What Is a Uterine Polyp?

Uterine polyps (metropolypus) is a common gynecological disease. In a broad sense, it refers to all swellings attached to the uterine wall by slender pedicles, including endometrial polyps, endometrial adenomatous polyps, and malignant polyps. Most of them are benign, without obvious clinical symptoms, or causing increased menstruation, leucorrhea abnormalities, vaginal bleeding, uterine enlargement, and pain. Hysteroscopy shows that the size of the polyps varies, and the length of the pedicle varies. It is a common intrauterine lesion in gynecology. Among them, endometrial polyps are the most common.

Basic Information

English name

"uterinepolyp, metropolypus"

Visiting department

Gynecology

Common causes

Related to endocrine disorders, inflammatory stimuli and other factors

Common symptoms

Prolapse of the mass, abnormal vaginal discharge, vaginal bleeding

Contagious

no

Causes of uterine polyps

Endocrine disorders

Closely related to high estrogen levels. Long-term stimulation of estrogen can cause excessive growth of the endometrium, forming polyps, and can promote further growth of uterine polyps.

2. Inflammatory stimulation

The main cause is the long-term stimulation of chronic inflammation, which causes local mucosal hyperplasia and other lesions in the cervical canal. The proliferated mucosa gradually protrudes from the base to the outer mouth of the cervix and forms polyps, which easily leads to symptoms such as bleeding and easy to relapse.

3. Other

Hypertension, diabetes, obesity, endometrial hyperplasia, and age increase are all related to the occurrence of uterine polyps.

Clinical manifestations of uterine polyps

Early symptoms include the following:

1. Prolapse of mass

If polyps occur in young, unmarried women, these patients may present with a mass coming out of the vaginal opening.

2. Leucorrhea is abnormal

Patients may have leucorrhea and leucorrhea bloodshot. A few polyps with larger pedicles can prolapse from the cervix, cause a small amount of bleeding from the vagina, or bleed after intercourse and when squatting with hard stool. If polyps have ulcers, infections, and necrosis, bloody or purulent leucorrhea can occur.

3. Abnormal uterine bleeding

Patients may have more menstrual periods or shorter periods or prolonged periods, with menstrual periods. Some patients also bleed after their husbands and wives, and some patients even have bleeding similar to menstruation, and some patients may also show vaginal bleeding after menopause.

4. Infertility and abortion

Some patients with uterine polyps are associated with infertility or miscarriage, which is related to the location, size and number of polyps. If the polyp grows in the cervical canal, it may prevent the sperm from entering the uterine cavity; if it grows in the uterine cavity, it will prevent the implantation of fertilized eggs or affect the development of the embryo, leading to infertility and abortion.

Uterine polyp examination

Ultrasound examination

As the most commonly used auxiliary diagnostic method, transvaginal ultrasonography can determine the position, number and size of polyps, and at the same time observe the general morphological changes of the uterus.

2. Gynecological examination

Gynecological double consultation and triple consultation were used. When acute inflammation occurs with uterine polyps and infection, cervical congestion, edema, or erosion can be seen. Purulent secretions are discharged from the cervical canal, and pain can be felt when the cervix is touched. For elders with uterine polyps, a lump can be seen or touched at the cervix. Patients with chronic cervicitis can see cervical hypertrophy, polyps, gland cysts, eversion, etc., or see purulent secretions at the mouth of the cervix, which is harder on palpation. If it is cervical disease or polyps, there may be contact bleeding.

3. Hysteroscopy

Hysteroscopy can directly observe the situation in the uterine cavity, and can also biopsy suspicious lesions under direct vision.

4. Pathological examination

Endometrial polyps are composed of endometrium, and the surface is covered with a layer of cubic epithelium or low columnar epithelium. The middle part of the polyp forms a fibrous longitudinal axis, which contains blood vessels. Because the pedicle is narrow, blood supply is reduced, and polyps are extremely susceptible to degeneration. The most prone to thrombosis in the blood vessels of polyps, which becomes dark purple due to congestion, often starts to necrosis at the top, and may eventually fall off.

Uterine polyp diagnosis

Diagnosis can be confirmed based on clinical manifestations and related examinations.

Uterine polyp treatment

Principles of treatment: mainly surgical resection. The treatment plan should be considered comprehensively according to the patient's age, whether there are symptoms, whether there are fertility requirements, the nature of polyps, and the growth rate. Hysteroscopic polypectomy is the most important treatment method. For small focal or diffuse polyps, curettage should be carried out, especially at the base and corner of the palace. After hysterectomy, anti-infective treatment should be performed. Note the following:

1. If accompanied by inflammation, first control the infection.

2. If there is bleeding, stop bleeding mainly.

3. Operate after inflammation control.

4. After the surgical resection, the polyps should be sent for pathological examination. If there are signs of malignant changes, treatment measures should be taken as soon as possible.

5. The disease is prone to recurrence. It should be reviewed regularly after surgery and every 3 months.