Polyps In The Uterus - Treatment And Removal Of Cervical Polyps, Causes And Symptoms

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Video: Polyps In The Uterus - Treatment And Removal Of Cervical Polyps, Causes And Symptoms

Video: Polyps In The Uterus - Treatment And Removal Of Cervical Polyps, Causes And Symptoms
Video: Uterine polyps: Removal for infertility? 2024, March
Polyps In The Uterus - Treatment And Removal Of Cervical Polyps, Causes And Symptoms
Polyps In The Uterus - Treatment And Removal Of Cervical Polyps, Causes And Symptoms
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Causes, symptoms, treatment and methods for removing polyps in the uterus

What does a polyp in the uterus mean?

Polyps in the uterus
Polyps in the uterus

Polyps in the uterus are mushroom-like formations on a pedicle in the lumen of the cervical canal of an organ, which arise due to the proliferation of epithelial tissues. The reason for this process can be malfunctions of the immune system, hormonal imbalances, excessive estrogen production, as well as stressful conditions of the body.

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

By themselves, polyps in the uterus are not dangerous, although they can cause serous discharge and pain. But with impaired immunity or hormonal disruptions, there is a risk of pathological cell degeneration 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.

Content:

  • What does a polyp in the uterus mean?
  • Causes of uterine polyps
  • Symptoms of a polyp in the uterus
  • Why are polyps in the uterus dangerous?
  • Diagnosis of a polyp in the uterus
  • Treatment of cervical polyps
  • Removal of a polyp in the uterus

    • Hysteroscopy - polyp removal
    • Office hysteroscopy
    • Diagnostic curettage
    • Removal of polyps in the uterus with a laser
    • Discharge after removal of polyps from the uterus
  • Treatment after removal of a polyp in the uterus
  • What should a woman not do after surgery?
  • Answers to popular questions:

    • Do uterine polyps need to be removed?
    • Can a uterine polyp dissolve on its own?
    • Can you get pregnant with a polyp in the uterus?
    • Is it possible to give birth with a polyp in the uterus?
    • Can uterine polyposis lead to miscarriage?
    • Do uterine polyps affect the development of infertility?
    • When can you get pregnant after having a polyp removed?
    • Are polyps in the uterus removed without hospitalization?
    • How long to lie after removal of the polyp in the uterus?
    • When is sex possible after removal of polyps?
    • Can a polyp come out with periods?
    • Can a cervical polyp be reborn into cancer?

Causes of cervical polyps

Polyps in the uterus
Polyps in the uterus

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

The reasons for the development of polyps in the uterus:

  • Endometriosis, ovarian dysfunction, cyst, uterine fibroids and other gynecological diseases;
  • The period of age-related hormonal surges and falls - puberty or menopause with concomitant diseases such as chronic infections, diabetes mellitus, or dysfunction of the thyroid gland;
  • Overwork and psychoemotional overstrain, depression, stress;
  • Injury to the uterus during diagnostic procedures such as curettage or hysteroscopy;
  • Inflammatory processes of the uterine mucosa, endocervicitis;
  • Injury to the cervix during childbirth or during a surgical abortion;
  • Dysbacteriosis, thrush, chlamydia and genital infections associated with inflammation.

Concomitant pathologies are erosion, ectopia, leukoplakia, cervicitis and atrophic colpitis. At least one health problem from this list is observed in 70% of cases of endometrial polyposis.

Do hormonal changes contribute to the formation of uterine polyps?

The mucous membrane of the uterus is very sensitive to hormonal changes, and in response to hormonal imbalance, the endometrium may begin to thicken, individual groups of cells begin uncontrolled division, and polyposis occurs. For surgical treatment of uterine polyps to be successful, the woman's hormonal balance must first be restored.

Causes of hormonal imbalance:

  • Ovarian cysts and other tumor-like formations. An ovarian cyst prevents the release of an egg during ovulation, in response to this, the amount of estrogen produced in the body increases, which increases the risk of developing polyposis. In addition, ovarian tumors have cells that can produce estrogen themselves, creating additional prerequisites for endometrial hyperplasia;
  • Pituitary gland pathologies. The 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 affecting 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 the 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 in that they can turn into malignant formations during the process of malignancy.

On the subject: restoring hormonal disruption at home

At what age are you 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 the woman's hormonal background is least stable.

There are three crisis periods, during which the hormonal background changes due to the restructuring of the organs of the reproductive system:

  • Puberty. Hormonal changes in the body during puberty can lead to increased production of estrogen, which is necessary for the start of the menstrual cycle. Estrogens can act on the endometrium, stimulating its division and the formation of polyps. But a young organism has strong defense mechanisms that prevent pathological growths in the uterus, if there are no concomitant diseases - diabetes mellitus, infections of the genitourinary system, dysfunction of the thyroid gland, ovarian cysts;
  • Pregnancy and the period of breastfeeding. The hormonal background in pregnant women changes 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 are found only in the postpartum period;
  • Menopause period. Menopause is characterized by a decline in ovarian function and a decrease in the concentration of sex hormones in the blood. The menopause period usually begins at 45-50 years old, and at this time, against the background of changes in hormonal levels, the risk of developing neoplasms in the uterus may also increase. Hormonal drugs that women take to alleviate the negative manifestations of menopause can stimulate the proliferation of the endometrium, which also increases the likelihood of pathology.

Symptoms of a polyp in the uterus

Polyps in the uterus
Polyps in the uterus

Small growths and single polyps in the uterus usually do not manifest themselves as unpleasant symptoms, and often they are discovered by accident during a routine examination.

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

  • Pathological vaginal discharge;
  • Drawing pain in the lower abdomen;
  • Uterine bleeding not associated with menstruation.

In addition, it is possible to determine the presence of this disease by indirect symptoms - difficulty in conception up to infertility, violation of the monthly cycle, which is often observed with polyps of the cervix.

In what cases can polyps trigger cervical cancer?

The malignancy process consists of three stages:

  • Overgrowth of the endometrium or hyperplasia, the formation of polyps;
  • The transformation of one type of epithelial cells into another, or metaplasia;
  • Dysplasia is characterized by the appearance of malignant cells that can provoke cancer.

The risk of degeneration of endometrial polyps into a malignant tumor is small, this is observed in only 2% of clinical cases, however, any neoplasm requires careful examination.

Polyposis can cause reflex irritation of the uterus, thereby increasing the risk of termination and complications of pregnancy.

What symptoms should you see a doctor for:

  • Scanty periods or brown discharge;
  • Bloody discharge in women during menopause, if there was no period before that for several months or longer;
  • Difficulty conceiving in women of childbearing age;
  • Bloody discharge during or after intercourse;
  • Bloody discharge, unrelated to your period, which can be caused by uterine bleeding.

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 have arisen against the background of hormonal changes in the body, and appropriate diagnostics have been carried out.

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;
  • Menopause period. Since one of the symptoms of this condition is a violation of the menstrual cycle, it is difficult to detect neoplasms in the climacteric period without special diagnostics. Against the background of hormonal changes during menopause, the frequency of the formation of polyps in the uterus increases, this is facilitated by the lack of regular renewal of the endometrium during menstruation;
  • Fibrous polyps. Overgrowth of connective tissue, which does not contain blood vessels, cannot cause uterine bleeding, and therefore often goes 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 present unpleasant symptoms is not necessary. But the patient should undergo regular examinations to prevent malignant degeneration of the neoplasm. Hormonal drugs used in non-surgical treatments can stimulate their growth and worsen the course of the disease.

Why are polyps in the uterus dangerous?

Polyps in the uterus
Polyps in the uterus

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

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

  • Disruption of the normal course of pregnancy. In addition to the difficulties of conception, which arise 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 stages of pregnancy, uterine proliferation 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 in small portions with urine, bleeding begins and ends spontaneously without outside interference. Sometimes it is possible to detect uterine bleeding only by the symptoms of anemia, which occur due to the loss of hemoglobin. These signs include a general decrease in immunity, pallor of the skin, drowsiness, rapid 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;
  • Difficulty of 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 degeneration of cells. Malignancy most often occurs in adenomatous polyps. According to statistics, this process is observed in 1.5% of cases. Malignant transformation of cells leads to the destruction of healthy tissues, profuse blood loss and the growth of neoplasms. Bleeding during malignant polyp can even lead to the death of the patient. That is why with polyps of the uterus, even if they are asymptomatic, it is necessary to regularly undergo diagnostics by a doctor who classifies the type of growth and prescribes a treatment regimen;
  • The emergence of a chronic focus of infection. Normally, protective factors are present on the uterine lining 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, it is very vulnerable to pathogenic bacteria. Since a polyp without treatment can reach large sizes, the risk of a chronic focus of infection in the uterine cavity increases.

Diagnosis of a polyp in the uterus

Polyps in the uterus
Polyps in the uterus

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

  • General and biochemical blood test. A complete blood count (CBC) shows the number and shape of blood cells - erythrocytes, platelets and leukocytes, which determine the quality of blood and are altered by disease. So, with a decrease in the number of erythrocytes, 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, when their number decreases, the blood coagulates weakly, which contributes to bleeding;
  • Analysis of urine. The condition of the liver and kidneys is examined, in the presence of blood in the urine, uterine bleeding can be diagnosed. (read also: urine analysis according to Nicheporenko);
  • The histology of polyp tissue helps determine the type of growth. The doctor takes a biopsy, takes a sample and follows its constituent cells, after which he can classify the neoplasm. If an adenomatous polyp is diagnosed, its surgical treatment is recommended in order to prevent malignant degeneration of cells;
  • Bacteriological analysis. To carry it out, a smear is taken from the vagina and cervix and examined for the presence of pathogens. The test helps to identify chronic infections that lead to the formation of polyps, and this type of test is more effective than counting leukocytes. Together with bacteriological analysis, an antibiogram is performed, determining the sensitivity of pathogenic microorganisms to drugs;
  • Analysis for hormones. The state of the endometrium greatly depends 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 a patient at different times of the menstrual cycle, blood is taken for analysis, the amount of estrogen, progesterone, androgens, gonadotropic hormone is determined. If the hormonal balance is disturbed, the doctor can prescribe medications to correct it, which helps to relieve 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 study 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 the polyps and determine how high the risk of malignancy is. Errors at the diagnostic stage 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 the scanner into the vagina is necessary to detect polyps of the cervix. Ultrasound can diagnose polyps as small as one centimeter, smaller neoplasms require special equipment. In addition to the presence of polyps and determining their type, ultrasound allows you 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 degeneration;
  • Colposcopy. Examination 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 out into the vagina, but their base is located in the cervical canal. Colposcopy allows a more detailed study of the structure of these polyps, but conclusions about the cause of their occurrence can only be made after histological analysis;
  • Hysteroscopy. With hysteroscopy, a fibroscope 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. 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 by 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 transformation, the surface of the formation is uneven, has small nodes;
  • Hysterography is a less accurate research method; a contrast agent is injected into the uterine cavity and cervical canal, after which an x-ray is taken. Dark areas in the image 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 suspicion of oncology. Computed tomography allows you to determine the presence of metastases and their spread throughout the organs, which is necessary for the doctor in order to draw up an effective treatment regimen.

Additional methods for diagnosing uterine polyps

Other diagnostic procedures include:

  1. Cytological examination. 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, therefore it is often used in conjunction with other diagnostic methods.
  2. Tissue biopsy for analysis is 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 laboratory conditions.
  3. Tests for hormonal status are a necessary procedure, since in most cases the mechanism for the development of the disease is triggered precisely because of a hormonal imbalance. Based on the data obtained, the doctor can prescribe an individual drug treatment regimen.

Treatment of cervical polyps

Polyps in the uterus
Polyps in the uterus

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

Symptomatic treatment helps prevent bleeding and lower abdominal pain, which are often uncomfortable for patients.

Pain relievers used for this disease:

  • No-shpa;
  • 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 inflammation of the intestines, and also so as not to create unnecessary stress on the liver. If the pain does not subside after taking painkillers, then an urgent need to consult a doctor, since surgical removal of the polyp is required. With its growth, 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 promote the growth of polyps, it is necessary to observe the hygiene of the genitals. Rinsing with weak antiseptic solutions - potassium permanganate, collargol and septadine helps to prevent the multiplication of pathogenic microorganisms and the introduction of infection.

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

Medical treatment helps prevent new growths and relieve 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, you 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. Medical treatment helps to solve the problem of infertility, bloody and mucous secretions, which are often observed with such formations in the uterus.

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

In addition, surgery is necessary if the risk of malignant transformation 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

Removal of such a formation in most modern medical institutions is performed 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 capabilities of modern technologies, polypectomy and curettage are carried out quickly and without consequences, and the biological material obtained as a result of hysteroscopy undergoes histological analysis, thanks to the results of 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, distinctive features of the endometrium, the size of the polyp planned to be removed, and the patient's age.

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

  • In the presence of fibrous-type polyps, their removal is mandatory;
  • The polyp of the glandular-fibrous type indicates that hormonal changes occur in the process of the disease. This does not in any way affect the form and purpose of the surgical intervention, but in the postoperative period, hormonal therapy will be required to correct the disorders of the endocrine glands;
  • The detection of an adenomatous polyp, which often occurs in women in a premenopausal state, is an indication for surgery to remove the uterus. Polyps, which can provoke oncology, are most guaranteed to be eliminated with the help of complex operations: extirpation of the uterus, supravaginal amputation with accompanying revision of the ovaries, sometimes together with the appendages.

Hysteroscopy - polyp removal

Polyps in the uterus
Polyps in the uterus

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 significantly increases the reliability of the surgeon's work, on whose professionalism the patient's health will depend.

Hysteroscopy is used not only to eliminate the formation itself, but also for the accompanying examination of the uterine cavity, provoking 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). Nevertheless, careful and accurate cutting off of the pathological tissue with a special instrument through a natural opening (in this case, the vagina and cervical canal) avoids any serious consequences typical for abdominal operations.

The entire procedure is closely monitored by a surgeon who guides the movement of a hysteroscope (a tube with a camera and a device to remove a polyp at the end) inserted into the cervix. With the help of a video camera, the uterine cavity is examined, and the pathological tissue is removed after evaluating the polyps according to parameters such as size, location and number.

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

Find out more: Hysteroscopic removal of endometrial polyps

Office hysteroscopy

This is a method of thorough diagnostics, which is carried out with a hysteroscope without tools, which eliminates the need for pain relief, that is, there is no injury. The technique gives the doctor the opportunity to examine the uterus with the subsequent choice of therapy in conjunction with the patient. Mini-hysteroscopy, in addition to polyposis, allows diagnosing fibroids, synechiae, endometrial hyperplasia and other diseases of the female genital organs.

Diagnostic curettage

Scraping 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 personnel 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 tell whether abnormal cells remain in the tissues that can provoke a relapse.

Even after a successful hysteroscopy, 30% of patients return to the doctor for recurrent polyp treatment. 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 scraping, 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 caused by 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 of removing uterine polyps.

Scraping is performed using a cervical dilator, which holds it in this position all the time while the surgeon works with a special curette (metal loop). With this instrument, excess tissue with polyps is scraped from 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 the high-tech equipment, which makes it possible to reduce the trauma of the operation to get rid of polyps to practically zero. Targeted destruction of pathological tissues using a laser is performed quickly and without scars, as well as 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 conventional surgery to remove any type of polyps, laser burnout would seem like fantastic. In the newest medical centers with the appropriate equipment, a full cycle of treatment for cervical polyps (examination, analysis of results, drawing up an operation program and, in fact, laser removal) can be performed in just three hours! No hospital stay, disability or rehabilitation due to injury to the uterus and surrounding tissues.

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

What are vaginal discharge after removal of uterine polyps?

Image
Image

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

Do not worry if, after hysteroscopy, you find:

  • 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 removal of polyps, the doctor can judge whether the healing processes are normal. Discharge is 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 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 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, therefore, the healing process after them is faster, and the intensity of discharge is less;
  • Blood supply to the neoplasm. Each anatomical formation and organ has its own degree of blood supply intensity, it 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;
  • Ingrowth depth, size and shape. The larger the polyp, the more vascularized it is. Polyps with large vessels on a thick pedicle after surgical treatment provoke spotting 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 own blood vessels of the uterus may increase, due to which the healing and rehabilitation process slows down.

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

  • Bloody. The release of clotted blood can be observed when blood enters the uterine cavity during surgery. The discharge of fresh blood can continue for 1-2 days after the operation, during which the blood vessels of the uterus were damaged;
  • Physiological discharge. 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 the wound has healed, the discharge disappears;
  • Purulent discharge is observed with a bacterial infection, among the causative agents of which are staphylococci, streptococci and other microorganisms. The discharge has a yellow or greenish tint. If untreated, the infection can cause a purulent abscess with complications up to infertility;
  • Putrid discharge may be a sign of a secondary infection. One of the postoperative complications is clostridia getting into the uterine cavity. These microorganisms can multiply in the absence of air and cause foul-smelling foamy discharge.

What complications can arise after surgical removal of uterine polyps?

There are four most common surgical treatments for this condition:

  • Excision of the polyp leg using hysteroscopy methods - used to treat single neoplasms with a long leg;
  • Cryodestruction of a polyp - treatment of a 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 is one of the least traumatic 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 is 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 serious consequence of perforation can be inflammation of the pelvic peritoneum due to microorganisms that have got there from the uterine cavity. Treatment is with antibiotics and additional surgery;
  • Hematometer - an accumulation of blood in the uterine cavity caused by a spasm of its cervix, which makes it difficult to evacuate. This complication is very dangerous, since clotted blood is a medium 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 naturally. If antispasmodic drugs do not help, a probe is used to suck blood from the uterine cavity;
  • Scarring and adhesion formation - if the inner lining of the uterus is severely damaged, which is often the case with curettage, the connective tissue undergoes scarring. This disrupts the function of the endometrium, the ovum cannot attach to the surface with scars and adhesions, which results in infertility or ectopic pregnancy. The risk of this complication is reduced by laser removal of uterine polyps or cryodestruction methods;
  • Inflammatory processes - can be caused by an infection in the uterine cavity, lead to serious consequences up to infertility, complicate the healing process. For treatment, antibiotic therapy is used. The use of antiseptics during surgery and cauterization of the wound helps to prevent this complication. Laser removal is considered the safest, because during it, infection is unlikely due to the lack of direct contact of instruments with the uterine membrane;
  • Malignancy is a malignant degeneration of tissues, from which the oncological process begins;
  • Recurrence of the disease is the re-formation of polyps caused by mechanical damage to the uterine mucosa. In addition, it is not possible to guarantee the absence of new polyps, even if the operation was uneventful. To prevent their appearance, 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 appear again after a while. This is due to an incorrectly performed operation, the individual characteristics of the organism, or the malignant nature of the formation.

  • If the polyp tissue is not completely removed, it can grow again in the same place. This happens after a poorly performed operation. Often, new polyps in the uterus develop after twisting the leg of the old one, if there are parts of the tissue or cells of the neoplasm. Polyps occur again if cauterization of the wound has not been performed.
  • Other diseases are the cause of new polyps in the uterus - 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 causes of the growth of new polyps, there may be hormonal agents that disrupt the balance of estrogen and progesterone, thyroid disease, diabetes mellitus, 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 in itself can create the prerequisites for a relapse of the disease. Therefore, during the rehabilitation period, it is important to provide the patient with peace, not to expose her to psycho-emotional stress and to carry out general strengthening therapy in order to increase the body's defenses.

To prevent the recurrence of endometrial polyposis, the gynecologist usually prescribes antibiotics and gestagenic drugs to correct hormonal levels.

Rehabilitation treatment after removal of polyps in the uterus

Polyps in the uterus
Polyps in the uterus

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

But for prophylactic purposes, the doctor can 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 blood accumulation in the organ cavity;
  • Antibiotics are prescribed if the cause of polyps is 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 (scraping, excision and twisting of the polyp leg);
  • Hormonal drugs are prescribed to patients in whom neoplasms have arisen due to unstable hormonal levels, with surges and falls in the level of sex hormones, or with excessive production of estrogen. For these purposes, gestagens (Norkolut, Duphaston) and hormonal contraceptives (Yarina, Regulon, Janine) are used - this helps to prevent the recurrence of fibrous polyps.

In order to maintain the immune system and stabilize the hormonal background, herbalists can advise the infusion of borax 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 - vitamins A, C and E.

What should a woman not do after polyp surgery?

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

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

  1. Do not overheat your body, as this raises blood pressure and increases the risk of bleeding. Within a month after the operation, you should avoid taking hot baths, baths, saunas, as well as prevent hyperthermia by any means;
  2. It is better not to take drugs based on acetylsalicylic acid (Aspirin, Citramon, Upsarin, Cardiopyrin, Tomapirin, etc.), as they worsen blood clotting and contribute to bleeding;
  3. Physical overstrain, especially associated with heavy lifting, is prohibited. Any sports, dance, gymnastics and outdoor activities are also prohibited;
  4. During the month of rehabilitation, physical and chemical interventions into the reproductive system (sexual intercourse, douching, etc.) are also prohibited;
  5. Obviously, some patients have to be reminded of the need to carefully observe intimate hygiene, and not only after the operation, but also constantly.

Answers to popular questions about uterine polyps

Polyps in the uterus
Polyps in the uterus

Do uterine polyps need to be removed?

The methods of modern medicine allow you to quickly and painlessly remove any neoplasms, but, ultimately, the choice remains with the patient. Removal is strongly recommended if medical treatment fails to relieve unpleasant symptoms, or if polyps do not stop growing. Adenomatous polyps have a high potential for malignant transformation, therefore, they must also be removed.

Can a uterine polyp dissolve on its own?

A polyp is an anatomical formation of overgrown connective tissue that does not respond well to external influences. Therefore, it is impossible to get rid of a polyp in a non-surgical way, hormone therapy only helps to stop its growth and prevent new growths. These are very effective treatments for small polyps with a low risk of malignant transformation. However, if these neoplasms press on the uterus, deliver painful sensations and prevent pregnancy, they must be removed.

Can you get pregnant with a polyp in the uterus?

The onset of 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 embryo attachment can be difficult. If it is impossible to attach the 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 exfoliation at the site of the polyposis focus, uterine bleeding, fetal development disorders 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 polyps overgrow in the uterus lead to miscarriage?

Yes, the likelihood of miscarriage is increased if polyps are present in the uterus. The main cause of miscarriage in this disease is placental abruption. Normally, the placenta attaches to areas of the inner 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 does not attach well, nutrition of the fetus 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 disruptions in the course of pregnancy due to mechanical pressure exerted on the fetus by large neoplasms.

Do uterine polyps affect the development of infertility?

Small, solitary polyps do not impair fertility. 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. Infertility can also be provoked by large formations at the bottom of the uterus, since 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 disorders and infertility.

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

Removal of polyps is a safe and quick operation, which in most cases takes place without complications, which makes it possible to become pregnant in the first month after treatment. An obstacle to pregnancy after removal of polyps can be infection during surgery, the occurrence of adhesions and scars at the site of the removed neoplasms, hormonal instability and uterine bleeding, as well as a relapse of the disease.

Are polyps in the uterus removed without hospitalization?

Hospitalization for removal of polyps takes on average 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 after removing 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 should not have sex after surgery until the healing process is complete. On average, this happens after six weeks. The woman should not have bloody or brown discharge unrelated to periods, anemia and weakness. If sex occurs before the end of the rehabilitation period, there is a high chance of microtrauma and infection.

Can a polyp come out with periods?

Polyps are very difficult to treat non-surgically. Hormonal drugs are able to remove unpleasant symptoms and stop the growth of the 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 is a deception in order to sell the drug more profitably or a delusion common among illiterate people in the gynecological field.

Can a cervical polyp be reborn into cancer?

This disease may well give rise to the development of a malignant tumor. The transformation of a polyp into cancer occurs in about 1.5% of cases.

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The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist

Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.

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