Polyps in the uterus, how is the operation going. Methods for removing a polyp in the uterus, the course of the operation, postoperative treatment

The postoperative period after removal of polyps in the uterus may be different depending on the stage of the disease, comorbidities, the chosen surgical technique and the type of anesthesia used. Today we will try to cover this topic in detail so that our readers have no questions left.

What is hysteroscopy?

If earlier the removal of various formations in the uterine cavity was carried out by blind mechanical curettage of the entire endometrium or suction using vacuum aspiration, and complex cases required open surgical intervention, today most operations are performed through a hysteroscope. This device enters the uterus through the vagina with a thin tip and displays a picture from the built-in camera. Through the cavity of the tube, the doctor can deliver tools to remove the polyp. This method provides several significant advantages over outdated methods of surgical intervention:

Accuracy, or rather, the aiming of actions. To remove a small formation, it is not necessary to remove the entire intrauterine layer. The doctor sees the polyp at all stages of manipulation, can make sure that fragments of the leg do not remain on the mucous membrane of the organ.
Minimal damage. Incisions are not made in the abdominal wall and the uterus itself, the actions are carried out only at one point, and not along the entire inner surface of the organ.
The previous factors lead to a reduction in the recovery period. Heals quickly within a few days to 1-2 weeks after removal.
Suitable for women of any age and is not an obstacle to childbearing in the future.
The hysteroscope helps to visually examine the uterus from the inside and detect other pathologies.
Ability to biopsy suspicious areas. What is high-precision prevention of oncological diseases.
The method is fast. The whole procedure, including preparation, takes no longer than half an hour. It takes 1-2 minutes to remove the polyp.
The risk of recurrence, which reaches 80% with curettage, is reduced by 2-3 times. The professionalism of the doctor and the correct behavior of the patient after the operation can together reduce the likelihood of the recurrence of polyps to zero.
Complications in the form of bleeding or infection as a result of the operation are present only theoretically. In practice, problems arise in isolated cases.
The convenience for the patient is that the removal of the polyp can be done on an outpatient basis. It is not necessary to stay in the hospital and take a long-term sick leave.

Types of hysteroscopy

This voluminous concept includes different ways of conducting. Therefore, the word "hysteroscopy" alone cannot describe what will be done in a particular case.

By difficulty:

A standard removal procedure that is performed on an outpatient basis without anesthesia, under local anesthetics or short-term general anesthesia. Suitable for a few small uterine polyps that are not burdened by concomitant pathologies;
Difficult cases, when the formation is quite large, the area affected by polyposis is extensive, or there are additional problems in the form of fibroids or endometriosis, require a removal procedure under general anesthesia in a hospital setting. This includes working with patients who have general health problems, such as poor blood clotting.

By purpose:

Diagnostic hysteroscopy is performed to examine the endometrium of the uterus, as well as to take a biopsy sample for histology;
The medical procedure is carried out in order to eliminate formations;

Attention! Sometimes diagnostic manipulations end with the removal of the polyp.

By type of equipment used:

Mechanical hysteroscopy, when the formation is removed by excision or unscrewing with forceps and other surgical instruments.
Electrocoagulation, if an electrode in the form of a loop is used to separate the body of the polyp. Tissues are melted under the influence of current.
Laser removal allows you to evaporate the formation quickly and without scarring.
Radiosurgery is comparable in efficiency to the previous method; a special instrument is used for removal, evaporating tissues with radio waves.

The mechanical one is often completed with the treatment of the wound with an electrocoagulator to avoid bleeding.

How is the recovery after hysteroscopy

The rehabilitation period as a result of the removal of uterine polyps continues until the onset of menstruation, which indicates the return of the organ to normal functioning.

Feelings of the patient

At the end of the operation, the woman does not feel the effects of anesthesia, even if a short-term general anesthesia was used. Although the procedure, combined with feelings and worries, can lead to slight weakness and dizziness in the first hours. Physiological sensations are expressed in bloody discharge for 1-3 days and uterine contractions, an increase in temperature to 37.5 is considered normal. The leucorrhoea is red or brown and slight. After removal of large formations, daub may be present for 1-2 weeks. Spasms are sometimes painful, so analgesics are allowed.

Attention! Using a mask instead of intravenous anesthesia is the best choice due to the absence of weakness, dizziness and nausea upon waking.

Sick leave and hospitalization

The patient is left in the clinic for 1-2 weeks rarely if the operation was difficult. For example, a large polyp or a large number of formations was removed. This period is necessary for the recovery and monitoring of the woman's condition.

In a normal situation, when a standard hysteroscopy was performed without any complications, the patient goes home a few hours after the procedure. When using general or epidural anesthesia, the anesthesiologist must observe the condition of the woman, until she is fully recovered from the drugs, she is in the clinic. A sick leave is given for 3-4 days, for a longer period the patient is released from work if her activity is associated with heavy physical exertion, which is prohibited until healing.

Treatment after removal

After the operation, the therapy does not end, the patient is not only regularly examined, but also prescribed medications:

Antibiotics are used to prevent infection. Penetration of instruments into the uterus through the cervical canal, and damage to the endometrium can provoke the reproduction of pathogenic microorganisms.
Hormonal drugs are used to restore the balance of the endocrine system. Medications are usually aimed at increasing the level of Progesterone and suppressing estrogen. Because the distortion towards the latter leads to the formation of polyps. If you do not take action, then there will be a relapse of the pathology. For this purpose, oral contraceptives of the appropriate composition, gonadotropic drugs and gestagens are prescribed. For such treatment, the basis may be an analysis of the level of sex hormones or a combination of polyps with other pathologies - hyperplasia, fibroids, adenomyosis and others.

Attention! Hormonal treatment is permissible only at the end of wound healing, because such agents delay this process.

Recovery time after various removal methods

After the operation, the site of action becomes inflamed in the first 2-3 days, so a slight increase in temperature is considered normal during this period. Further, healing processes begin, first a crust forms on the surface of the wound, then it falls off and the endometrium is restored.

As a result of mechanical removal, healing occurs in 10-14 days, depending on the professionalism of the surgeon and the size of the formation.

After electrocoagulation, the process can be reduced to 7-10 days. However, it is possible to form a scar at the site of exposure to current, which is undesirable for women who plan to give birth to children.

As a result of laser or radio wave surgery, the wound heals in 3-5 days, or a little longer after the removal of large polyps. A feature of these methods is the normal restoration of healthy tissues without scars.

Whatever the method, the official rehabilitation period lasts until the onset of menstruation, which comes in 4-6 weeks, sometimes a little later.

Control studies after surgery in the uterus

During the rehabilitation period, a month from the removal of the polyp, the woman visits the gynecologist once a week. The doctor will ask about the discharge, sensations, examine on the chair. Such visits are needed to control complications. After the first menstruation, the patient will undergo a second hysteroscopy for diagnostic purposes or ultrasound of the pelvic organs.

If an imbalance of hormones was established before the operation, tests are prescribed. In addition, a swab is taken from the vaginal wall to rule out infection. In the future, control studies are carried out after 6 months and a year later. If a woman is planning a pregnancy, she continues to be monitored.

When to conceive a child after removal of uterine polyps?

Fertilization can occur already at the end of rehabilitation and the completion of the first menstruation, but this is highly undesirable. A completely healthy uterus will be after 3-4 cycles. Pregnancy may end in miscarriage or proceed with pathologies. Therefore, doctors recommend waiting, and the timing is individual. A healthy woman, as a result of the removal of a single polyp, safely conceives a child 3 months after the operation. Weakened general condition, related problems can prolong the waiting period. The need for hormone therapy increases the period to 1-1.5 years.

Expert opinion

Olga Yurievna Kovalchuk

Doctor, expert

Attention! If after the operation pregnancy does not occur within 6 months of unprotected sex life, then you need to look for the cause of infertility in another and examine the man and woman completely.

What can not be done after the removal of uterine formations?

To prevent complications, a number of restrictive rules of daily life during the rehabilitation period are imposed on the patient.

It is forbidden:

Insert something into the vagina - tampons, suppositories, syringe;
Having sex, even with a condom, can cause bleeding;
Lift heavy, over 3 kg;
Stretch physically, including when playing sports;
Immerse yourself in water - a bath, pool, river, sea;
Warm up in a bath or sauna.

In addition to prohibitions, there are indications for action for the recovery of a woman and the prevention of relapse:

Observe half-bed rest in the first 3 days, that is, lie more than move;
Take vitamins;
Eat a balanced diet, the balance of hormones largely depends on food;
Get rid of excess (for medical reasons) weight. Excess estrogen comes from the visceral fat in a woman's abdomen;
Visit the gynecologist's office every 6-12 months for preventive examinations;
Monitor your monthly cycle and general condition, any changes can be the first signs of pathology.

Complications resulting from hysteroscopy

Surgical intervention has a number of theoretically possible negative consequences. After removal of a polyp from the uterine cavity, the following can happen:

Bleeding, the appearance of which is often associated with a woman's non-compliance with the rules of the rehabilitation period.
Infection as a result of the operation is almost impossible. During the procedure, the uterus is treated with antiseptic solutions, the entire instrument is sterile, and after the operation, a course of antibiotic therapy is prescribed.
Embolism is the entry of air into the vessels, which can cause the death of the patient. This happens as a result of preparing the uterus for the procedure, when carbon dioxide is injected into the cavity to straighten the walls. The professionalism of the doctor will not lead to such consequences. As a rule, liquids are used more often for this purpose.
Acute allergic reaction to anesthetics. Before the operation, the anesthesiologist must conduct special tests that can determine the safe drug for anesthesia. In addition, the state of the cardiovascular and respiratory system of the patient is taken into account.
Damage to the cervix when inserting the tip of the hysteroscope.
Perforation of the uterine wall, that is, a hole as a result of manipulation. It is very dangerous for a woman's life. Therefore, the correct setting of the equipment, the observation of the course of actions and the experience of the surgeon are important.
Non-infectious inflammation and adhesions as a result can cause infertility. Prevent this preventive observation during the rehabilitation period.
recurrence of pathology. Its probability increases with incomplete removal of the polyp, therefore, the professionalism of the doctor also plays an important role here.
Oncology as a result of incomplete removal of a formation containing cancer cells. Therefore, all polyps after surgery are sent for histology in order to study their structure and composition. If a dangerous diagnosis is confirmed, a decision may be made to repeat hysteroscopy or amputation of the uterus.

Attention! The listed complications after surgery are noted in isolated cases, the appearance of many of them depends on the experience of the surgeon, so you need to carefully consider the choice of a doctor.

Treatment of polyps in the uterus is carried out in two stages. The first is the removal of mucous formations in an operable way, and the second is the rehabilitation period after leaving the hospital. If the responsibility for the high-quality performance of surgical procedures falls entirely on the shoulders of doctors, then at the recovery stage it is the patient who acts as a key figure.

After removal of the polyp in the uterus, the general condition of the woman improves, but the absence of sharp pains and other uncomfortable sensations in the lower abdomen is not a reason for refusing further treatment. The main goal of postoperative manipulations is to prevent the formation of new unwanted inclusions in the uterus. In the absence of complications, the recovery period lasts from three to six months. This time interval is directly dependent on the method that was used to carry out the polyp removal procedure. Influencing the female body with the help of various medications, specialists constantly monitor its condition, gradually, excluding the manifestations of all kinds of negative factors that interfere with the normal functioning of the uterus.

The methods and duration of rehabilitation treatment after removal of a polyp in the uterus are selected depending on the individual characteristics of the patient. When making an appointment, the doctor takes into account such important parameters as:

The age of the woman;
Features of the course of the disease;
Type and number of formations;
The presence of complications and pathologies.

Important! Determining the nature of the origin of the polyp is extremely important, since only this will eliminate the possibility of their reappearance.

During the first three days, after the removal of polyps, it is recommended to take one tablet of Nosh-pu (Drotoverin), 3 times a day, to relieve possible tension in the muscle tissues of the uterus, which can result in a hemtometer - the accumulation of a large amount of blood masses in the uterine cavity due to for a spasm of the neck.

Anti-inflammatory drugs also occupy an important place in postoperative rehabilitation. The course of taking such drugs can last from two to ten days, so you can reduce the risk of infectious complications. In exceptional cases, it may not be carried out. If the cause of the polyps was a chronic inflammatory process, suggesting the presence of pathogenic microbes in the uterus, then the use of antibiotics will reduce the chance of a relapse. When getting rid of polyps, severe trauma to the uterine tissues can occur (curettage, unscrewing the legs of polyps, cutting off with a scalpel or loop), which increases the possibility of developing inflammation. It is possible to prevent such a development of the situation with the help of antibiotic therapy. For patients with untreated infectious diseases of the genitourinary system, the use of antiseptic drugs is mandatory.

After removal of a large polyp or multiple small formations, at the initial stage, patients may have pain in the lower abdomen. The most outstanding set of painkillers will help to cope with them: dexalgin (at the initial stage with severe pain), analgin, ibuprofen.

Important! If the walls of the uterus have been severely injured, the doctor may prescribe physiotherapy sessions that prevent the formation of unwanted adhesions, especially in the cervical region.

To stimulate the recovery processes in the body, after the removal of polyps, doctors recommend the use of multivitamin complexes. Vitamins A and C are of key importance in the first weeks of rehabilitation.

Any operation is stressful for the whole organism, especially when it comes to the female genitourinary system, since an unstable hormonal background only worsens the situation. Increased irritability negatively affects the entire rehabilitation process, slowing it down. In acute manifestations of depression, the doctor may prescribe the use of various sedatives and antidepressants.

If the appearance of polyps was triggered by the presence of a hormonal imbalance, then without proper treatment, their reappearance is not excluded, entailing a new surgical intervention. The selection of drugs is made individually, depending on the type of mucous neoplasms. From time to time, hormonal and anti-cancer therapies are carried out together.

The main components of hormonal treatment:

Important! Duphaston does not affect body weight and has the fewest side effects, unlike other similar analogues.

Histological examination after removal of polyps is carried out to determine their ability to reproduce. Material for analysis is obtained by scraping. In the laboratory, specialists study the structure of neoplasm tissues under a microscope, having previously treated the sample with chemical reagents to prevent its decay. The test results are sent directly to the attending physician within 1-2 weeks after the sampling procedure.

Important! The female body undergoes various changes throughout its life cycle. These metamorphoses have a huge impact not only on the overall hormonal background, but also on reproductive function. In patients aged 40 to 50 years, the body is in the process of menopausal restructuring (periods of menopause and postmenopause), this period is dangerous for the degeneration of polyps into malignant tumors.

The choice of the optimal diet will have a positive effect on the regeneration of the body after the removal of polyps. When planning a menu, you should adhere to the following rules:

Use meat and fish dishes to increase the total calorie content;
Eat more fresh, vitamin-rich vegetables and fruits;
Exclude the use of highly salty and spicy foods, it contributes to the activation of infectious processes;
Limit the use of alcoholic beverages for a while, under the influence of which tissue regeneration slows down.

After removal of polyps, it is necessary to regularly observe a gynecologist. The first appointment is most often scheduled 10-14 days after discharge from the hospital, since by this time the result of the histological analysis comes. Subsequent visits to a specialist are carried out after one, three and six months. At the same time, a quarterly and semi-annual examination involves an ultrasound scan.

Features of treatment after removal of the endometrial polyp in the uterus

Competent hormonal therapy is the main component of successful rehabilitation after the removal of endometrial polyps, since the cause of their appearance is considered to be a violation of the functioning of the ovaries. Failure of the reproductive organs provokes an increased reproduction of estrogen and a decrease in the level of progesterone production.

After removal of endometrial polyps, areas of bleeding granulation tissue are often found on the mucous walls of the vagina. To neutralize such formations, cauterization with lapis is used.

Detection of neoplasms with a glandular structure is not uncommon. They are formed by stromal cells and endometrial glands. In a large number of cases, glandular polyps occur in women who are subject to changes in reproductive functions, and, to be more precise, who are going through puberty or menopause. Such phenomena negatively affect the balance of the hormonal background, which can lead to the appearance of polyposis formations.

Postoperative treatment involves a number of appointments of an individual nature, but there are also a number of mandatory measures:

The use of the following drugs in the process of leveling the hormonal background: Duphaston and Utrozhestan;
The use of antibacterial drugs such as Indomethacin, Meloxicam, Diclofenac, Celecoxib, Piroxicam;
Careful douching with antiseptic solutions (Chlorhexidine).

After removal of endometrial polyps, there is a high percentage of the risk of their reappearance. To prevent such events, outpatient consultations with the attending physician after discharge are held every month throughout the entire rehabilitation period. Each visit to a specialist is associated with an ultrasound scan.

To speed up the healing process of damaged tissues after removal of a polyp in the uterus, there are a number of general recommendations that must be followed. During the first month after the operation, you can not:

Lift objects weighing more than 3 kg;
Do sport;
Visit the pool, bath, sauna;
Take a hot bath;
Use drugs that adversely affect blood clotting (Aspirin, Diclofenac, Citramon, Upsarin);
Lead a sexual life.

Before resorting to the help of herbal medicine, you should consult with your doctor. This will avoid a number of unpleasant consequences and allergic reactions.

A good therapeutic effect in the treatment of diseases of the female genitourinary system is provided by such herbs as celandine and upland uterus. Sometimes an alcohol infusion based on a golden mustache is used.

Infusions of celandine, sage and chamomile are often used for douching, acting as a local antiseptic, but you should not get carried away with such procedures. They can upset the balance of the microflora of the vagina.

In order to increase the production of progesterone, you can use a decoction of the sacred vitex. His reception begins only in the second phase of the monthly cycle. The full course is 3-4 months. And in order to calm the nervous system in the postoperative period, various herbal teas are used, which include mint and thyme.

The rehabilitation period after removal of the uterine polyp is of great importance for the patient's body. Strict observance of the schedule of mandatory visits to the doctor and the implementation of his recommendations will help reduce the risk of recurrence of neoplasms, as well as detect in time and then avoid the development of negative consequences after surgery.

Pregnancy after removal of polyps is possible immediately, after the end of the recovery period. Despite this, many women are forced to undergo additional examinations to prevent complications during pregnancy.

If the polyp has already been diagnosed, then it will not be able to resolve in any way. The only adequate treatment is surgery. The postoperative period requires mandatory compliance with all the doctor's recommendations for the rapid recovery of the female body.

Modern techniques allow women with unrealized motherhood to give birth to their own children soon after the operation. However, pregnancy planning should be carried out with extreme caution.

Methods for removing uterine polyps

Removal of polyps is performed by several methods, which are selected based on:

general clinical history of the woman,
data from laboratory and instrumental studies,
nature of the polyposis
risks of malignant growths.

The only adequate treatment for an endometrial polyp is surgery.

There are the following types of intervention:

Polypectomy. Removal occurs by twisting the polyp until it is torn off. After that, the wound is cauterized with electrodes or liquid nitrogen. Next, the polyp is sent for histological examination. A week after the operation, a control ultrasound is performed.
curettage. The surgical procedure known as curettage implies. Often the procedure is complicated by postoperative infection and recurrence of polyposis.
Ablation of the uterine cavity. Ablation is used in women of mature age with realized motherhood, or in women with a risk of polyp degeneration into a malignant tumor.
Removal is carried out with a laser, radio frequency waves, liquid nitrogen, electric currents. After ablation, a woman is unable to carry a child on her own.
. The procedure is therapeutic and diagnostic in nature, refers to endoscopic methods for the removal of polyps.
The main advantage is the ability to diagnose and simultaneously remove polyps using powerful optical equipment. In addition, recovery after such manipulation is much faster.
Hysterectomy or high amputation. A radical method for the treatment of polyposis in cases of suspected oncogenic degeneration of neoplasms and the growth of metastases. The uterus is removed along with the appendages.

The most common method is polypectomy - an organ-preserving surgical technique that allows a woman to realize the desired motherhood in the near future.

Removed a polyp - factors affecting the delay in pregnancy

In the vast majority, the removal of uncomplicated polyps does not lead to serious consequences and problems with the subsequent bearing of a child. Many women manage to successfully conceive within a month after the operation. However, there are factors that can delay a long-awaited pregnancy.

Hormonal disorders

Unstable levels of sex hormones are a common cause of delayed conception. Usually, clinicians are faced with a significant excess in the level of estrogens - female sex hormones. On the one hand, in such a situation, the chances of conception increase. On the other hand, instability in the ratio of hormonal balance can provoke rejection of the fetal egg.

The most common method of removing polyps is polypectomy - an organ-preserving surgical technique that allows a woman to realize the desired motherhood in the near future.

With unsuccessful attempts against the background of hormonal disorders, there are risks of recurrence of polyposis.

Infectious diseases

The postoperative condition of women is often complicated by infection. If the infection has become a trigger for the formation of polyps, then the penetration of pathogenic environments into the postoperative wound is quite large.

The infection can penetrate with insufficient sanitation of equipment and antiseptic treatment of the genital organs after manipulation.

Infections affect the possibility of carrying a pregnancy, which is expressed in the following manifestations:

Recurrent polyposis;
Intrauterine infection of the embryo and growing fetus;
Malformations and anomalies in the development of organs, systems of the unborn child;
Risks of miscarriage in early and late periods.

In order to avoid infectious complications, pregnancy should be planned after completion of antibiotic therapy.

Along with the usual examinations, one should donate blood for a polymerase chain reaction, a bacteriological analysis for the absence of an active infection.

adhesive process

Spikes are possible after curettage of the uterus. Curettage causes severe trauma to the uterus, so recovery requires several months. The formation of adhesions is due to the formation of strands, which can become an obstacle in the successful planning of pregnancy. Adhesions require repeated removal.

To prevent the risk of adhesions, it is necessary:

follow all doctor's recommendations;
attend sessions of electrophoresis, magnetotherapy, laser therapy, therapeutic exercises, sessions of ultrasound therapy.

Anemia bleeding

After removal of polyps, internal bleeding is possible.

Due to blood loss:

iron deficiency anemia develops
the level of hemoglobin and the volume of erythrocytes decrease.

In such a situation, conception and normal pregnancy are difficult.

If pregnancy occurs, the fetus develops chronic hypoxic syndrome.

To prevent anemia, the following recommendations are required:

Medical rehabilitation therapy with iron preparations;
Elimination of bleeding;
Power correction.

Women need to undergo regular examinations by a doctor, ultrasound examinations, blood and urine tests for the full implementation of healthy motherhood.

General malaise, weakness

Fatigue and stress can weaken a woman's body. Often, menstrual irregularities join, and therefore problems with normal conception.

The formation of adhesions is due to the formation of strands, which can become an obstacle in the successful planning of pregnancy.

In the absence of serious complications, experts advise planning a pregnancy in the next 2-3 months after the removal of polyps.

Firstly, sparing techniques exclude severe trauma to the uterine cavity. Secondly, there are always risks of recurrence of polyposis, after which a new removal procedure will be required.

Is it possible to get pregnant after scraping?

It is worth understanding one thing - pregnancy after treatment of polyposis becomes more real than before surgical treatment.

Any operation requires a certain recovery period, and therefore it is important for a woman:

undergo medical treatment
do a follow-up ultrasound
get tested for the absence of infection and start trying to conceive.

The total duration of the postoperative period varies between 7-12 weeks. Only if there are no complications and the course of medical correction is completed, one can think about procreation.

How long can I get pregnant after hysteroscopy?

After hysteroscopy, the chances of a successful conception and completion of a natural pregnancy increase significantly, but it is impossible to determine the exact timing. Pregnancy can occur immediately or years later.

In the absence of pregnancy, a woman will have to undergo additional diagnostics for:

infectious diseases,
conditions of the endometrium of the uterus,
features of ovulation in women.

You may have to undergo a long course of hormone replacement therapy. It is important to analyze the quality of spermatozoa in men.

In practice, women of reproductive age have the opportunity to conceive within 4 weeks to six months after surgical treatment of polyposis in the absence of complications.

The specialist in this video tells more about planning pregnancy after the curettage procedure:

The chances of getting pregnant after removing polyps are much higher in women of reproductive age. It is impossible to predict the exact dates due to the individuality of each organism. The reproductive activity of women is determined by many different factors, including the traumatic effect on the endometrium as a result of therapeutic and diagnostic measures.

For women of reproductive age, the appearance of growths on the inner walls of the uterus becomes a collapse of hopes, especially if there are problems with conception. Properly performed surgery to remove the polyp gives a chance to give birth to a healthy child. Why do growths appear on the endometrium, how to deal with them? It is useful for women to know the features of surgical intervention, the chances of recovery, and possible complications.

What is a polyp in the uterus

Under the influence of inflammatory processes, hormonal disorders and many other reasons, endometrial hyperplasia may begin in a woman's uterus. The growth of mucous membranes leads to the appearance of polyps. These formations are safe for life, but can provoke:

chronic failures of the menstrual cycle;
infertility;
complicated pregnancy;
miscarriage;
development of a malignant neoplasm.

A polyp in the uterine cavity has features. There is a solitary formation or in the form of numerous processes. In shape - rounded or mushroom-shaped, has a thick base or thin stem, with a color from light pink to burgundy. According to histological features, varieties of endometrial neoplasms are distinguished, which are formed from:

connective tissues - fibrous;
glandular cells - glandular;
combinations of two varieties - fibro-glandular;
tissues with atypical cells - adenomatous, developing into cancer;
remnants of the placenta after childbirth - placental.

A small polyp in the uterus has no symptoms. Pronounced signs of pathology appear with large sizes or polyposis - multiple formations. It is necessary to perform an operation if women have:

uterine bleeding;
brown vaginal discharge in the middle of the menstrual cycle;
pain in the lower abdomen and lumbar region;
discomfort and spotting during intercourse;
heavy and painful periods;
conception problems;
the occurrence of iron deficiency anemia;
secretion of mucous whites from the vagina;
miscarriages.

Why do polyps appear

One of the main reasons for the development of formations in the uterine cavity is hormonal disorders associated with an excess of estrogens and a lack of progesterone. This situation is caused by endocrine and neuropsychiatric disorders. The provoking factors for the occurrence of polyps are:

trauma during childbirth;
installation of intrauterine devices;
diabetes;
hyperestrogenism;
hypertonic disease;
hypodynamia;
taking the anticancer drug Tamoxifen;
obesity;
decrease in immunity.

A polyp on the uterus can form as a result of such gynecological pathologies:

vaginitis;
colpitis;
endometriosis;
mastopathy processes;
polycystic ovaries;
adenomyosis;
uterine fibroma;
glandular endometrial hyperplasia;
diagnostic curettage;
consequences of abortion;
vascular growths in the endometrium;
genital infections.

Removal of polyps

Treatment of uterine neoplasms begins with conservative therapy. Removal of a polyp in the uterus is carried out if indicated. These include:

lack of results of drug treatment;
brown discharge with an unpleasant odor;
soreness, discomfort during sexual contact;
meager discharge during menstruation or their absence;
infertility;
severe uterine bleeding;
miscarriages;
heavy and prolonged menstruation;
age over 40;
polyp size more than 10 mm;
identification of atypical cells that provoke oncology.

The operation to remove a polyp in the uterus is carried out by several methods:

hysteroscopy - elimination of the formation by twisting its legs with the help of special equipment;
diagnostic gynecological curettage - curettage - removal of the upper layer of the mucosa using a curette;
burning with a laser beam;
radiosurgical excision;
cryodestruction with liquid nitrogen.

How to remove a polyp in the uterus without surgery

If a woman is contraindicated for surgery or she is opposed to this method of treatment, doctors conduct medical conservative therapy. Several groups of drugs are used depending on the age, condition of the patient, and symptoms. Gynecologists prescribe combined oral contraceptives Regulon, Yarina, which:

reduce the size of polyps, contribute to their removal;
are used for nulliparous women from 18 to 35 years;
used when the size of the polyp is less than 10 mm;
give a result in the presence of uterine bleeding.

Treatment without removal of the polyp is carried out using drugs:

Duphaston, Utrozhestan - gestagens with the active substance progesterone - normalize the functions of the endocrine system, improve the condition of the blood;
Diphereline, Zoladex - gonadotropin releasing hormones - are prescribed for menopause, women over 35 years old, with focal and total endometrial hyperplasia.

If it is possible not to perform the operation, gynecologists prescribe medications:

antibiotics - Monomycin, Zitrolide, Doxycycline, if the cause of the formation of polyps is sexual infections, inflammation in the pelvic area;
iron preparations Ferlatum, Fenyuls - for anemia caused by blood loss;
vitamin complexes to maintain body tone;
homeopathic remedies on a natural basis - require a long-term intake according to the scheme.

Laser removal

For women of childbearing age, this is the safest method of treatment that preserves reproductive function. Unfortunately, due to the high cost, not all clinics have laser equipment. Removing a polyp in the uterus in this way has the following advantages:

a small risk of bleeding - the vessels are cauterized by the high temperature of the beam;
greater accuracy of the operation;
there is no injury to neighboring tissues;
minimal risk of infection;
scars and adhesions do not appear;
short recovery period;
layer-by-layer removal of the polyp gives fewer relapses.

The operation to remove the endometrial polyp with a laser is performed 7 days after the start of the menstrual cycle, when the endometrium is thin and the formation is clearly visible. The duration of the intervention is from 10 minutes to one and a half hours - depending on the size of the build-up. The rehabilitation period is up to 8 months. Before manipulation:

two hours before the operation, the uterine cavity is filled with an antiseptic to prevent infection;
a hysteroscope is inserted through the vagina - an optical device for monitoring the progress of the operation on the screen.

Surgical intervention occurs according to the following scheme:

according to the results of preliminary diagnostics on ultrasound, an operation plan is drawn up;
in accordance with the dimensions of the polyps, the power of the installation is regulated, with small sizes, the tissues are evaporated, with large ones, the laser exposure goes in layers;
in the area of the neoplasm, local anesthesia is performed;
a polyp is removed;
cauterization of blood vessels is carried out to stop internal bleeding.

Hysteroscopy

The elimination of endometrial growths by this method is considered minimally invasive. Hysteroscopy is recommended to be carried out no later than the tenth day after menstruation. Features of surgical intervention:

the duration of the operation is from 10 minutes to half an hour - depends on the number of growths;
there is no violation of reproductive function - a woman after undergoing a course of recovery can give birth;
The operation prevents the development of malignant neoplasms.

Removal by hysteroscopy has good reviews from gynecologists and patients. The technique has disadvantages - the likelihood of infection, bleeding, but there are more advantages:

with the help of the camera there is a constant control of the procedure;
no pain or discomfort;
removal is safe;
no need for stitches.

Hysteroscopy of the uterine polyp occurs according to the following plan:

general anesthesia is performed;
a gynecological dilator is inserted into the cervix;
the cavity is filled with gas to straighten the walls;
a flexible tube with a video camera is placed in it - a hysteroscope;
the position of the neoplasm, size, quantity is determined;
removal is carried out with a special tool;
tissues are sent for histological examination;
the wound is treated by electrocoagulation, laser, cryogenic method to stop bleeding, exclude recurrences.

Diagnostic curettage

The essence of this operation is the removal of the upper layer of the uterine mucosa along with growths. Diagnostic curettage is carried out according to urgent indications - the presence of severe bleeding. The procedure is characterized by:

intervention occurs blindly;
removal of the stem of the neoplasm becomes impossible;
the operation is scheduled three days before menstruation in order to prevent significant blood loss, the uterus began to contract in a timely manner;
the appearance of complications - the recurrence of the appearance of growths, inflammatory processes, the accumulation of blood clots in the cavity.

For best results, it is recommended that you first remove the polyp by hysteroscopy, then do a diagnostic curettage to examine all endometrial tissues. The operation, performed by qualified specialists, eliminates the recurrence of growths. Indications for scraping are:

multiple endometrial polyps;
recurrent formations;
the risk of developing into a malignant tumor.

Surgery is performed under general anesthesia with the following sequence:

produce intravenous anesthesia;
after anesthesia, the expansion of the uterine walls is performed with a special probe;
do curettage of the surface layer of the uterus with a curette;
tissues are sent for histology;
the internal cavity is treated with iodine solution;
a woman puts a heating pad with ice on her stomach to reduce the uterus.

Postoperative period

In order for the recovery stage after removal of growths in the uterus to pass faster, it is necessary to follow the recommendations of specialists. Postoperative activities begin already in the hospital. During this period, the patient:

prescribe broad-spectrum antibiotics to eliminate inflammation, infection;
prescribe a diet to normalize intestinal motility;
In the morning and in the evening during the first week, temperature control is carried out.

During postoperative recovery in a hospital, medications are prescribed:

in the presence of pain - non-steroidal anti-inflammatory drugs - Loksidol, Indomethacin;
to activate the work of the intestines - injections of Proserpine;
in order to normalize blood circulation - Phlebodia 600;
to exclude the formation of blood clots - anticoagulants under the supervision of a physician.

When discharged from the clinic after surgery, you must adhere to the following rules:

constantly wash the perineum with intimate hygiene products or soap in the morning and evening;
organize a balanced diet to prevent constipation;
empty the bladder without delay, immediately after the appearance of the urge;
observe the regime of work and rest;
monitor the nature of postoperative discharge;
regularly undergo gynecological examinations;
take drugs to restore the menstrual cycle.

For quick rehabilitation after surgery in the uterus to remove growths, women are contraindicated for a month:

use drugs that thin the blood - acetylsalicylic acid, venotonics, so as not to provoke bleeding;
swim in open water;
visit the swimming pool;
douching;
use tampons.

What not to do to a woman after surgery

In the first days after removal of endometrial growths, minor bleeding is possible. In order to recover faster, to exclude blood loss, it is necessary to take into account the recommendations of gynecologists. In the postoperative period it is forbidden:

visiting saunas, baths;
prolonged exposure to the sun;
lying in a hot bath - you can only take a shower;
solarium use.

To exclude complications after surgery on the uterus, women need to carefully consider their health. In the first month of rehabilitation is unacceptable:

actively engage in sports - walking is allowed;
lift things weighing more than three kilograms;
have a sexual life;
take alcohol;
eat foods that contribute to the development of constipation;
to push during the act of defecation.

Consequences

Failure to comply with the rules of behavior and regimen in the postoperative period can provoke serious complications. After removal of the growth of the endometrium, the occurrence of:

recurrence of polyposis;
malignant neoplasms - with incomplete removal of tissues with atypical cells;
discomfort and pain during sexual intercourse;
significant bleeding;
long delay in the menstrual cycle.

Among the unpleasant consequences of surgical removal of neoplasms in the uterus:

development of endometrial infection due to untreated genitourinary diseases;
infertility;
pain in the lower abdomen, perineum;
inflammation as a result of a violation of antiseptics and the lack of therapeutic measures after surgery;
hematometer - accumulation of blood in the uterine cavity.

It is not excluded the occurrence of complications after diagnostic curettage:

uterine perforation - puncture of the wall in case of poor-quality expansion, friability of tissues;
temperature rise;
the appearance of dark discharge with an unpleasant odor;
profuse uterine bleeding;
the occurrence of severe, acute pain;
spasms of the cervix;
the appearance of scarring;
development of the adhesion process.

Treatment after removal of a polyp in the uterus

After the surgical intervention, in order to exclude complications, correct the hormonal background, restore the menstrual cycle, it is necessary to undergo a course of treatment under the supervision of a doctor. Drug therapy begins in the clinic and continues at home. Gynecologists prescribe drugs:

No-shpa - in the first days after removal to exclude a hematometer;
Nocrolut, Duphaston - if growths of a glandular or glandular-fibrous type are detected, if the occurrence of polyps in the uterus is provoked by a hormonal failure;
painkillers - Dexalgin, Paracetamol.

Depending on postoperative symptoms and for prophylactic purposes, it is recommended to use:

antibacterial agents - Diclofenac, Piroxicam;
physiotherapy - magnetic therapy, UHF, electrophoresis;
douching with antiseptics - Miramistin, Chlorhexidine;
hormonal drugs to restore the menstrual cycle - Regulon, Janine;
homeopathic remedies prescribed by a doctor;
medicinal plants - upland uterus, celandine;
diet food;
vitamin complexes for the general tone of the body.

Hormonal correction

Gynecologists emphasize the importance of restoring hormone balance after surgery. This is of particular importance when the cause of the growths is an excess of estrogen and a deficiency of progesterone. The lack of hormonal correction can nullify the results of the operation, cause relapses. Indications for treatment are:

violation of the menstrual cycle;
growths of a glandular or glandular fibrous nature;
hormonal disbalance.

Medications are used taking into account the age of the woman, the type of growths. Recommended hormone therapy:

for patients under 35 years of age, estrogen-gestal contraceptives are prescribed - Yarina, Regulon, Zhanin, which restore the balance of hormones and the menstrual cycle;
in the presence of formations of a glandular-fibrous, glandular nature, for women over 40 years old, during menopause, use Norkolut, Dufaston, Utrozhestan;
Mirena spiral - provides local supply of hormones to the uterus, has a minimum of side effects, is placed for 5 years.

After removal of the growth in the endometrium, a course of therapy using antibiotics is provided. This will help avoid dangerous consequences. Treatment with antibacterial drugs is prescribed:

in the case of chronic genitourinary infections as a provoking factor of neoplasms;
in order to avoid recurrence;
when removing polyposis by traumatic methods - diagnostic cleaning, unscrewing the legs;
to prevent the occurrence of postoperative infection;
in the presence of inflammatory processes in the reproductive organs.

In order for the doctor to correctly prescribe medications, the patient takes tests to identify the causative agent of the infection, its sensitivity to antibiotics. The drugs are used in the form of tablets, capsules for oral administration, solution for injection. Taking into account the severity of the condition, the complexity of the operation, the presence of consequences, the doctor prescribes:

course of treatment - from two to ten days;
broad-spectrum antibiotics for prophylactic purposes in the absence of infection;
drugs directed against a specific pathogen.

Price

Surgical intervention after diagnosing polyps in the uterus is carried out in public medical institutions free of charge. Unfortunately, not all of them are equipped with modern equipment. On a paid basis, the removal of endometrial growths is performed under the following conditions:

commercial clinics;
specialized medical centers;
medical and rehabilitation institutions.

When planning the operation, it must be taken into account that diagnostic procedures and analyzes are carried out for an additional fee. The cost of removing neoplasms in the uterus depends on the level of the clinic, the qualifications of its employees, the availability of modern equipment, and the number of polyps to be removed. For residents of Moscow, the cost of surgical intervention is:

Video

What does a polyp in the uterus mean?

- These are mushroom-shaped formations on a stalk in the lumen of the cervical canal of an organ, which arise due to the growth of epithelial tissues. The reason for this process may be malfunctions, hormonal imbalances, excessive production of estrogen, as well as stressful conditions of the body.

Polyps account for approximately 25% of all diagnosed benign changes in the cervix, among which there are also warts, erythro- and leukoplakia. Chronic infection, psycho-emotional stress, crisis periods of the reproductive system - puberty, pregnancy and childbirth, can provoke their occurrence.

By themselves, polyps in the uterus are not dangerous, although they can cause serous discharge and pain. But in case of impaired immunity or hormonal failures, there is a risk of pathological degeneration of cells and the onset of a malignant process. Therefore, women with polyps in the uterus should be regularly examined by a gynecologist to monitor the condition of the neoplasms.

Causes of cervical polyps

There is no single reason for the formation of polyps, the mechanism of endometrial growth can be triggered by a number of factors, including age-related changes associated with hormonal surges, gynecological diseases, systemic diseases, and hormonal regulation disorders.

Reasons for the development of polyps in the uterus:

Endometriosis, ovarian dysfunction, cyst, and other gynecological diseases;

The period of age-related hormonal surges and recessions - puberty or menopause with comorbidities such as chronic infections, or impaired function;

Overwork and psycho-emotional overstrain,;

Injury to the uterus during diagnostic manipulations, such as curettage or hysteroscopy;

Inflammatory processes of the uterine mucosa, endocervicitis;

Injury to the cervix during childbirth or during a surgical abortion;

Pathology of the pituitary gland. Gonadotropic hormone, which is produced in the pituitary gland, affects the synthesis of estrogen. If, as a result of a skull injury, tissue hypoxia, severe poisoning, or damage during brain surgery, the pituitary gland produces too much of this hormone, then estrogen is released in large quantities, which stimulates the formation of polyps in the uterus;

Adrenal dysfunction. The adrenal glands secrete hormones that regulate the vital activity of the whole organism, including those that affect the concentration of sex hormones in the blood;

The use of hormonal drugs, oral contraceptives. Means that affect the hormonal balance of the body should be prescribed by a doctor individually for each patient. The mechanism of action of oral contraceptives is based on the effect on the balance of estrogen and progesterone. If the dosage or individual reaction to the drug is violated, there may be a risk of adenomatous polyps, which are very dangerous because they can turn into malignant tumors in the process of malignancy.

At what age is the most likely to develop uterine polyps?

Since this disease of the uterus is directly related to hormonal changes in the body, the risk of polyps increases when a woman's hormonal background is the least stable.

Three crisis periods are noted during which the hormonal background changes due to the restructuring of the organs of the reproductive system:

The period of puberty. Hormonal changes in the body during puberty can lead to increased production of estrogen, which is necessary to start the menstrual cycle. Estrogens can act on the endometrium, stimulating its division and the formation of polyps. But the young organism has strong protective mechanisms that prevent pathological growths in the uterus, if there are no concomitant diseases - diabetes mellitus, infections of the genitourinary system, thyroid dysfunction,;

Pregnancy and the period of breastfeeding. The hormonal background in pregnant women varies greatly, since the reproductive system must support the development of the fetus for all nine months. And then hormonal changes associated with lactation can cause the growth of these formations in the uterus, including placental polyps, which occur only in the postpartum period;

The period of menopause. Menopause is characterized by the extinction of ovarian function and a decrease in the concentration of sex hormones in the blood. The menopause period usually begins at the age of 45-50, and at this time, against the background of hormonal changes, the risk of developing neoplasms in the uterus may also increase. Hormonal drugs that women take to mitigate the negative manifestations of menopause can stimulate the growth of the endometrium, which also increases the likelihood of pathology.

Symptoms of a polyp in the uterus

Small growths and solitary polyps in the uterus usually do not manifest themselves as unpleasant symptoms, and often their detection occurs by chance during a routine examination.

Only mechanical damage to the polyp or infection can lead to noticeable symptoms:

Pathological discharge from the vagina;

Drawing pain in the lower abdomen;

Uterine bleeding not associated with menstruation.

In addition, the presence of this disease can also be determined by indirect symptoms - difficulty in conception up to, a violation of the monthly cycle, which is often observed with cervical polyps.

When can polyps cause cervical cancer?

The process of malignancy consists of three stages:

Growth of the endometrium or, the formation of polyps;

The transformation of one type of epithelial cells into another, or metaplasia;

Can cervical polyps be asymptomatic?

This pathology is characterized by an asymptomatic course, therefore it is possible to detect uterine polyps at an early stage only if they arose against the background of hormonal changes in the body, and an appropriate diagnosis was made.

In the following cases, the disease is asymptomatic:

Chronic infections of the genitourinary system. In this case, the formations grow slowly and do not have pronounced symptoms. Small polyps are also difficult to detect, since pathological signs appear only when the size reaches 1 cm;

The period of menopause. Since one of the symptoms of this condition is a violation of the menstrual cycle, it is difficult to detect neoplasms during the menopause without special diagnostics. Against the background of hormonal changes during menopause, the frequency of formation of polyps in the uterus increases, this is also facilitated by the lack of regular renewal of the endometrium during;

Fibrous polyps. The growths of connective tissue, which does not contain blood vessels, cannot cause uterine bleeding, and therefore often remain undiagnosed. At the same time, education can reach a significant size and develop over several years, without causing inconvenience and pain to a woman.

Surgical removal of endometrial polyps that do not show unpleasant symptoms is not necessary. But the patient must regularly undergo examinations to prevent malignant degeneration of the neoplasm. Hormonal agents used in non-surgical treatment can stimulate their growth and exacerbate the course of the disease.

Why are polyps in the uterus dangerous?

The danger of such formations in the uterus is primarily associated with their possible malignancy or malignant degeneration. Even polyps that have been growing for many years without showing negative symptoms can turn into cancer at any time.

What complications can occur in the absence of treatment of uterine polyps:

Violation of the normal course of pregnancy. In addition to the difficulty of conception that occurs if a large area of the endometrium is occupied by polyps, the risk of ectopic pregnancy increases, which leads to rupture of the fallopian tubes and serious pathologies. In later pregnancy, uterine growths can provoke placental abruption, leading to spontaneous abortion;

Uterine bleeding. As the size of the polyp increases, blood vessels appear in it. In such vessels, the walls are characterized by increased permeability, which can lead to periodic bleeding. In this case, blood loss is usually small, blood accumulates in the uterine cavity or is mixed with urine in small portions, begins and ends spontaneously without outside interference. Sometimes it is possible to detect uterine bleeding only by symptomsthat occur due to loss of hemoglobin. These signs include a general decrease in immunity, pallor of the skin, drowsiness, fatigue, dry mouth. Bleeding that does not stop for a long time and requires the intervention of a doctor is most likely caused by malignant processes;

Difficulties in conception. A large number of such formations in the uterine cavity or one polyp, reaching a significant size, is a mechanical obstacle to the attachment of the embryo to the walls of the endometrium. Therefore, conception can be difficult;

Malignant transformation of cells. Malignancy most often occurs in adenomatous polyps. According to statistics, this process is observed in 1.5% of cases. Malignant degeneration of cells leads to the destruction of healthy tissues, profuse blood loss and growth of the neoplasm. Bleeding during malignancy of the polyp can even lead to the death of the patient. That is why with uterine polyps, even if they are asymptomatic, it is necessary to regularly undergo a diagnosis by a doctor who classifies the type of growth and prescribes a treatment regimen;

The emergence of a chronic focus of infection. Normally, there are protective factors on the uterine mucosa that prevent the development of infection. Polyps, on the other hand, are usually formed from connective tissue, which does not contain protective factors, and because of this is very vulnerable to pathogenic bacteria. Since a polyp without treatment can reach a large size, this increases the risk of a chronic focus of infection in the uterine cavity.

Diagnosis of a polyp in the uterus

To diagnose growths in the uterus, a number of tests are performed:

General and biochemical analysis of blood. A complete blood count shows the number and shape of blood cells - erythrocytes, platelets and leukocytes, which determine the quality of blood and change under the influence of diseases. So, with a decrease in the number of red blood cells, we can talk about uterine bleeding, even if they are insignificant and invisible to the eye. An increase in the number of leukocytes - white blood cells - indicates the development of an infection in the body, including a genitourinary infection, which is a risk factor for the formation of polyps. Your doctor may prescribe antibiotics to prevent infection and reduce the risk of new polyps. Platelets provide blood clotting, therefore, with a decrease in their number, the blood coagulates weakly, which contributes to bleeding;

Histology of polyp tissue helps to determine the type of overgrowth. The doctor takes a biopsy, takes a sample and follows the cells that make it up, after which he can classify the tumor. If an adenomatous polyp is diagnosed, its surgical treatment is recommended in order to prevent malignant degeneration of cells;

bacteriological analysis. For its implementation, a swab is taken from the vagina and cervix and examined for the presence of pathogens. The analysis helps to identify chronic infections that lead to the formation of polyps, while this type of study is more effective than counting white blood cells. Together with bacteriological analysis, an antibiogram is carried out, determining the sensitivity of pathogenic microorganisms to drugs;

Hormone analysis. The state of the endometrium is very dependent on the concentration of certain hormones in the blood. If polyps are found in the uterus, it is necessary to determine the cause of their occurrence, and it often lies in hormonal disorders. To determine the hormonal status of the patient at different times of the menstrual cycle, blood is taken for analysis, the amount of estrogen, progesterone, androgens, and gonadotropic hormone is determined. If the hormonal balance is disturbed, the doctor may prescribe drugs to correct it, which helps to remove the negative manifestations of endometrial polyposis and prevent neoplasms.

Methods for diagnosing cervical polyps

This disease is diagnosed by instrumental methods - ultrasound, colposcopy, hysteroscopy, metrography, CT and MRI. A thorough examination of neoplasms is necessary in order to correctly prescribe a treatment regimen and draw conclusions about the need for surgery. It is not enough just to detect uterine polyposis, it is necessary to classify polyps and determine how high the risk of malignancy is. Errors at the stage of diagnosis can lead to a malignant process and various pathologies of the reproductive system.

So, to determine the presence of polyps in the uterine cavity, use:

Ultrasonography. Ultrasound is performed in two ways - through the abdominal wall and transvaginally. The first method is used during the diagnosis of polyps in the organ cavity, and the introduction of a scanner into the vagina is necessary to detect cervical polyps. Ultrasound examination allows diagnosing polyps with a size of one centimeter, smaller neoplasms require special equipment. In addition to the presence of polyps and determining their type, ultrasound allows us to draw conclusions about the type, growth rate of neoplasms and the likelihood of malignancy. Thus, polyps that grow into the wall of the uterus are more prone to malignant transformation;

Colposcopy. The study of the cervical canal using a gynecological mirror allows you to determine the number of polyps, to examine the surface of large cervical neoplasms. Large growths can fall into the vagina, but their base is located in the cervical canal. Colposcopy allows you to explore the structure of these polyps in more detail, but it is possible to draw conclusions about the cause of their occurrence only after a histological analysis;

Hysteroscopy. During hysteroscopy, a fiberscope is inserted into the vagina - a long flexible tube with a camera located at the end, if an obstacle is encountered in its path, a polyp is diagnosed. The growths of the cervix close the lumen of the cervical canal, so it is quite easy to detect them. The study of the uterine mucosa using hysteroscopy methods allows you to accurately determine not only the presence of formations and their number, but also the place of attachment of the leg, inflammatory processes and the risk of malignancy. At the initial stage of malignant degeneration, the surface of the formation is uneven, has small nodes;

Hysterography is a less accurate method of research, a contrast agent is injected into the uterine cavity, after which an x-ray is taken. Dark areas in the picture indicate the presence of polyps, but the technique cannot provide information about their type and structure;

CT and MRI. These methods provide the most accurate data on the location of the polyp, the degree of its ingrowth and cell malignancy. Since these diagnostic procedures are expensive, they are usually prescribed in case of suspected oncology. Computed tomography allows you to determine the presence of metastases and their spread throughout the organs, which is necessary for the doctor to draw up an effective treatment regimen.

Additional methods for diagnosing uterine polyps

Other diagnostic procedures include:

Cytological study. A special apparatus collects fluid from the uterine cavity (aspirate) and examines the smear for the presence of pathologically degenerated cells. This method is not as accurate as a biopsy, so it is often used in conjunction with other diagnostic methods.

Biopsy of tissues for analysis- one of the most accurate ways to determine the type, structure and cause of polyps, the study of the material selected during the biopsy is carried out in the laboratory.

Tests for hormonal status- a necessary procedure, since in most cases the mechanism of the development of the disease is triggered precisely because of a violation of the hormonal balance. Based on the data obtained, the doctor can prescribe an individual drug treatment regimen.

Treatment of cervical polyps

If the diagnosed polyp has a low probability of malignant degeneration, then instead of removal, the doctor may recommend symptomatic treatment, which is aimed at eliminating unpleasant manifestations.

Symptomatic treatment helps prevent spotting and pain in the lower abdomen, which often cause inconvenience to patients.

Painkillers that are used for this disease:

Diclofenac;

ibuprofen;

Naproxen.

They cannot be used for a long time, so as not to provoke pathologies of the digestive tract, such as peptic ulcer and intestinal inflammation, and also so as not to create an unnecessary burden on the liver. If the pain does not subside after taking painkillers, then it is urgent to see a doctor, as surgical removal of the polyp is required. When it grows, its size can increase from 1 cm, it can cause severe pain and must be removed.

To prevent the development of infection, which can complicate the treatment process and contribute to the growth of polyps, it is necessary to observe the hygiene of the genitals. Rinses with weak solutions of antiseptics - potassium permanganate, collargol and septadine help to prevent the reproduction of pathogenic microorganisms and infection.

Is it possible to get rid of uterine polyps without surgery?

Drug treatment helps prevent new growths and remove the symptoms of already present neoplasms, but they do not affect the cause of the pain syndrome.

It is impossible to get rid of the disease without surgery; in the absence of surgical treatment, one can only slow down their growth and prevent the occurrence of new polyps. For this, hormone replacement therapy is used to help adjust the ratio of estrogen and progesterone. Drug treatment helps to solve the problem of infertility, bloody and mucous discharge, which are often observed with such formations in the uterus.

Painkillers - paracetamol, ibuprofen, drotaverine - are used to relieve pain caused by mechanical pressure of the polyp, twisting its legs. But these drugs are not able to eliminate the cause of pain and cannot remove severe pain, so surgical removal of uterine polyps is often required.

In addition, surgery is necessary if the risk of malignant degeneration is increased, as is the case with adenomatous polyps. In this case, drug treatment can only be used to prevent recurrence of the disease.

Removal of a polyp in the uterus

The removal of such an education in most modern medical institutions is carried out using one of the most common methods - hysteroscopy. Hysteroscopy is a gentle operation with simultaneous examination of the uterine cavity and curettage of the cervical canal. Thanks to the possibilities of modern technologies, polypectomy and curettage are carried out quickly and without consequences, and the biological material obtained as a result of hysteroscopy undergoes a histological analysis, thanks to which the treatment carried out by doctors is corrected and improved.

There are different tactics for getting rid of endometrial polyposis, depending on several factors in the development of the disease: its cause, the presence of concomitant diseases of hormonal regulation, the distinguishing features of the endometrium, the size of the polyp planned for removal, the age of the patient.

As a result of the research, the following general rules are derived:

In the presence of fibrous-type polyps, their removal is mandatory;

A polyp of the glandular-fibrous type indicates that hormonal changes occur during the course of the disease. This does not affect the form and purpose of the surgical intervention in any way, but in the postoperative period, hormonal therapy will be required to correct disorders of the endocrine glands;

The detection of an adenomatous polyp, which often occurs in premenopausal women, is an indication for an operation to remove the uterus. Polyps that can provoke oncology are most guaranteed to be eliminated with the help of complex operations: extirpation of the uterus, supravaginal amputation with an accompanying revision of the ovaries, sometimes together with appendages.

Hysteroscopy - polyp removal

Only an experienced doctor is capable of performing hysteroscopy at a high level, so you should not neglect the services of medical institutions using equipment based on modern high technologies. This greatly increases the reliability of the surgeon, whose professionalism will depend on the health of the patient.

Hysteroscopy is used not only to eliminate the formation itself, but also for an incidental study of the uterine cavity, which provokes a minimum of complications. Removal of a polyp using this method can hardly be called a surgical operation, since it takes place without internal intervention (violation of the integrity of the covering tissues). However, careful and accurate cutting of the pathological tissue with a special tool through a natural opening (in this case, the vagina and cervical canal) avoids any serious consequences that are characteristic of abdominal operations.

The whole procedure is carefully controlled by the surgeon, who controls the movement of the hysteroscope (a tube with a camera and a device for removing a polyp at the end) inserted into the cervix. Using a video camera, the uterine cavity is examined, and the pathological tissue is removed after assessing the polyps in terms of size, location, and number.

On the part of the patient, in order to improve the working conditions of the surgeon and, as a result, the results of the operation, one should adhere to the fasting regimen - this will help to avoid postoperative nausea. Also, hysteroscopy should be performed only after menstruation, on one of the first ten days of the cycle - this is necessary for better visualization of the organ under study.

Office hysteroscopy

This is a method of thorough diagnostics, which is carried out by a hysteroscope without instruments, which eliminates the need for anesthesia, that is, there is no injury. The technique gives the doctor the opportunity to conduct an examination of the uterus with the subsequent choice of therapy together with the patient. Minihysteroscopy, in addition to polyposis, allows you to diagnose fibromyoma, synechia, endometrial hyperplasia and other diseases of the female genital organs.

Diagnostic curettage

Curettage is one of the oldest operations performed on the uterus, but even now you can find medical facilities where it is performed due to the lack of educated staff and technical support for hysteroscopy. Diagnostic curettage can also be prescribed in addition to hysteroscopy to obtain endometrial samples, according to which, after histological analysis, it will be possible to say whether pathological cells remain in the tissues that can provoke a relapse.

Even after a successful hysteroscopy, 30% of patients return to the doctor to treat a recurrent polyp. This is due to the complexity of the treatment of the bed (laser, cryogenic coagulation), as well as the possible trauma of the operation itself. What can we say about curettage, during which the surgeon has to blindly remove the neoplasm and its leg.

But in some cases, such an operation is due to urgent indications, such as severe uterine bleeding. Curettage helps prevent blood loss that occurs against the background of endometrial hyperplasia. In this case, bleeding usually appears unexpectedly, and requires urgent assistance. Thus, in modern medicine, diagnostic curettage is assigned the role of an operation to preserve hemostasis, and not a method for removing uterine polyps.

Curettage is performed using a cervical dilator, which keeps it in this position all the time while the surgeon works with a special curette (metal loop). With this tool, excess tissues with polyps are scraped off the walls of the uterus and cervical canal, which become samples for laboratory analysis.

Removal of polyps in the uterus with a laser

The most modern way to remove polyps from the cervix is laser burning. Its advantage lies in the unprecedented accuracy of high-tech equipment, which allows to reduce the trauma of the operation to get rid of polyps to almost zero. Targeted destruction of pathological tissues with a laser is carried out quickly and without scarring, and with full preservation of the possibility of fertilization, which is so important for women who are still planning to have children.

For women who have undergone routine surgery to remove any type of polyp, laser burning would seem like fantasy. In the latest medical centers with the appropriate equipment, a full cycle of cervical polyp treatment (examination, analysis of results, preparation of an operation program and, in fact, laser removal) can be done in just three hours! No hospital stay, disability or rehabilitation due to trauma to the uterus and surrounding tissues.

Obviously, laser removal of polyps is considered to be the most effective way to deal with neoplasms in the cervix. Thanks to the layer-by-layer control of laser penetration, the doctor saves most of the tissues surrounding the polyp, which significantly reduces the recovery period, eliminates blood loss and scarring. Such a sparing procedure allows a woman of reproductive age to fully rehabilitate and return the ability to conceive in six months, and sometimes even earlier.

What is the discharge from the vagina after removal of uterine polyps?

The postoperative period for patients consists of two scheduled gynecological examinations within a week, followed by the appointment of rehabilitation procedures. The nature of rehabilitation therapy depends on age, the cause of the disease and its characteristic features.

Do not worry if after hysteroscopy are found:

Pain in the abdomen, similar to pain from contraction of the uterus during menstruation;

Constant discharge for two to three weeks after surgery.

The above phenomena are considered normal and indicate a successful completion of treatment. By the nature of the discharge after the removal of polyps, the doctor can judge whether the healing processes are normal. Allocations are observed in most patients after surgery, their type depends on the shape and size of the polyps, the degree of their vascularization, the presence or absence of infection, and also on the method of their removal.

Factors affecting the intensity of postoperative discharge, and their type:

bacterial infections. If the formations developed against the background of a chronic infection, or if the infection occurred during the operation, the healing process takes longer and may be accompanied by purulent discharge from the vagina;

Removal method. Cryodestruction and laser removal of a polyp are considered less traumatic methods of surgical treatment than curettage or twisting of the leg, so the healing process after them is faster, and the intensity of the discharge is less;

Blood supply of the neoplasm. Each anatomical formation and organ has its own degree of blood supply intensity, has its own blood vessels. The type of vascularization of the neoplasm, the number of blood vessels and their size determine the intensity of discharge after surgery. Fibrous formations are less vascularized than glandular-fibrous and adenomatous polyps, respectively, and there is less discharge after their removal;

Depth of ingrowth, its size and shape. The larger the polyp, the more vascularized it is. Polyps with large vessels on a thick stalk after surgical treatment provoke bloody discharge from the vagina. In addition, if the leg of the polyp grows deep enough, then in the process of its removal, the risk of damage to the uterus's own blood vessels may increase, which slows down the healing and rehabilitation process.

In general, there are 4 types of discharge in the postoperative period:

Bloody. The release of clotted blood clots can be observed when blood enters the uterine cavity during surgery. The discharge of fresh blood can last 1-2 days after the operation, during which the blood vessels of the uterus were damaged;

Physiological secretions. Normally, postoperative discharge lasts no more than two days or up to 2 weeks when the uterus is scraped, their volume is up to 50 ml. They are transparent, may contain ichor. After healing, the discharge disappears;

Purulent discharge observed with a bacterial infection, among the causative agents of which are other microorganisms. The discharge is yellow or greenish in color. In the absence of treatment, the infection can cause a purulent abscess with complications up to infertility;

Putrid secretions may be a sign of a secondary infection. One of the postoperative complications is the ingress of Clostridium into the uterine cavity. These microorganisms can multiply in the absence of air, causing foamy discharge with an unpleasant odor.

What complications can occur after surgical removal of uterine polyps?

There are four most common ways of surgical treatment of this disease:

Excision of the legs of the polyp by hysteroscopy methods- used to treat solitary neoplasms with a long stem;

Polyp cryosurgery- treatment of the neoplasm with liquid nitrogen, after which it is separated from healthy tissues with tweezers;

Curettage - removal of a part of the mucous membrane of the uterus or cervical canal with a vacuum device or a surgical instrument;

Laser burning- one of the most minimally invasive methods with the lowest risk of complications in the form of bleeding and infections.

Among the complications of surgical treatment of endometrial polyposis are:

perforation of the uterus- a through hole in the wall of the organ, which communicates its cavity with the abdominal cavity, which can lead to severe infectious and inflammatory processes. Perforation can occur during blind curettage or during surgery on areas of the endometrium with scars and adhesions. A severe consequence of perforation may be inflammation of the pelvic peritoneum due to microorganisms that have entered there from the uterine cavity. Treatment is with antibiotics and additional surgery;

Hematometer - accumulation of blood in the uterine cavity, caused by a spasm of its neck, which makes the evacuation process difficult. This complication is very dangerous, because clotted blood is an environment for the development of pathogenic microorganisms, which can cause infection. For treatment, antispasmodics are used, which relax the cervix and promote the release of blood in a natural way. If antispasmodic drugs do not help, a probe is used to suck blood from the uterine cavity;

Scarring and adhesion formation- if the internal mucosa of the uterus is severely damaged, which often happens during curettage, the connective tissue undergoes scarring. This disrupts the function of the endometrium, the egg cannot attach to the surface with scars and adhesions, which results in infertility or ectopic pregnancy. The risk of this complication is reduced when uterine polyps are removed with a laser or cryodestruction methods;

Inflammatory processes- can be caused by infection in the uterine cavity, lead to serious consequences up to infertility, hinder the healing process. Antibiotic therapy is used for treatment. The use of antiseptic agents during the operation, cauterization of the wound helps to prevent this complication. Laser removal is considered the safest, since during it infection is unlikely due to the lack of direct contact of the instruments with the uterine membrane;

Malignancy - malignant degeneration of tissues, from which the oncological process begins;

Disease recurrence- re-formation of polyps caused by mechanical damage to the uterine mucosa. In addition, it is impossible to guarantee the absence of new polyps, even if the operation was without complications. To prevent their occurrence, it is recommended to undergo regular examinations and provide treatment for chronic diseases of the endocrine system, infectious and inflammatory processes.

What is the likelihood of recurrence of uterine polyps?

In 10% of cases, after removal of uterine polyps, neoplasms reappear after a while. This is due to an incorrectly performed operation, the individual characteristics of the organism, or the malignant nature of the formation.

With incomplete removal of polyp tissues it can grow back in the same place. This happens after an operation performed poorly. Often, new polyps in the uterus develop after twisting the legs of the old one, if parts of tissues or neoplasm cells remain. Polyps reappear if cauterization of the wound has not been performed.

The cause of new polyps in the uterus are other diseases- this is a fairly common cause of relapse, since such neoplasms rarely appear on their own, hormonal disorders of the body contribute to their occurrence. Among the reasons causing the growth of new polyps may be hormonal agents that disrupt the balance of estrogen and progesterone, thyroid disease, diabetes, genitourinary infections and chronic diseases of the reproductive system.

hereditary predisposition. The patient needs to undergo frequent preventive examinations, and all polyps detected at an early stage should be cauterized by laser surgery.

postoperative stress by itself can create the preconditions for a relapse of the disease. Therefore, during the rehabilitation period, it is important to provide the patient with peace, not subject her to psycho-emotional stress and conduct general strengthening therapy in order to increase the body's defenses.

To prevent the recurrence of endometrial polyposis, the gynecologist usually prescribes antibiotics and progestin preparations to correct the hormonal background.

Rehabilitation treatment after removal of polyps in the uterus

After an operation to remove such neoplasms using hysteroscopy or laser surgery, the risk of complications associated with traumatic tissue damage and infectious processes is minimal.

But for preventive purposes, the doctor may prescribe antispasmodics, hormonal drugs and antibiotic therapy:

Antispasmodics, which include No-shpa, are taken on the day after surgery to relieve spasm of the cervix, which can provoke an accumulation of blood in the organ cavity;

Antibiotics are prescribed if the cause of polyps was the infectious processes of the genitourinary system, as well as to prevent secondary infection. Antibiotics are necessary after operations with an increased risk of tissue injury (curettage, excision and unscrewing of the polyp stem);

Hormonal drugs prescribed to patients in whom neoplasms have arisen due to an unstable hormonal background, with surges and drops in the level of sex hormones, or with excessive production of estrogen. For this purpose, gestagens (Norkolut, Duphaston) and hormonal contraceptives (Yarina, Regulon, Zhanin) are used - this helps to prevent the recurrence of fibrous polyps.

In order to maintain the immune system and stabilize the hormonal background, phytotherapeutists may recommend an infusion of a boron uterus, celandine, and other remedies based on medicinal plants. In addition, vitamin complexes are prescribed to strengthen the body's immune barrier, in particular, powerful antioxidants - A, C and E.

What can not be done to a woman after surgery to remove polyps?

As mentioned earlier, from 14 to 20 days after hysteroscopy, most patients experience bleeding in small amounts. This indicates the effectiveness of the healing processes.

In order not to interfere with normal tissue regeneration, you need to follow a few rules:

You can not overheat your body, as this increases and increases the risk of bleeding. Within a month after the operation, hot baths, baths, saunas should be avoided, and hyperthermia should be prevented by any means;

It is better not to take drugs based on acetylsalicylic acid (Aspirin, Citramon, Upsarin, Cardiopyrin, Tomapirin, etc.), as they impair blood clotting and contribute to bleeding;

Physical overexertion, especially associated with heavy lifting, is prohibited. Any sports, dancing, gymnastics and outdoor activities are also prohibited;

During the month of rehabilitation, physical and chemical interventions in the reproductive system (sexual intercourse, douching, etc.) are also prohibited;

It may seem obvious, but some patients have to be reminded of the need for careful observance of intimate hygiene, and not only after surgery, but all the time.

Answers to popular questions about uterine polyps

Is it necessary to remove polyps in the uterus?

The methods of modern medicine allow you to quickly and painlessly remove any neoplasm, but, ultimately, the choice is up to the patient. Removal is definitely recommended if medical treatment does not help to get rid of unpleasant symptoms, or if the polyps do not stop growing. Adenomatous polyps have a high potential for malignant transformation, and therefore must also be removed.

Can a uterine polyp resolve on its own?

A polyp is an anatomical formation of overgrown connective tissue, which is difficult to external influences. Therefore, it is impossible to get rid of the polyp in a non-surgical way, hormone therapy only helps to stop its growth and prevent new growths. These are quite effective methods for treating small polyps with a low risk of malignant transformation. However, if these neoplasms put pressure on the uterus, cause pain and prevent pregnancy, they must be removed.

Is it possible to get pregnant with a polyp in the uterus?

Pregnancy with a polyp in the uterus is possible, but if the polyp is large (1-2 cm) or there are a lot of them in the uterine cavity, then attachment of the embryo can be difficult. If it is impossible to attach an egg to the endometrium, the risk of an ectopic pregnancy increases with all the ensuing complications.

Is it possible to give birth with a polyp in the uterus?

Pregnancy and childbirth can be difficult if there is such a growth in the uterus. Among the frequent complications of pregnancy are placental abruption at the site of localization of the focus of polyposis, uterine bleeding, impaired fetal development due to mechanical pressure exerted by the polyp. Complications during childbirth: violation of the elasticity of the walls of the uterus due to growths, deterioration of uterine contractility, the risk of mechanical damage to the polyp and blood loss as a result of uterine bleeding.

Can the growth of polyps in the uterus lead to a miscarriage?

Yes, the chance of miscarriage increases if there are polyps in the uterus. The main cause of miscarriage in this disease is placental abruption. Normally, the placenta is attached to the areas of the internal mucous membrane of the organ and implements air exchange and nutrition of the fetus through the mother's body. In areas of the endothelium with polyps and growths, the placenta is poorly attached, fetal nutrition is difficult and the risk of detachment increases. Other causes of miscarriage in endometrial polyposis: a malignant process that begins with malignancy of polyp cells, as well as malformations and abnormalities in the course of pregnancy due to the mechanical pressure exerted on the fetus by large neoplasms.

Do uterine polyps affect the development of infertility?

Small solitary polyps do not interfere with reproductive function. The danger is represented by multiple growths that occupy a large area of the inner surface of the uterus and interfere with the attachment of the egg. Large formations on the bottom of the uterus can also provoke infertility, as they block the fallopian tubes and prevent the penetration of the egg. In addition, even small growths can block the cervical canal, making it difficult for sperm to enter the uterine cavity from the vagina and, thereby, make conception impossible. Malignancy or degeneration of polyp cells into malignant cells also leads to reproductive dysfunction and infertility.

When can I get pregnant after removing a polyp in the uterus?

Removal of polyps is a safe and fast operation, which in most cases passes without complications, which makes pregnancy possible already in the first month after treatment. An obstacle to pregnancy after removal of polyps can be infection during surgery, the occurrence of adhesions and at the site of removed tumors, hormonal instability and uterine bleeding, as well as relapse of the disease.

Are polyps removed in the uterus without hospitalization?

Hospitalization for removal of polyps takes an average of 1 to 3 days. If there are no complications and pain, then the patient can go home in the evening of the same day when the operation was performed.

How long do you need to lie down after removal of a polyp in the uterus?

Two hours after the operation, if there is no pain and weakness, you can get out of bed and go about your daily activities.

When is sex possible after removal of a polyp in the uterus?

You can not have sex after the operation until the healing process is complete. On average, this happens after six weeks. A woman should not have bloody or brown discharge not associated with menstruation, anemia and weakness. If sex happens before the rehabilitation period ends, there is a high chance of microtrauma and infection.

Can a polyp come out with menstruation?

Polyps respond very poorly to non-surgical treatment. Hormonal drugs can remove unpleasant symptoms and stop the growth of a polyp, but they cannot reduce it in size, separate it from the uterine wall and remove it from the body. Therefore, the stories that polyps come out with menstruation after taking a certain remedy are a fraud in order to sell the drug more profitably or a delusion common among illiterate people in the gynecological field.