occur among benign uterine formations and polyps, which are formed from the internal mucous uterine layer.
Similar neoplasms are found in about 10% of women, and among the gynecological problems polyps occupy about a quarter of cases. Such a statistical picture indicates a considerable prevalence of such a disease.
In fact, polyps are peculiar intrauterine outgrowths protruding into the uterine cavity. This pathological mucosal growths, having a leg or growing on a wide base.
They differ in structure, location, size, histological structure, and can develop completely asymptomatic. Although most often uterine polyps manifest painful symptoms, bleeding and infertility.
Causes of endometrial polyposis
The main cause of the formation of uterine polyps are neurohormonal factors and inflammatory endometrial changes.
- Provoke the appearance of polyps of a condition like hyperestrogenia or hormonal ovarian dysfunction. These conditions are accompanied by hyperplastic endometrial changes in the form of polypoid growths. Such conditions are often accompanied by pathologies typical of increased estrogen content such as uterine fibroids, mastopathic processes or glandular endometrial hyperplasia, adenomyosis or ovarian polycystosis.
- Chronic pathological processes contribute to endometrial polyposis: female inflammations like oophoritis, adnexitis or endometritis, sexual infectious lesions, damage to the uterus during abortion and curettage, long-term wearing of the intrauterine device.
- In the risk group of , the emergence of endometrial polyps specialists include women with obesity, neuropsychiatric disorders, immune disruptions, thyroid pathologies, hypertension, or diabetes.
- Vascular proliferation is also capable of causing the development of polyposis. When the vascular channels are blocked or expanded, active multiplication of epithelial cells begins around them.
- It happens that polyposis in the uterine cavity is caused by a genetic predisposition, a hypodynamic way of life or a prolonged intake of Tamoxifen. This medication is used in antitumor therapy to block hormone-sensitive receptors. As a result, in some patients polypous formations begin to grow actively.
Types of polyps of the uterus
Polyps have a fairly simple structure, including the leg and the body.
Photo of the polyp on the peduncle in the uterus
According to histological signs, the uterine polyps are divided into the following varieties:
- Fibrous - these formations are formed from connective tissue cells, have a dense structure, occur predominantly in women after 40 in the pre-menopausal or menopausal period when the female bodymassive hormonal changes;
- The glandular - consists of iron-fibrous cellular structures. Such polyps usually occur in relatively young patients. They can develop in the form of cystic formations that have a liquid inside. The most common cause of this polyposis is endometrial hyperplasia;
- Adenomatous - they contain atypical altered cellular structures. Such entities are prone to malignancy;
- Iron-fibrotic - consists of a mixture of connective tissue and glandular cell structures;
- Placental - such polypous formations are formed in women after childbirth in the event that placental cells remain in the uterine cavity, from which later polyps develop.
Symptoms and signs
Uterine polyps can sometimes develop in a latent way, i.e., secretly, but eventually the pathology acquires a characteristic set of symptoms, which are as follows:
- When the latent stage of development ends, the patient begins to be bothered by bleeding from the uterus of a dysfunctional nature of acyclic or cyclic type. Menses become plentiful and painful, and brownish vaginal discharge disturbs them;
- Any sexual contact causes discomfort and pain, and after them also spotting;
- Patients of menopausal age have unusual bleeding;
- Frequent hemorrhage provokes the development of iron deficiency, which is sometimes manifested by very severe anemic forms. The patient often suffers weakness, dizziness, her skin becomes pale;
- If multiple or single polyps reach a large size, the patient is concerned about pain localized just above the pubic area. Painful symptomatology can bother constantly and be noisy, and in some patients the pain is cramping and arises periodically;
- Often the polyposis of the endometrium in women is accompanied by the release of vaginal mucosal leucorrhoea;
- Polyps can cause miscarriages and infertility, so with such problems it is necessary to go through the necessary examination for polyposis.
Similar symptoms are characterized by uterine pathologies like endometriosis, myomatous formations, so a diagnosis is needed to identify the disease.
What is the danger of the disease?
Despite the benign origin, polyps can be a threat to women's health. Among the most "harmless" consequences, experts identify chronic menstruation malfunction.
But polyposis of the endometrium can provoke more serious problems like complicated pregnancy, infertility or polyp birth. The latter case can lead to removal of the uterine body.
The most dangerous consequence of a polyp can be malignancy, when the tumor is reborn as a malignant entity. Therefore polyps need compulsory medical supervision.
Polyp in the womb and pregnancy
Polyposis formation can provoke infertility or miscarriage, so they are very dangerous for pregnancy. The ideal option is the removal of polyps before the onset of pregnancy.
Experts believe such a combination is not very pleasant, but not tragic. If a woman could become pregnant with polyposis, then usually the pregnancy continues without any complications.
Certainly, there are risks of termination of pregnancy, but it all depends on the specific situation. In any case, after the birth of the baby, the polyps are removed.
Sometimes polypous formations are formed in the uterine body after childbirth. Usually, placental polyps appear in place of the placenta remnants. In a similar situation after giving birth, a woman is about for about three weeks worried about excessive uterine bleeding.
Placental polyps are removed surgically with the remaining placenta, then scraping is performed.
Outgrowth dimensions and how fast can it grow?
Uterine polyps can have various sizes from 1 to 30 mm, although most often such formations do not exceed 10 mm.
Polyp can not grow for a long time and does not cause trouble for the patient, but in the presence of provoking factors like progesterone deficiency, pregnancy, abortions, curettage, the growth of polyposic lesions may increase.
Diagnosis
After a physical examination, the patient is referred for diagnostic procedures:
- Ultrasound examination;
- Hysteroscopic diagnostics;
- Scraping;
- Metrography - X-ray examination of the uterine cavity.
Photo ultrasound diagnosis of the polyp in the uterus
If necessary, the diagnosis of polyps of the uterus is complemented by other studies.
Treatment of
formation The main way to get rid of uterine polyps is endoscopic removal.
Polypectomy is performed during hysteroscopy. Usually the procedure is carried out 2-3 days after menstruation. Such terms are explained by the fact that during this period the thin and polypous formations of the endometrial layer are perfectly visible. The removal is carried out by an electric loop, and the breakaway point is ignited.
If the formulations are small, the doctor may recommend hormonal treatment. Preparations containing hormones can reduce the production of estrogens, and the level of progesterone, on the contrary, increases.
As a result, the hormonal causes of polyposis are eliminated, the formations shrink and leave the uterus at regular monthly intervals.
If polyposis was caused by endometrial inflammation, then antibiotic therapy is indicated.
With multiple nature of polyposis, therapy can be supplemented by endometrial scraping in those areas where there are clumps of polyps. After curettage, the damaged areas are disinfected with a special solution. Remote polyps are sent for histology.
Reviews for the treatment of
Victoria:
I was removed by the scraping of the uterus. They made anesthesia, scraped out the area where the polyp was located - that's all. Nothing wrong. A couple of hours after the procedure, I went home already.
Anastasia:
I was already 2 times polip hysteroscopy removed and again relapse. After each removal the course of hormone therapy passed. All the same in 1,5-2 years again the polyp appears. Did or made in different clinics.
Relapse
There is no way to treat uterine polyposis, which would be 100% protected against recurrence of pathology. Virtually every 10 patients after a successful removal of the growth there is a re-formation of it.
Preventative measures
There is no specific prevention of polyps, therefore the main measures to prevent such formations involve exclusion of provoking factors:
- Normalization of hormonal background, menstruation and ovulation;
- Avoid prolonged use of hormonal contraception;
- Annual visit to the gynecologist;
- Control of body weight, if necessary, diet and exercise for weight loss;
- Exclusion of intrauterine interventions such as abortions, scraping, etc.
As a result of following such recommendations, polyps can be avoided.
A video about how the umbilicalus looks like on a uzi: