infection.

Polyps of the cervical canal form in the depths of the external os, the middle or upper part of the endocervix. If they have a long stalk, they can protrude into the vaginal lumen and be visualized during a simple examination. The surface of the cervical canal polyp can be covered with columnar epithelium, like the surface of the canal itself, or with cells of stratified squamous epithelium, similar to the vaginal mucosa.

When a polyp forms in the cervical canal, a large number of blood vessels grow into it, so in response to even a slight damaging effect, the polyp begins to bleed.

Polyps of the cervical canal do not have specific symptoms. Small polyps, especially those without a long stalk, may not manifest themselves clinically and are discovered by chance. Larger polyps may be accompanied by slight bleeding.

Polyp of the cervical canal during pregnancy is a common occurrence (22%). As a rule, they are small, do not manifest themselves clinically and are diagnosed accidentally during ultrasound. The presence of small polyps in the cervical canal in pregnant women does not require immediate intervention, since it does not threaten pregnancy. After childbirth, the patient must undergo a repeated thorough examination to clarify the cause of the cervical polyp and undergo the necessary treatment.

Diagnosis of cervical canal polyps consists of a gynecological examination, colposcopy, and ultrasound scanning using a vaginal probe.

All polyps of the cervical canal are removed surgically. The final diagnostic verdict is made by the histological laboratory based on examination of the polyp tissue after its removal.

Surgery for a polyp of the cervical canal cannot guarantee a complete recovery. After surgical removal, cervical polyps may recur (12-15%). Therefore, the postoperative treatment program includes measures to prevent relapses.

Causes of cervical canal polyp

It is impossible to pinpoint the reasons why polyps necessarily form in the cervix, but their development is always accompanied by one of the provoking factors or a combination of them.

Conditions that provoke the development of a polyp are most often:

— Mechanical damage to the epithelium lining the cervical canal during abortion, diagnostic curettage, hysteroscopy, aspiration biopsy, uterine probing, improper insertion of the intrauterine device and similar manipulations.

Also, the cervical canal can be injured by extensive birth ruptures or obstetric manipulations (manual examination of the uterine cavity to remove a piece of unseparated placenta, obstetric forceps, and the like).

Obviously, the healing process is accompanied by excessive growth of “new” mucous cells in the damaged area. Major damage is not necessary for the formation of a polyp; sometimes it develops in the area of microtrauma.

— Structural changes that occur on the surface of the cervix. Often, polyps of the cervical canal are combined with erosions (true and false) and similar pathologies.

— Specific infectious inflammation in the area of the external genitalia. Sexual infections (and the like) after damage to the vaginal epithelium against the background of reduced local immunity are able to rise into the cervical canal, where they change the composition of the cervical mucus and provoke local inflammation. Against the background of inflammatory edema, the epithelium of the cervical canal becomes loose and easily vulnerable. In response to inflammatory damage, the cervical epithelium begins to grow excessively, forming a polyp.

— Chronic nonspecific inflammatory processes in the vaginal epithelium (,), cervix (endocervicitis,) or uterus (endomyometritis).

— Persistent dysbiotic processes in the vagina. Long-term disturbances in the normal composition of the vaginal microflora and pH fluctuations lead to the creation of favorable conditions for the colonization of the vagina by opportunistic microorganisms that can provoke inflammation.

- Ovarian dysfunction. The largest number of cases of the appearance of polyps in the cervical canal is recorded among patients with dishormonal pathologies: uterine fibroids, hyperplastic processes in the endometrium. Obviously, the excessive influence of estrogens stimulates the pathological proliferation of the epithelium of the cervical canal.

Sometimes the ovaries are not the cause of hormonal dysfunction. It can be triggered by severe psycho-emotional stress (stress, overwork) or endocrine diseases (thyroid dysfunction).

— Physiological reasons. A polyp of the cervical canal during pregnancy is formed for physiological reasons, when excessive cell growth is provoked by normal hormonal changes. A similar reason exists for cervical polyps during menopause.

The above reasons do not always provoke the growth of polyps in the cervical canal. Sometimes cervical polyps appear in the cervical canal for unknown reasons.

Symptoms of a cervical canal polyp

Most cervical canal polyps do not cause negative subjective sensations. Small polyps, especially “sessile” ones with a wide base, can remain asymptomatic in the cervical canal for a long time and be diagnosed accidentally.

The clinical picture of cervical canal polyps is associated with the development of complications. More often, pedunculated polyps are complicated, especially those partially protruding beyond the external os to the surface of the cervix. When the surface of such a polyp is injured, light bleeding appears upon contact with it. This happens when using vaginal hygienic tampons, gynecological examination, intimacy or douching.

Intermenstrual bleeding is not typical for an uncomplicated polyp of the cervical canal. But they can appear when the polyp is complicated by necrosis or inflammation.

Mucous or mucopurulent accompanies the presence of a cervical polyp in the event of infectious inflammation. It develops more often with large polyps, which significantly narrow the lumen of the cervical canal and also create favorable conditions for inflammation.

The location of a large polyp in the area of the external pharynx prevents it from closing correctly, causing nagging pain. All other existing symptoms (severe pain, menstrual irregularities, etc.) are due to concomitant pathology (fibroids, inflammation of the genitals, endometriosis, and the like).

Polyps that have reached a large size may be accompanied by copious mucous discharge due to constant pressure on the glands of the cervical canal.

Most cervical polyps are pedunculated and localized closer to the external os. Therefore, their diagnosis during a gynecological examination does not cause difficulties, since they are visualized in the lumen of the cervical canal even with the naked eye.

The size and shape of cervical canal polyps vary widely. More often they do not exceed half a centimeter in size, are oval or round (less often mushroom-shaped or leaf-shaped), have a long stalk that allows them to hang into the vagina, and a smooth surface.

There are blood vessels in the stroma of the polyp; they are visible through the columnar epithelium covering the polyp and give it a dark pink color. Less commonly, when their surface is covered with flat stratified epithelium, polyps look whitish. The polyp acquires a dark, bluish tint if its blood circulation is disrupted (leg torsion, injury).

The consistency of the polyp is determined by the presence of fibrous tissue in them; the more of it there is in the polyp, the denser it is.

After examining the cervix, all patients require a colposcopic examination to clarify the diagnosis. The method allows you to examine the polyp in more detail, determine the structure and structure of the cells covering it.

The structure of the polyp of the cervical canal can only be clarified by histological examination, which is necessarily carried out after surgical removal of the polyp.

According to the cellular composition, cervical polyps are classified into:

— Glandular polyp of the cervical canal. Rarely exceeds 1 cm in size. It appears more often in young women. Its structure is dominated by chaotically located glands.

— Fibrous polyp of the cervical canal. Appears mainly in old age. It consists predominantly of dense fibrous stroma and contains almost no glands.

Fibrous and glandular polyps of the cervical canal differ only in the ratio of glandular and dense connective tissue. The glandular structure of the polyp makes it softer. The fibrous polyp of the cervical canal is more dense.

— Glandular-fibrous, mixed, polyp of the cervical canal. It has an equal ratio of glandular and fibrous structures. Mixed polyps often reach large sizes (2.5-3 cm).

The choice of therapeutic tactics depends on the structure of the polyp, which in most situations indicates its origin.

Highly located polyps of the cervical canal cannot be seen during an examination or colposcopic examination, but they are clearly visible during an ultrasound scan with a vaginal probe. In the presence of a polyp, the lumen of the cervical canal is deformed, and the polyps themselves look like parietal formations of a homogeneous structure of varying density.

Additional diagnostic measures are carried out in the case of a combination of cervical canal polyps with other gynecological pathology.

Sometimes patients with polyps formulate their diagnosis incorrectly. For example, they may say “polyp of the cervical canal of the uterus.” The cervical canal refers exclusively to the cervix, and it is incorrect to use the expression “cervical canal of the uterus.” Therefore, the phrase “cervical polyp” should be replaced with “cervical polyp” or “cervical polyp.”

Treatment of cervical canal polyp

It is impossible to eliminate a polyp of the cervical canal non-surgically, so they all undergo surgical removal. However, there are situations when small cervical polyps without associated complications are treated conservatively with the use of anti-inflammatory drugs. Indeed, with such treatment, polyps can significantly decrease in size or disappear altogether. Similar situations arise when growths of the inner surface of the cervical canal of inflammatory origin (pseudopolyp) are mistaken for a true polyp of the cervical canal.

When the size of the polyp decreases after anti-inflammatory treatment, this means that the surrounding inflammation is eliminated, and the polyp itself remains in the cervical canal and must be surgically removed.

Preliminary preoperative preparation is required only in the case of concomitant inflammatory phenomena in the vagina and cervical canal. The polyp is removed after a course of antibiotic therapy if tests are normal.

The operation to remove a cervical polyp is coordinated with the patient’s menstrual cycle. It is usually prescribed in the first two weeks after the next menstruation.

There are several methods of surgical treatment of a cervical canal polyp, but the ultimate goal is always its removal followed by histological examination. To determine whether there are structural abnormalities in the tissues surrounding the polyp, not only the tissue of the polyp is examined, but also the area of the mucosa on which it grew.

After removal of the cervical canal polyp, the patient should be monitored. The decision on further medical tactics is made after the histological conclusion. After eliminating the glandular cervical polyp, no special treatment is performed after surgery. Fibrous polyps arising in the cervical canal in postmenopausal patients have a small risk of malignancy (malignancy), so they should not be left without due attention.

Mixed, glandular-fibrous polyps of the cervical canal are often accompanied by hormonal dysfunction, which can provoke a relapse of the disease. To prevent the cervical polyp from growing again, adequate correction of existing hormonal disorders is carried out.

In situations where the patient refuses to remove the polyp from the cervical canal, it is necessary to resort to drug treatment. Hormonal and antibacterial drugs eliminate more negative symptoms and help stop the further growth of cervical canal polyps, but are not able to eliminate them.

There are no specific methods for preventing recurrence of cervical canal polyp today. The only effective method is to eliminate the factors that provoke relapse. It is necessary to maintain normal hormonal function, promptly treat inflammatory processes of the genitals, eliminate endocrine disorders, and avoid abortion.

Removal of a polyp of the cervical canal

The procedure for surgical removal of a cervical polyp (polypectomy) requires hospitalization of the patient. It is carried out under mandatory adequate anesthesia.

When the polyp is located on a long stalk, it is literally unscrewed, and then the bleeding at the site of its attachment is eliminated.

Regardless of the chosen surgical technique, after removing the polyp itself, the entire cavity of the cervical canal is scraped. Curettage eliminates the possibility of leaving a small number of cells from which the polyp will grow again, and also allows you to examine the “background” on which it formed.

It is possible to remove a polyp from the cervical canal using several methods:

— Diathermocoagulation. The polyp of the cervical canal is excised with a special electric “knife”. The procedure is similar to cauterization; after it, a small crust remains, covering the wound surface. Underneath it, gradual healing and restoration of normal columnar epithelium occurs. When the wound surface is completely healed, the crust is torn off. The method is well suited for eliminating small polyps that have a wide base, but leaves a small scar.

— Cryodestruction. Exposure of the polyp to low temperatures. After treatment with liquid nitrogen, the polyp is “frozen” and then cut off. A significant advantage of the method is the absence of a postoperative scar, but its disadvantage is the long (about a month) healing of the postoperative wound.

— Laser (classical) polypectomy. Small, uncomplicated polyps are captured using an electrical loop and cut off with a laser scalpel.

— Hysteroscopic method. The most popular, painless and safe method. A special optical device is used - a hysteroscope. The method has a great advantage because during the procedure it allows you to visually assess the condition of the mucous membrane of the cervical canal and uterine cavity, detect and remove endometrial polyps.

Infrequently, histological examination reveals signs of malignant transformation of cervical tissue. After such a conclusion, the cervix must be removed to stop the development of unwanted changes.

The cervical canal is an elongated cavity that connects the uterus to the vagina. Polyps in this part of the body account for approximately a third of all benign neoplasms affecting the female reproductive system.

They are easily diagnosed upon examination; details of the clinical picture are clarified by histological examination and ultrasound. Treatment is performed surgically. It consists of two stages: removal of the cervical canal polyp and curettage. Leaving a tumor untreated can be dangerous to a woman’s health.

Preparing for surgery

Before removing a polyp, your doctor may order the following tests:
Vaginal smear for the presence of pathogenic bacteria - ureaplasma, mycoplasma, chlamydia.
PCR analysis for the presence of viruses - HIV, hepatitis B and C, papillomavirus, HPV (herpes simplex virus).
Ultrasound. You may have to do a series of tests, the last one immediately before the operation or a few days before it.
Some clinics require an X-ray of the lungs and ECG results.
Consultation with a phlebologist, especially for varicose veins of the lower extremities. If you have this disease or a predisposition to it, your doctor may recommend wearing compression stockings or using elastic bandages during the operation. This is necessary to prevent vein thrombosis.

Hysteroscopy is an examination of the uterus and cervical canal using an endoscope.

If the decision to undergo surgery is positive, the patient is recommended to:
Two weeks before the procedure, stop drinking alcohol and smoking (or reduce the number of cigarettes you consume);
On the eve of the operation, do a cleansing enema, shave the hair around the genitals;

On the day of the procedure, avoid eating and drinking water.

Contraindications

Some chronic diseases (diabetes mellitus, cirrhosis, renal failure, hemophilia) impose restrictions on any operations. The question of the possibility of intervention in this case is decided by the gynecologist together with a medical specialist.

Types and course of surgical intervention

The essence of the operation

The choice of anesthesia depends on the size of the polyp. For large tumors, general anesthesia is preferred (painkiller is delivered by injection into a vein, the patient is conscious) and hospitalization. Small polyps are removed under local anesthesia; using low-traumatic techniques, the operation can be performed on an outpatient basis.

hysteroscopy

A woman sits on a gynecological chair. A hysteroscope is inserted into the cervix– This is a tube with a light source and a camera. It allows you to accurately see the location of the polyp. Sometimes a hysteroresoscope equipped with an attachment with a cutting surface is used.

The doctor twists out a polyp, completely removing it; if necessary, the pedicle is excised, which may be located in the thickness of the epithelial tissue (this should be visible on ultrasound). Multiple tumors are excised. After this, scraping is performed– complete cleansing of the mucous membrane of the cervical canal and uterus. It is performed using a special instrument - a curette.

Note. A curette is a medical spoon, which is a rod with an attachment resembling a spatula or a loop with a pointed edge.

Some doctors have a negative attitude towards this practice because it is aphysiological, but most are inclined to use it because it reduces the risk of relapse. With low-traumatic removal methods and a small polyp, curettage can be abandoned.

The removed tissue and polyp are examined. It is necessary to confirm the benign nature of the tumor. Tests are prepared within 1 to 10 days.

Types of surgical treatment of polyp

Despite the same essence of the operation, technologies may differ in the method used for removal.

Main types of surgical intervention:

Polypectomy. The neoplasm is twisted until it is completely detached from the wall of the cervical canal or truncated using a special conchotome instrument. The operation is indicated for the removal of polyps up to 3 cm in size. The bed is cauterized.
Laser coagulation. The stalk of the polyp is excised using radiation. This method allows the vessels feeding the neoplasm to be coagulated, which minimizes the risk of bleeding. Laser coagulation is effective for removing polyps of any size.
Cryodestruction. This way you can get rid of small polyps. The stem is frozen with liquid nitrogen, after which the polyp is removed. The method is considered low-traumatic; after its use there are no scars left.
Diathermoexpression. This method involves destroying the base of the polyp using a loop through which an electric current is passed. There is a risk of formation of adhesions and erosions. The method is used for deformation of the cervix and dysplasia of its walls.
Radio wave coagulation using the Sugitron apparatus. The doctor touches the leg of the polyp with an electrode; when the wave passes through the cellular structures, the latter heat up and are destroyed. When using a Sugitron generator, thermal damage is reduced by three times compared to the action of a loop with electric current.

Video: polyp of the cervical canal. Radio wave, loop polypectomy

Recovery period

During the first week after surgery to remove a cervical polyp, the patient will receive (or take herself during an outpatient procedure) antibiotics, painkillers, and anti-inflammatory drugs to prevent infection.

The very presence of polyps is an indication for determining hormonal levels. The course of treatment usually ranges from 3 months to six months. The rate of epithelial restoration is positively influenced by the ozonation method (use of applications with ozonized oil) and physiotherapy.

Rehabilitation lasts on average 4 weeks. During this time, women are advised to:

Avoid physical activity, heavy lifting;
Do not take a bath, do not visit the sauna, bathhouse, solarium;
For hygiene procedures, use a shower daily;
Do not have sexual activity before consulting a gynecologist;
Don't use tampons.

Complications

The most important unpleasant consequence of the operation is the recurrence of the disease - the appearance of a new polyp. Even the most modern techniques associated with the destruction of the polyp bed and curettage do not lead to 100% remission. In 10-12% of cases, the tumor appears again (as of 2005).

Other possible complications include the following:

Formation of scars and adhesions. As a result of frequent removal of polyps or their multiplicity, epithelial tissue is replaced by connective tissue. As a result, the canal itself becomes narrower, difficulties with conception arise, and infertility may develop.
Infection. During surgery, the immune status decreases and the body becomes more susceptible to pathogenic viruses and bacteria. The risk of infection at the site of the removed polyp is especially high.
Malignant degeneration of tissue. A cancerous tumor may develop if the polyp is not completely removed. The remaining cells begin to grow and can give rise to a malignant neoplasm.
Bleeding when the wall of the cervical canal is injured. Treatment depends on the extent of the damage, and further surgery may be required.
Allergic reaction, swelling. Corrected by taking antihistamines. As a rule, they pass without consequences.
Hemameter- internal bleeding. The difficulty of diagnosis lies in the fact that the woman does not observe any discharge. This occurs due to spasm of the cervix - blood cannot leave the organ. Possible nagging pain, pallor of the integument. Treatment is carried out by taking antispasmodics or suctioning the blood using a probe.

Important! Minor discharge in the first days after surgery and minor discomfort in the lower abdomen are not causes for concern.

What does refusing surgery entail?

Some women, having undergone several surgical interventions and faced with constant relapses of the disease, decide to use unconventional methods. You can find the following recommendations online:

Psychotherapy – getting rid of suppressed fears and secret desires.
Using vaginal suppositories with celandine.
Herbal medicine, in particular, the use of boron uterus collection.

These methods have no proven effectiveness, classical medicine refuses to recognize the possibility of their effect on the polyp. Even if it does not grow, if it is present in the cervical canal, bleeding often occurs, sexual intercourse becomes difficult and painful, and difficulties arise with conception and childbirth.

If the walls of the polyp are constantly damaged, there is a high risk of infection, which can lead to more unpleasant consequences than periodic operations. A woman's vagina normally harbors certain bacteria. Just like in the intestines, they form symbiont microflora, which plays an important role in the body. However, if there is a permanent open wound, bacteria can become dangerous pathogens and cause infection. The spread of the process in the absence of treatment leads to very serious consequences, including removal of the uterus.

In addition, modern experts talk about the so-called “malignancy” of the polyp. Over time, the tumor can begin to grow rapidly, affecting neighboring tissues. The fight against cancer is much more difficult and costly compared to timely removal of a polyp.

Important! Despite the need for surgical intervention, it is better to make sure before deciding to perform or not to perform the operation that the diagnosis is correct. To do this, you need to undergo an ultrasound strictly after the end of your period and conduct an endoscopic examination.

Price of the procedure, operation under compulsory medical insurance

Removal of a cervical polyp is performed free of charge in a hospital setting. Methods depend on the technical equipment of the medical institution. No additional fees should be charged.

Prices can vary greatly between clinics. The cost of surgery using low-traumatic methods is usually the lowest. Price for treatment with the Surgiton device usually does not exceed 5,000 rubles. Polyp removal with laser will cost 8,000 – 10,000 rubles. Other methods will cost more due to the need to stay in the hospital - 12,000 - 17,000 rubles.

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The cervical canal is the internal space of the cervix, which plays an important role in the process of conceiving and carrying a child, and also protects the woman’s reproductive system from infections.

A common pathology of this cavity is a polyp, which is a tumor-like formation that tends to expand into the lumen of the cervical canal.

In the early stages, it may be invisible to either the patient or the gynecologist during examination, but over time it becomes dangerous to the woman’s health. The appearance of a polyp is provoked by the following reasons:

Disturbances of the endocrine system. A predisposition to the occurrence of neoplasms is observed with increased levels of estrogen in the blood.
Injuries to the cervix that could occur as a result of childbirth, abortion or diagnostic curettage.
Endocervicitis, which involves the development of inflammation of the mucous membrane of the cervical canal. The likelihood of a polyp occurring increases if the disease becomes chronic.
Pathologies of the reproductive system - ovarian cysts, endometrial polyps in the uterus.
Presence of STDs and human papillomavirus.

Classification of polyps (types)

Cervical canal polyp photo

Based on their consistency, polyps are divided into several types. The approaches to treating each of them are different, and the degree of risk of developing a malignant tumor also differs.

Glandular polyp of the cervical canal- occurs most often and is a capsule covered with the endometrium and containing chaotically located glands.

The tumor does not grow large (as a rule, its size does not exceed 1.5 cm), and its treatment does not cause any negative consequences for the patient.

Angiomatous polyp of the cervical canal– characterized by containing a large number of blood vessels. It is this type of neoplasm in the cervix that is most prone to bleeding, especially during menstruation.

Fibrous polyp of the cervical canal– consists of connective tissue, which makes it possible to see it during an ultrasound examination. It is found mainly in patients over 50 years of age.

This is one of the most dangerous types of polyps, since its removal can provoke the development of a malignant tumor, but it is also impossible to leave it untouched. To minimize the risks, doctors prescribe hormonal correction after excision of the tumor.

Glandular fibrous polyp of the cervical canal– can grow large and reach 2.5 cm in diameter. In addition to the endometrium, it consists of connective tissue, therefore it is dense and visible on ultrasound.

The presence of such a polyp in the cervical cavity can cause discomfort and nagging pain.

During a gynecological examination, the doctor may notice certain changes in the cervical part of the uterus. These signs will indirectly indicate the presence of a polyp:

Thickening of the cervix
Swelling of the cervical canal
Pain on palpation of the cervix
Hypertrophy of the external pharynx
When performing cervicoscopy, neoplasms are found to be round in shape and have a soft, elastic consistency.

Even before visiting a doctor, a woman may observe symptoms that will indicate pathologies in the cervical cavity:

Drawing sensations in the lower abdomen, not associated with the approach of menstruation.
Bleeding a few days before menses and for a few days after. A similar symptom is observed with endometriosis, but in this case, spotting before the onset of menstruation will be scanty, without a tendency to gradually increase.
Nagging pain during the entire period of menstrual bleeding.
The appearance of bloody discharge after intense sexual intercourse (with angiomatous polyp).
Menstruation becomes scanty, but its duration increases. Most often this happens in the presence of large tumors that almost completely block the lumen of the cervix.
Leucorrhoea having a grayish tint and an unpleasant odor.

Small polyps usually do not show any symptoms and are only detected during cervicoscopy.

Removal of a polyp of the cervical canal - methods, pros and cons

Tumor-like neoplasms of the cervical canal can only be treated surgically, but first the doctor must find out what type of pathologically altered epithelium he is dealing with.

Removal of a polyp of the cervical canal is carried out in several ways - it all depends on where it is located and what size it is.

Surgical curettage

A hysteroscope is inserted into the cervix so that the gynecologist knows exactly where the tumor is located. The tumor is twisted out and its stem is excised. The doctor’s task is to remove all parts of the polyp the first time, otherwise the disease may relapse. Incomplete removal can provoke the development of a malignant tumor.

In some cases, the stalk of the polyp is located deep in the epithelial tissue. After the tumor is completely excised, the cavity of the cervical canal is curetted, which is carried out using a curette.

Advantages of the method: Surgical curettage of the polyp is considered the most reliable method, after which a high percentage is given that there will be no relapse of the disease.

Flaws: the method is very traumatic and deeply damages the tissue of the cervical canal, so they try to use it only in cases where a large polyp has to be removed.

Polypectomy

Under the control of a hysteroscope, the doctor twists the polyp and then separates it from the walls of the cervix. Further actions will depend on where the tumor is located. If it is localized far from the external pharynx, then after twisting and separating it, a section of the wall is cauterized.

When the polyp is located close to the external os of the cervix, it is excised and sutures are placed at the surgical site.

Polypectomy is very similar to the removal method described above. The only difference is that in this case, complete curettage of the cervical canal is not performed.

Advantages of the method: less traumatic, involves less blood loss than with curettage.

Flaws: there is a risk of relapse of the disease.

Cryodestruction

The method is actively used to remove small tumors. The polyp is fixed and then treated with liquid nitrogen. These manipulations lead to instant cell death and detachment of the pathologically changed area from the wall of the cervical canal. The wound from removal is treated with a coagulator.

Advantages of the method: cryodestruction is effective, has high protection against relapse of the disease and is available in almost every medical center.

Flaws: the removed material cannot be sent for histological examination, so after the operation it is no longer possible to find out whether the polyp was malignant or not.

Radio wave loop polypectomy

A loop is placed around the polyp, through which the doctor passes radio waves. They pass through the cells of the neoplasm, completely destroying them, but not over the entire area, but only in the place where the loop is located.

As a result, the pathologically altered area of the epithelium is excised and removed from the cervical canal. Using radio wave coagulation, it is possible to remove not only small but also medium-sized polyps.

Advantages of the method: material remains for histological examination. In addition, such removal is almost bloodless, painless and has a quick healing period.

Flaws: if coagulation is not carried out professionally, there is a risk that the polyp will not be completely removed.

Laser coagulation

The doctor fixes the polyp and twists it so that its stem is clearly visible. A laser beam is directed at her and her cells are instantly destroyed. The polyp bed is then coagulated to prevent even minor bleeding.

Advantages of the method: laser coagulation allows you to remove very large polyps and is ideal for those patients who have difficulties with blood clotting.

Flaws: a somewhat long healing period during which you should not experience heavy physical activity.

There are women who doubt whether it is necessary to remove a polyp of the cervical canal if it is small and does not manifest itself in any way.

It is important to know here that in order to prevent cancer, all neoplasms that are subject to regular trauma and microtrauma must be excised. A cervical polyp is constantly damaged during menstruation, may be partially removed during childbirth, or become malignant under the influence of hormonal changes.

Cervical polyp and pregnancy

If the polyp does not completely block the lumen of the cervical canal, then the ability to conceive a child will remain. However, serious problems may arise when carrying it.

The neoplasm provokes frequent inflammatory diseases of the cervix and vagina.
There is a danger of premature removal of the mucus plug.
There is a risk of premature shortening of the cervix and the occurrence of isthmic-cervical insufficiency (ICI).
There is a constant threat of miscarriage due to a slightly open cervical pharynx.
The risk of developing a malignant tumor under the influence of sudden changes in hormonal levels.

A polyp of the cervical canal during pregnancy does not require removal if its diameter is less than 1 cm. If the neoplasm is large, the issue of its excision is decided on an individual basis.

Complications of the polyp

Polyps have a high risk of recurrence. The reason for this is poor-quality removal, when the leg, located deep in the epithelial tissues, is partially excised. As a result, after some time the tumor appears again.

If the pathologically changed area is left without treatment, the tumor will continue to grow and manifest itself in the form of pain and contact bleeding. When a large polyp is removed, the wound healing period increases, which carries a certain risk of infection.

To avoid complications and deterioration of health, it is necessary to identify a tumor in the cavity of the cervical canal at an early stage of its development. To do this, you need to do an ultrasound and be examined by a gynecologist 2 times a year, and also contact a specialist if intermenstrual bleeding appears.

Removal of a polyp of the cervical canal - associated with the elimination of benign tumors localized at the entrance to the cervix. If they are not removed in time, complications will arise, and the woman’s genitourinary system can be seriously damaged. Therefore, such an operation should be performed immediately after the discovery of polyps.

Indications for surgery

Polyps in the cervical canal can be detected by visual examination using a gynecological speculum. If their presence is confirmed, additional diagnostics are performed - cervicoscopy. The doctor uses binocular optics to assess the size of the tumors, their color and exact location. All these parameters will influence the decision about the need to perform surgery.

In general, polyps in the cervical canal must be removed in any case, because they cannot be treated conservatively. But sometimes the attending physician prescribes antibiotics and hormones to the patient to stop the growth and development of formations. This may be necessary to postpone surgery if for some reason it is not yet possible.

Let us highlight the indications for immediate surgery to remove polyps:

Large size of formations (more than 10 cm). They clog the fallopian tubes and grow rapidly. And if they develop during pregnancy, the woman may have a miscarriage.
Age over 40. This is the premenopausal period, when a woman’s hormonal background changes in such a way that it promotes multiple polyposis in different parts of the genitourinary system. Therefore, it is important to immediately remove existing polyps to avoid the appearance of new ones.
Ineffectiveness of therapeutic treatment. If hormones and antibiotics do not help, and the situation continues to worsen, the polyps must be removed urgently.
Infertility associated with large tumors in the cervical canal. While it is possible to restore a woman’s reproductive function, this must be done. If you delay, infertility can become chronic.
Adenomatous polyps are types of tumors that mutate into cancer cells. They need to be removed first.

The polyp looks like a small bump on a stalk. And it is precisely this leg that distinguishes it from a cystic formation. But when removing a polyp, it is necessary not only to tear it off, but also to scrape out the place where it was attached.

How to recognize polyps in the cervical canal

The sooner polyps are detected, the easier the operation will be. But can you feel their presence? By what symptoms can a woman determine that there are pathological formations in the cervical canal?

Bloody discharge that appears after intimacy is one of the signs of the presence of polyps. They are also indicated by intermenstrual bleeding. This also indicates that the tumors are inflamed. A glandular polyp of the cervical canal, consisting of glands of the uterine mucosa, or large polypous growths provoke discharge, which is mucus and pus with an unpleasant odor. If the polyps have grown so much that they have gone beyond the cervical canal into the cervix, they will not allow it to close. And this causes severe nagging pain that appears even at rest.

The presence of polyps in the cervical canal does not always manifest itself with the listed symptoms. If the formations are small or fibrous in nature, then the woman may not feel anything special. And how to detect them in this case? A regular medical examination with a gynecologist will help, which must be done at least once a year, and after 30 years - once every six months.

Why do polyps develop?

There may be several reasons for the formation of polyps in the cervical canal. These are genital infections, changes in the vaginal microflora, disruption of the normal functioning of the ovaries, hormonal surges, endocrine diseases, as well as mechanical damage. A woman can receive injuries during sexual intercourse, masturbation, or during childbirth if they are accompanied by specific obstetric manipulations.

By the way! Installation of an intrauterine device can also seriously injure the mucous membrane of the cervical canal and provoke the formation of polyps.

Types and course of surgical intervention

The operation to remove polyps in the cervical canal is performed under local anesthesia or general anesthesia, depending on the complexity of the intervention. In this case, no incisions are made: all manipulations are carried out through the vagina, and the patient is placed on a gynecological chair.

For better visualization of the surgical field and free access to it, a hysteroscope is inserted into the vagina, at the end of which there is a camera and a light source. This allows you to control the progress of the intervention.

Today, there are 5 ways to remove cervical canal polyps. The choice of method depends on the patient’s diagnosis, as well as the capabilities of the clinic where the operation is performed.

Classic polypectomy

The doctor grabs the tumor with a special tool, twists it until the stem becomes thinner and allows the polyp to easily separate. Then this area is scraped out with a curette - a medical spoon. This is necessary to prevent relapse. At the end of the polypectomy, all bleeding areas are cauterized with a coagulator to stop the bleeding and disinfect.

The leg of the polyp is first cut off with a laser beam, and then the residual tissue is burned out with it. This technique is faster and safer than the previous one, because curettage severely injures the mucous membrane. And the power of the laser beam can be adjusted to destroy only the superficial affected tissue.

Cryodestruction

The polyp stalk is frozen with liquid nitrogen, making the separation process easy and bloodless. There is no need to scrape out the bed, because frozen tissue is not able to develop. Gradually they die and disappear.

Diathermoexcision

A loop is placed around the stalk of the polyp, through which an electric current is passed. The neoplasm is separated and the bed is automatically cauterized. The technique is similar to laser, but sometimes only diathermoexcision can be used: for example, with dysplasia of the uterine walls or with cervical deformation.

Radio wave coagulation

A loop is also put on the leg, but it is no longer current that is passed through it, but radio frequency waves. The polyp comes off, and the vessels are instantly sealed. This method is superior to all others.

Recovery after polyp removal

Despite the fact that the operation is performed through the vagina, without implying any incisions in the abdominal cavity, the woman faces a long rehabilitation period. It begins with bed rest in a hospital ward. The patient will receive antibiotics, anesthetics and anti-inflammatory drugs for 7-9 days.

Among the postoperative symptoms, the woman will feel nagging pain for the first week. She may also be bothered by copious discharge mixed with blood. During this period (and at least another 3-4 months), you should use only pads, and in no case tampons.

After being discharged from the hospital, the patient should “rest” at home for another week or two, especially if she has a hard job. After all, for the next month she cannot lift weights, bend over, or squat sharply. You will have to forget about sexual relations for 2 months, until the internal wounds are completely healed. Baths, saunas, swimming pools are also temporarily prohibited.

Polyps of the cervical canal in pregnant women

For a pregnant woman, any disease is a risk to her own health and a threat to the life of her unborn baby. It is especially difficult for a woman if she has gynecological pathologies, because they can interfere with normal pregnancy and childbirth. Is it possible and necessary to remove polyps during pregnancy?

What is the danger

Polyps that are found in pregnant women are rarely large. Why? Because if the formation were large, it would clog the lumen of the cervix, preventing sperm from penetrating inside. It turns out that a woman becomes pregnant either with small polyps or without them. But even small tumors in the cervical canal can cause a lot of harm to the expectant mother.

A cervical polyp during pregnancy can irritate the cervix, causing it to contract. This often provokes a miscarriage (so-called spontaneous abortion). Even if the polyp is not large, and it did not affect pregnancy in any way, during childbirth the formation can be injured and turn into a malignant tumor. In addition, the symptoms that cause watering in the cervical canal can seriously worsen the course of pregnancy, disrupting the normal well-being of the mother.

How to treat

It is impossible to treat a pregnant woman with antibiotics. It is only permissible to use hormonal drugs. They will slow down the growth of the polyp so that the woman can safely carry and give birth.

If the polyp of the cervical canal during pregnancy is very large, or it is polyposis (multiple foci), then surgical treatment is performed, i.e. removal of tumors. Otherwise, a late miscarriage may occur, or childbirth will be very difficult.

By the way! If a large polyp is suddenly discovered shortly before birth, the patient undergoes a cesarean section so as not to risk the health of the child and herself.

Possible complications after polyp removal

The most unpleasant consequence of surgery to eliminate polyposis in the cervical canal is relapse. This means that the patient will have to relive the symptoms, followed by surgery and recovery. And this can seriously affect your peace of mind, because a normal life is out of the question.

But even if a woman is not at risk of relapse, she may encounter other complications after removal of polyps.

Scars and adhesions. They are formed due to the replacement of epithelial tissue with connective tissue. This causes a narrowing of the cervical canal and can lead to infertility.
Attachment of infection. This is caused by a decrease in immunity after surgery, as well as the patient’s failure to comply with recommendations during the rehabilitation period. Taking a bath, early sexual intercourse, using tampons - all this can lead to infection of unhealed wounds in the cervical canal.
Degeneration into a malignant formation. This is almost the same relapse, because cancer cells are obtained from incompletely removed polyp legs.
Swelling, allergies to drugs. Both the genital organs and parts of the body that are not related to the genitourinary system can swell. It all depends on whether the patient is allergic.
Bleeding in the uterus. The danger of this complication is that the woman does not see these discharges, because... they remain inside the uterus due to its spasm and inability to open. The blood begins to rot and provokes severe intoxication. Treatment is carried out with antispasmodics and, if necessary, antibiotics.

Gynecological operations always involve risks for a woman’s general health and her genitourinary system. Therefore, you should regularly visit a gynecologist and treat all diseases in a timely manner, incl. in endocrinology.

– tumor-like formations emanating from the cylindrical epithelium of the endocervix and growing into the lumen of the cervix. Polyps of the cervical canal usually manifest themselves as leucorrhoea, contact bleeding, and nagging pain. Diagnosis of cervical polyps includes a vaginal examination, colposcopy, cervicoscopy, and histological analysis of cervical scrapings. Removal of a polyp of the cervical canal is done by unscrewing its stem and cauterizing the bed, followed by scraping out the cervical mucosa.

Diagnosis of cervical canal polyps

The basic principles for diagnosing polyps of the cervical canal are their visual detection, study using colposcopy (cervicoscopy), ultrasound, knife biopsy of the cervix with curettage of the cervical canal.

During a gynecological examination, thickening and hypertrophy of the cervix and bright pink polyp-like formations of a round or grape-shaped shape protruding from the cervical canal are visualized in the speculum. Polyps covered with stratified epithelium with keratinization processes have a whitish color; if the blood circulation in the polyp is impaired, it acquires a dark burgundy or purple color. In polyps protruding into the vaginal lumen, depending on the number of stromal elements, a soft or hard-elastic consistency is determined.

Colposcopy and cervicoscopy allow you to see small polyps of the cervical canal, examine their structure in more detail, the presence of inflammation, necrosis, ulceration of the surface, as well as other existing changes in the cervix. To exclude endometrial polyps in the uterine cavity, a gynecological ultrasound is performed.

After a visual examination, a biopsy is performed with fractional curettage of the walls of the cervix and histological examination of the material. Before surgical removal of cervical canal polyps, smears are examined for infection using bacterial culture and PCR methods. If an STD is detected, their preliminary course therapy with monitoring of cure is indicated.

Treatment of cervical canal polyps

Any polyps of the cervical canal are an indication for removal. Under aseptic conditions, after exposing the cervix with speculum, the polyp of the cervical canal is captured with a window clamp and removed using a twisting motion. Then the cervical canal is scraped with a curette, ensuring thorough removal of the polyp stalk. The polyp bed is additionally processed by cryogenic or radiofrequency methods. If there are echographic signs of changes in the endometrium, hysteroscopy is performed with diagnostic curettage of the uterine cavity.

Polyps located close to the external pharynx are excised wedge-shaped and a catgut suture is applied. Polyps localized in the upper parts of the cervical canal require targeted removal under hysteroscopic control. The removed material is sent for histological examination to study the benignity of the polyp of the cervical canal. In the future, depending on laboratory data, anti-inflammatory or hormonal therapy may be prescribed.

Recurrent cervical polyposis is an indication for cone-shaped amputation of the cervix. Removal of cervical canal polyps during pregnancy is carried out if the size of the formation exceeds 10 mm, there is rapid growth, bleeding, signs of necrosis or initial malignancy (dyskaryosis) of the polyp.

Complications of cervical canal polyps

Recurrences of cervical canal polyps develop when the stalk of the neoplasm is incompletely removed. In rare cases, thermal burns are observed due to cauterization of the polyp bed, stricture and stenosis of the cervix. Unremoved polyps of the cervical canal can provoke bleeding, support genital tract infections, cause cervical factor infertility, and become malignant. Management of pregnancy in patients with cervical canal polyps requires the prevention of spontaneous miscarriage, ICI, premature birth, and cervical dystocia.

Prevention of cervical canal polyps

The conditions for the prevention of cervical canal polyps are: regular medical examinations, prevention and timely treatment of gynecological and endocrine pathologies, and exclusion of traumatic effects on the cervix. If suspicious symptoms appear, you should immediately undergo examination by a gynecologist.