Polyp of the cervical canal - types of polyps and methods of removal (pluses / minuses). Polyp of the cervical canal - methods of surgical removal, management of the postoperative period Duration of the operation to remove the polyp of the cervical canal

Polyps are benign tumors on mucous membranes. They can be localized in different parts of the human body - in the intestines, in the nasal cavity, uterus, etc. Sometimes doctors can only observe such formations for many years, and not treat them in any way if they do not change their size and do not annoy the patient in any way. . But in some cases, it is necessary to perform surgical removal of polyps, and after it - further therapy. So, the topic of our conversation today will be treatment after removal of a polyp in the cervical canal.

Doctors assure that polyps of the cervical canal are very common, they are easily diagnosed during the examination. Surgical removal of such formations involves performing direct resection of the polyp, as well as curettage.

Basically, after the surgery, the patient is discharged the very next day. It is believed that the removal of the polyp is tolerated quite easily. Even in the inpatient department, a woman is prescribed antibacterial drugs (antibiotics), which have a wide spectrum of action. They will need to be taken at home, for the time recommended by the doctor (usually within one week). The drugs of choice are often drugs with azithromycin, for example, Sumamed.

Also, patients who have undergone surgery to remove a polyp in the cervical canal are usually prescribed non-steroidal anti-inflammatory drugs. Such medicines prevent inflammation and help eliminate discomfort after surgery. To achieve this effect, ibuprofen-containing drugs can be used.

Even after the operation to remove the polyp, the doctor may prescribe the use of methyluracil suppositories - for the speedy regeneration of tissues and their epithelization, as well as to achieve an anti-inflammatory effect. In addition, douching with Miramistin, an effective antiseptic, may be recommended.

Usually, when polyps are found, doctors perform a series of laboratory tests to determine the level of hormones. Quite often, such a pathology is caused precisely by hormonal disorders or occurs against their background. In such situations, the patient is selected hormonal treatment to correct the detected problem. The duration of therapy in this case can vary from several months to six months or even more. Hormonal drugs can be injected or taken as tablets.

It is worth noting that the root cause of the appearance of a polyp may also lie in the influence of other factors, for example, viral ones. In such a situation, doctors prescribe the patient to take antiviral drugs and drugs that help improve the functioning of the immune system.

In some cases, for successful tissue healing after polyp removal, the doctor may recommend the ozonation method and various types of physiotherapy.

Methods of therapy after elimination of the polyp of the cervical canal are selected on an individual basis.

Gynecology knows some types of benign formations. One of these formations is the polyp of the cervical canal. When a gynecologist makes such a diagnosis, patients have a number of questions that only a knowledgeable specialist can answer. The concern is understandable: the female sphere is very sensitive to any pathologies, there are fears that infertility will not occur.

Why is it necessary to remove a polyp

A polyp has an unpleasant tendency to degenerate into a malignant tumor, so it is imperative to get rid of it. Overgrown polyps interfere with conception. During pregnancy, polyps begin to rapidly increase in size, because of them, a caesarean section is prescribed during childbirth. Therefore, the question of whether it is necessary to remove the polyp of the cervical canal disappears by itself.

Do not be careless when you find a polyp, get an examination and treatment as soon as possible. The further the pathology goes, the greater the risk of complications.

The polyp is removed by modern methods quickly and painlessly, there is no need to be afraid of the operation. Methods in which the patient is put to sleep with anesthesia to remove the polyp are used less and less, giving way to high medical technologies.

How to treat a polyp of the cervical canal

In order to detect oncology of the polyp, a tissue sample is taken for histological examination. If an oncological degeneration of the polyp is detected, it is indicated to remove the cervix.

To remove the polyp, the cervical canal was previously forced to be injured by scraping its mucous membrane. To prevent complications before surgery, the patient should undergo a small course of antibacterial and anti-inflammatory therapy.

Does it hurt to remove a cervical polyp? Since scraping of the mucosa is painful, the operation was performed under general anesthesia. In a narcotic dream, the patient does not feel pain. Modern practice has made the removal of polyps less traumatic and almost painless. So removing the polyp is much better.

Among the modern methods used are the following:

Removal with a laser beam- coagulation of vessels occurs, excision of the polyp leg with a laser beam;
Removal by cauterization with liquid nitrogen- shown when removing small polyps by tissue freezing;
Removal by radio emission due to tissue heating polyps and their destruction;
Polyp removal with diathermoexcision destruction of its base by electric current.

How to prepare for surgery

So, how is a cervical canal polyp removed? Preparing for the operation, it is necessary to have accurate information about the removed polyp.

By examining a smear from the vagina, the presence of pathogenic microflora is checked, in particular, ureaplasma, mycoplasma and chlamydia can be detected.
PCR analysis checks for the presence of viruses. It can be a variety of viruses, even HIV.
Ultrasound reveals the localization, shape and size of polyps.
X-ray - to detect pathologies of the respiratory system.
ECG - to detect pathologies of the heart.
An examination by a phlebologist is required for patients with varicose veins of the leg veins.
Hysteroscopy with an endoscope - the uterus and cervical canal are examined.

Two weeks before the operation, the patient is forbidden to smoke (at least reduce the number of cigarettes smoked) and drink alcohol. On the eve of the operation, the patient makes a cleansing enema and removes hair near the genitals. On the day for which the operation is scheduled, you can not eat or even drink water.

The patient is placed on a gynecological chair. The gynecologist inserts a hysteroscope into the cervical canal, through which the polyp can be seen. In other cases, a hysteroresoscope is used (this is a device with a cutting nozzle).

The polyp is removed by twisting it and excising the leg (the base of the polyp is visible on the screen of the ultrasound machine). Scraping completely cleans the mucous membrane of the canal and cervix.

Curettage has the advantage of reducing the risk of recurrence of polyps. Lack of technology: invasiveness and the need for anesthesia with general anesthesia. With a small size of the polyp, more modern technologies of the operation are shown.

After the operation, a wound remains in the tissue of the canal mucosa, it is necessary to prevent its infection. For this purpose, the patient is prescribed antibiotics.

Operation by radio waves

The Surgitron apparatus delivers high-frequency radio waves to an electrode used as a surgical scalpel. Polyp cells evaporate when heated by high frequency vibrations. Polyp cells themselves emit thermal energy, which destroys them. At the same time, the electrode does not heat up, due to this, the mucosa of the canal is not at risk of getting burned.

After the removal of the pathological formation by radio waves, scars and scars are not formed, the surface of the mucosa is smooth. After the operation, there is no pain syndrome, so there is no need to take painkillers.

liquid nitrogen operation

cryodestruction method. Liquid nitrogen has a very low temperature - minus 195.7 degrees Celsius. At this temperature, the polyp cells are destroyed by being frozen.. This method has significant drawbacks: it is painful, it is used under anesthesia. It is necessary to carefully calculate the depth of exposure to cold, so as not to involve healthy canal tissues in freezing. The operation leaves behind a small bleeding wound.

laser surgery

Laser removal is a gentle method. The laser is good because it hits the polyp accurately. Only pathological tissues are exposed to the laser beam, the rest of the channel surface is not affected. Polyp cells are removed layer by layer, while the doctor changes the intensity of radiation. Vessels damaged by the destruction of the polyp are sealed with the same laser beam, due to which there is no bleeding. It is preferable to remove the polyp with a laser: it is not necessary to introduce mechanical instruments into the canal. The operation is carried out under the maximum control of the doctor. Laser equipment allows you to calculate the intensity of radiation, its duration and the depth of penetration of the beam into the tissue. A scar at the site of the removed polyp is not formed. After laser surgery, the rehabilitation period is reduced to two weeks.

High frequency electric current operation

Method of diathermocoagulation. The base of the polyp's leg is cauterized with a high-frequency electric current. The cauterization process is painful and requires anesthesia. Unfortunately, this method did not perform well: complications arise after the operation. Therefore, modern medicine refuses this method.

Fortunately, it is not always necessary to resort to surgery: there are cases of spontaneous disappearance of polyps. On the recommendation of a doctor, a gynecological examination should be repeated after the next menstruation.

The operation to remove polyps has contraindications:

Inflammatory processes in the genitals;
Pregnancy;
Period;
Oncological processes;
Uterine bleeding.

The removal of polyps in chronic diseases is not prohibited, but strictly limited: in diabetes mellitus, in cirrhosis of the liver, in hemophilia, in renal failure. The gynecologist is obliged to consult with a specialized specialist.

What are the possible complications

After the operation, a new polyp may occur as a complication. Other complications are possible:

Scars and adhesions;
Infection;
Oncological rebirth;
Bleeding due to trauma to the cervical canal;
Allergy and swelling;
Internal bleeding (hemometra).

Recovery after surgery

Initial recovery will take approximately four weeks. The first week of the operated patient should take antibiotics in order to exclude the development of infection. If the pain syndrome interferes, you will have to take painkillers, and the inflammatory process is blocked with anti-inflammatory drugs.

Polyps signal with their appearance that not everything is fine in the production of hormones. It is necessary to monitor the composition of the blood to identify hormonal imbalances. Stabilization of hormonal parameters will require treatment from three months, sometimes treatment is delayed up to a year. Ozonation with special oil applications and physiotherapy contribute to the accelerated restoration of the epithelium.

Physically do not strain;
Banned bath, sauna, bath and solarium;
daily shower;
Sexual life is prohibited without the permission of a gynecologist;
Do not use vaginal tampons.

Special states

Sexually transmitted infections often provoke the growth of polyps. When such an etiology is present, it becomes an indication for curettage of neoplasms. The papilloma virus affects negatively any formations, not only polyps: genital warts, warts. The virus provokes the occurrence of malignant neoplasms.

The process of polyp growth accelerates during pregnancy, often polyposis occurs with the onset of pregnancy. The accelerated growth of polyps is favored by a change in the hormonal background. A feature of polyps that appear during pregnancy is decidual metamorphosis: the formations do not have legs, located on a large base.

There is a danger of nuclear changes in polyps during pregnancy: dyskaryosis and malignancy. A patient with such phenomena is placed under special control in order to avoid termination of pregnancy. Shown caesarean section.

Operation cost

The polyp of the cervical canal can be removed in a public hospital, it's free. In commercial clinics, the operation is paid - from 5000 rubles, depending on the technology used. Laser removal, for example, costs from 8,000 to 10,000 rubles.

Often, during a gynecological examination or during an ultrasound scan, the doctor diagnoses a polyp located in the cervical canal of the cervix. Should I leave the polyp of the cervical canal alone, or do I need to sound the alarm and urgently remove it?

It is worth choosing the “golden mean”: contact a qualified gynecologist who will prescribe the necessary examination to identify the cause of the pathological process and then choose the best treatment option.

Types of cervical polyps

The cervical polyp has the appearance of an outgrowth of the outer layer of the mucous membrane on the vascular pedicle, protruding into the lumen of the cervical canal. The stalk may be filiform or rather wide, but the presence of vessels in it (vascularization) distinguishes a true polyp from a pseudopolyp.

Also, this symptom causes some risk of developing oncology when exposed to provoking factors. Therefore, polyps, although they are benign neoplasms, are considered a precancerous form of damage to the female genital organs.

Most often, polyposis outgrowths form at the border of the cervical and cervical epithelium and are often found during a routine gynecological examination with mirrors. Internal cervical polyps are detected by ultrasound.

The polyp outwardly looks like a formation in the form of a mushroom (leg and cap) of a pale pink color. When pinching the legs, the polyposis growth acquires a purple-bluish color.

Like any polypous formations in the reproductive organs, cervical polyps are a sign of a woman's impaired health.

The reason for this may be:

inflammatory process - a necessary factor in the occurrence of cervical polyps - vaginal dysbacteriosis (gardnerellosis), endometriosis, genital infections;
hormonal changes - menopause, lack of progesterone / excess estrogen;
microtraumatization of the cervical canal - hysteroscopy, abortion, complicated childbirth;
external factors - insufficient / improper hygiene, stress;
immunodeficiency - general and local against the background of frequent inflammatory diseases of the uterus, vagina;
burdened heredity - benign or malignant formations of the genital area in relatives;
endocrine disorders - hypo-, hyperthyroidism, obesity.

Signs and symptoms of cervical polyps

The polyps of the cervical location themselves, especially small and single ones, do not manifest themselves with any symptoms.

The only sign of the development of pathology can be leucorrhoea - whitish mucous vaginal discharge.

symptoms (polyp photo)

However, asymptomatic course is most often the exception to the rule. In most cases, a cervical polyp develops against the background of other diseases that give the following symptoms:

discomfort in the lower abdomen, periodic sharp or pulling pains;
pathological discharge - mucous or bloody spotting;
contact bleeding after sexual contact;
disturbed menstrual cycle - a change in the volume of blood released and the duration of menstruation, extramenstrual bleeding;
infertility.

In most cases, cervical polyps are diagnosed in combination with cervical erosion, endometrial polyps, cystic ovarian lesions, and fibroids.

What is colposcopy, which doctor conducts the study and what are the indications for this procedure:

Polyp of the cervical canal during pregnancy

A neoplasm found in the cervical canal in a pregnant woman is not always a polyp.

pseudopolyp- outgrowth of the mucosa into the lumen of the cervical canal without signs of vascular germination - a functional state due to hormonal changes in the female body and preparation for childbirth. Usually such pseudopolyps disappear on their own after childbirth.

A true polyp of the cervical canal during pregnancy causes irritation of the cervix and can provoke a miscarriage in the first weeks. Large and multiple growths are especially dangerous in this regard.

Polyposis formations can be injured during childbirth - this increases the risk of malignancy (malignancy).

Should it be removed?

Removal of a cervical polyp in a pregnant woman is indicated with a diameter of more than 1 cm or signs of necrotization of polyposis tissues.

Diagnostics

Usually, the diagnosis of a cervical polyp is not difficult. Pathological neoplasms are detected in the following types of studies:

gynecological examination - polypous thickenings protruding from the external pharynx;
colposcopy and cervicoscopy - help to identify small neoplasms, fix the presence of translucent vessels in the leg, identify inflammation and necrosis;
Ultrasound (more informatively transvaginal) - determination of the structure of the polyp and its density by echogenicity (clear contours, reduced echogenicity of the site), identification of concomitant endometrial polyposis and fibroids;
hysteroscopy - an endoscopic technique allows you to accurately establish the diagnosis, makes it possible to simultaneously remove the polyp and take its tissues for histology.

In addition to the instrumental examination, the patient is also subjected to bacteriological culture (detection of infection), (detection of papillomavirus), PAP analysis for atypical cells, and a study of the hormonal background.

Treatment: is it necessary to remove the polyp of the cervical canal?

Conservative therapy with hormonal agents, as the main type of treatment for polyps, is appropriate only with the glandular structure of the neoplasm.

In other cases, planned or emergency surgical excision of polyposis growths and subsequent adequate therapy are indicated:

hormonal drugs;
anti-inflammatory drugs;
local immunostimulants.

Methods for removing a cervical polyp

Before any surgical intervention, anti-inflammatory therapy is first carried out in order to avoid the spread of infection after radical treatment.

Curettage of the cervical canal

It is advisable for the combined growth of multiple polyps in the cervix and the uterine cavity proper. However, the likelihood of re-growth of polyps with this type of treatment is quite high.

Cauterization of the polyp bed helps to reduce the risk of recurrence. The procedure of cervical curettage is performed on an outpatient basis under local anesthesia. It is mandatory to send a biopsy for histology.

Targeted hysteroscopy

A less traumatic technique is the twisting of a polyp with a leg. This reduces the risk of relapse.

Polyp pedicle constriction

A catgut suture is applied to a polyp located close to the external pharynx and visible during a gynecological examination.

Clamping of the vessels supplying the formation leads to its necrosis and rejection.

Cryodestruction

Focused freezing of the cervical polyp with a mixture of liquid nitrogen. Absolutely painless manipulation, takes only a few minutes.

Patients are warned that for several days or weeks, fluid flows out of the genital tract. Sexual life for this period stops.

Cauterization of a polyp

Modern methods of mini-traumatic removal of the cervical polyp through its cauterization involve the use of high-tech equipment.

Depending on the level of technical equipment of the clinic, the attending physician offers the patient laser excision, electrocoagulation, radiofrequency ablation.

Cervical conization surgery

Conical excision of the cervix is a traumatic method of treating a cervical canal polyp.

Cone-shaped excision of the tissues of the cervix, together with polyps, is advisable in women with recurrent cervical polyposis.

What is cervical conization, indications and recovery after the procedure:

Cervical amputation

Radical intervention is carried out with an unfavorable result of a histological examination, the detection of atypical cells.

This extreme measure leads to the impossibility of subsequent natural childbearing and is most often performed on older women.

Complications of polyps of the cervical canal

Infertility.
Bleeding and infection.
Scars on the cervix. Caesarean section in childbirth.
Relapses.
Cancer rebirth.

To avoid the formation of a cervical canal polyp and its subsequent removal, the following rules are recommended for women:

Regularly, twice a year, undergo a dispensary examination by a gynecologist.
Timely treat gynecological diseases and endocrine pathology.
Avoid trauma to the cervix - avoid abortion through contraception.
Observe intimate hygiene.
Seek medical attention at the first signs of pain and extramenstrual bleeding.

Polyp of the cervical canal - code for mcb 10

Pathology code in the international classifier of diseases.

Section N84:

Polyp of the female genital organs

Subsection N84.1:

Polyp of the cervical canal (cervix).

Content

A polyp of the cervical canal is called a local proliferation of cylindrical epithelium, which has the appearance of a growth of predominantly benign etiology. It is known that polyps of the cervical canal tend to grow in its cavity.

Cervical polyps cannot be attributed to a rare pathological condition. Their detection occurs in 25% of cases. Moreover, polyps of the cervical canal can be detected in women at any age. Despite the fact that cervical polyps are recorded even during pregnancy, they are inherent mainly in women after forty years.

Neoplasms can have a different structure and shape. In particular, polyposis neoplasms are located both on a stalk and on a wide base. Polyps can progress in groups and look like a bunch of grapes. Sometimes polyposis has a single character.

Usually neoplasms are about a centimeter in size. However, their size can vary from a few millimeters to two or three centimeters. If the cervical polyp is small, it can progress without symptoms for many years. Large formations often block the lumen of the cervical canal and are accompanied by certain symptoms. In order to prevent complications, large cervical polyps need to be removed.

The causes and factors of the appearance of polyposis are not well understood by scientists. As the main versions, hormonal disorders, inflammation and trauma of the epithelium in history are considered. It was revealed that in 70% of cases polyposis is accompanied by other gynecological diseases. While in healthy patients, polyposis is practically not detected.

Structure

The cervical canal is located in the inner part of the cervix. The surface of the cervical canal is lined with a single-layer cylindrical epithelium, the cells of which cause the velvety and red tint of the mucosa.

In the cervical canal, many glands of the submucosal layer function. The glands are part of the defense mechanism against infections. They continuously produce mucus that fills the cervical canal like a plug. In addition, mucus is distinguished by its alkaline reaction and its bactericidal properties. Thus, the narrowness of the channel itself and the produced secret prevents the penetration of pathogenic microflora into the sterile uterine cavity.

From the inside, the surface of the cervical canal is formed by multiple folds. That is why the channel resembles a spindle. The cervical canal forms two constrictions. The narrowing near the base of the cervix is the external os. In this area, the stratified squamous epithelium of the visible vaginal part of the cervix connects to the cylindrical single-layer tissue of the cervical canal. This area is called the transformation zone.

The internal os is formed by a narrowing of the cervical canal in the upper part, which is connected to the uterine cavity. The external and internal pharynx are formed by means of a connective tissue that differs in density. Narrowings are a kind of dampers that do not allow the infection to spread.

Polyps are usually located in the area of the external pharynx, as well as in the middle or at the top of the cervical canal. Most neoplasms have a long stalk and protrude into the vaginal lumen. Such a polyposis can be diagnosed during a general gynecological examination.

The surface of the formation may consist of cylindrical and squamous epithelium. Polyps covered with different types of epithelium differ in color.

Neoplasms contain a significant number of vessels that germinate during the formation of the polyp. This structure leads to bleeding when the surface is damaged.

In most cases, polyposis does not manifest itself. Small formations are often detected by chance. If they are large, bleeding may occur.

Polyposis of the cervical canal is detected during pregnancy in 22% of cases. Usually neoplasms are small in size and are not accompanied by a clinical picture. In such cases, pregnant women are shown observation, and treatment is carried out after childbirth and finding out the causes of the pathology.

In the process of diagnosing polyposis, several basic research methods are used, for example, ultrasound, colposcopy. Removal of a polyp of the cervical canal is not a guarantee of a complete cure. In 15% of cases, after removal, relapses of polyposis occur. Therefore, treatment after removal is also aimed at preventing recurrence of the pathology.

The reasons

Gynecologists emphasize that the exact cause of polyposis is unknown. Nevertheless, several factors provoking focal growth of the epithelium are considered as the main causes.

Trauma of the cervical canal. Violation of the integrity of the tissue can occur as a result of abortion, curettage, probing of the uterine body, hysteroscopy, incorrect installation of the spiral, hysteroscopy. Trauma can occur during childbirth. In the process of healing of the epithelium, its excessive growth occurs. Moreover, polyposis can develop even with minor damage to the tissue of the cervical canal.
Structural changes in the epithelium. Pseudo-erosion and leukoplakia can provoke the development of polyposis.
Inflammatory process caused by specific and non-specific microorganisms. Sexual infections with concomitant immune disorders penetrate into the area of the cervical canal. This leads to a qualitative change in the composition of the mucus and tissue edema. Against the background of edema, the epithelium becomes vulnerable and loose. Over time, the inflammatory process leads to the growth of cervical tissue and the formation of a polyp. Among the nonspecific inflammations that cause polyposis are called vaginitis, cervicitis and endometritis.
Bacterial vaginosis. Fluctuations in the acidity of the vagina and a violation of the composition of the intimate microflora are favorable conditions for the activation of opportunistic and pathogenic microorganisms.
Violation of the functioning of the ovaries. Often, polyposis is combined with such hormone-dependent pathologies as endometriosis, polyps of the inner layer of the uterus, endometrial hyperplasia. Gynecologists believe that these pathologies can be based on a single mechanism of occurrence - hyperestrogenism, which affects the processes of epithelial growth. Nevertheless, it should be borne in mind that sometimes hormonal changes can be triggered by long-term stress, obesity, diabetes and thyroid pathologies.
Physiological reasons. In this case, they mean the changes that occur during pregnancy and menopause. Hormonal changes cause excessive growth of cellular elements.

Despite some relationship between some factors and the development of polyposis, sometimes the cause of the pathology cannot be identified.

Symptoms

Small neoplasms are not accompanied by a clinical picture and are found when a woman contacts her for another reason. As a rule, these are polyps located on a wide base.

Often, signs of polyposis develop with the appearance of various complications. In gynecological practice, they are somewhat more often accompanied by complications of education, which are attached to the mucosa by means of a thin stalk. This type of polyp is distinguished by the exit of the surface beyond the external pharynx directly to the cervical surface. Thus, pedunculated polyps can easily be injured, for example, during the use of tampons, examination by a doctor, intimacy, douching.

The clinical picture of cervical polyposis usually includes.

Acyclic selections. This symptom is characteristic of the development of necrosis or inflammation.
Mucus secretions. Mucopurulent discharge appears with a concomitant inflammatory process. As a rule, this occurs with the growth of large polyps that narrow the lumen of the cervical canal. As a result, favorable conditions are created for the development of inflammation. The appearance of mucous secretions can be noted with pressure on the glands of the cervical canal.
Pain syndrome. Pain often occurs with large formations that interfere with the closure of the external pharynx. If the pain is intense, accompanied by cycle disorders, endometriosis or fibroids may be present.

If characteristic symptoms appear, you should consult a doctor and conduct a differential diagnosis.

Types and diagnostics

Due to the fact that polyps are often located on a thin stalk and go beyond the external pharynx, they are well defined by visual examination of the cervix. It is noteworthy that neoplasms are distinguished by a variety of external characteristics:

size from a few millimeters to 2-3 millimeters;
mushroom-shaped, leaf-shaped, oval or round shape;
long stem or wide base.

Polypous formations of the cervical canal contain many vessels that usually shine through the epithelial canal, causing a dark pink color. This is what polyps look like, whose surface is covered with a cylindrical epithelium. Whitish polyps are formed with the participation of stratified squamous epithelial tissue.

bluish color of the polyp may indicate torsion of the leg or injury, which leads to impaired blood circulation.

The consistency of the polyps of the cervical canal can be both soft and dense. It depends on the amount of fibrous tissue in the neoplasm. Dense polyps have a significant amount of fibrous tissue in their composition.

If the doctor visualizes polyposis during the examination, he recommends that the patient undergo a colposcopic examination, which allows you to examine the formation in detail, study the structure and exclude the possibility of pathological conditions of the epithelium.

However, accurate information about the structure of the polyp of the cervical canal can be obtained only after a histological diagnosis, which is always performed after the direct removal of the formation.

According to histological analysis, polyposis can be of several varieties.

The glandular type develops in relatively young women, for example, in the reproductive cycle. These are polyps with a size of 1 cm. The structure of glandular neoplasms suggests the content of glands localized in a chaotic manner.
The fibrous type is typical for older women. Polyps include dense fibrous tissue with few glands. The difference from the previous variety lies in the ratio of types of fabric. For example, fibrous polyps are more dense.
Glandular fibrous type called otherwise mixed. The ratio of the two types of tissue is equivalent. Such polyps can reach large sizes.

The greatest danger is represented by adenomatous polyps, which are a precancerous form. After their removal, the patient is recommended a course of chemotherapy.

The choice of treatment tactics depends on the polyposis structure. If the polyp is located high, it is not possible to detect it during visual examination and colposcopy. In such cases, ultrasound is used, which is performed using a vaginal probe. Usually, with polyposis, there is a deformation of the lumen of the cervical canal.

If concomitant gynecological diseases are suspected, additional research methods may be carried out.

Treatment tactics

Medical treatment is ineffective, since the polyp can only be eliminated by removing it. However, in some cases, small lesions are treated conservatively with anti-inflammatory drugs. With the complete disappearance of polyposis, it can be concluded that the diagnosis was incorrectly made. In this case, they speak of a pseudopolyp, that is, the formation of an inflammatory nature.

If, against the background of anti-inflammatory therapy, the neoplasm decreases, this means that the inflammatory process has been eliminated. Subsequently, the pathology is treated with removal.

Drug treatment of polyposis before removal is required only in the presence of an inflammatory process. In such cases, removal is performed after prior antibiotic therapy.

Removal of polyps of the cervical canal is not performed during menstruation. Removal is advisable to carry out in the first half of the cycle. When removing, different techniques can be used, after which the material is sent for histological examination. Moreover, not only the neoplasm, but also the surrounding tissues are subject to research. Histological examination is necessary to exclude a precancerous and malignant process.

Treatment after removal is prescribed in accordance with the results of the histological analysis. after removal do not need additional therapy. Fibrous polyps of the cervical canal grow in elderly patients and have a high risk of malignancy. That is why, when this variety is detected, an additional examination is usually carried out and the issue of subsequent therapy is decided.

Mixed polyps of the cervical canal are often the result of hormonal disorders. After their removal, hormone therapy is prescribed to prevent the occurrence of relapses.

If removal is not possible The patient is prescribed anti-inflammatory and hormonal treatment.

There are no specific methods of prevention. To avoid the development of polyposis, women should maintain hormonal function at the proper level, treat inflammatory pathologies in time and avoid abortions.

Removal techniques

Before removing the polyp, the patient is usually hospitalized. Removal is performed under anesthesia. Polyps growing on a stalk are unscrewed, and then the bleeding is eliminated. After removal, curettage of the cervical canal is shown. Removal of cells from surrounding tissues helps prevent recurrence. In addition, all material is sent for histological examination in order to identify a possible precancerous and malignant process.

Removal of polyps can be performed in several ways.

Diathermocoagulation. The formation is removed with a special electric knife. Removal resembles cauterization, after which a scab remains on the mucous membrane, covering the wound. Under this crust, epithelial tissue heals and regenerates. After the end of regeneration, the crust is rejected over time. Removal by diathermocoagulation is effective for small neoplasms that grow on a wide stalk. After such removal, scar tissue may remain.
Cryodestruction. Removal with liquid nitrogen involves exposing the polyp to low temperatures, which leads to its freezing. Then the neoplasm is cut off. After such removal, there is no scar. However, the healing process takes about two months.
Laser polypectomy. This is a classic removal, during which the polyp is captured with a laser loop, and then eliminated with a laser scalpel.
Hysteroresectoscopy. This is the safest and most painless removal, which is performed using a hysteroscope. Removal has a number of advantages, for example, the ability to visualize the mucous membrane of the canal and the uterine cavity. This allows you to carry out the removal with maximum accuracy.

After removal, the tissue is sent for histological examination. Despite the fact that the polyp refers to a benign pathology, in some cases signs of malignancy are revealed. To prevent the development of precancerous and malignant diseases, gynecologists carry out conization or amputation of the cervix, depending on the specific diagnosis.

The operation to remove polyps of the cervical canal today is carried out under video surveillance, which can significantly reduce the risk of injury and relapse. Another thing is that such equipment is not available in all regional clinics. Therefore, today we will consider methods of surgical intervention for cervix formations.

Polyps in the cervical canal

Drop-shaped or mushroom-shaped growths can form on any mucous membrane. So, in the format of the female body, they are found in the uterus, vagina and cervical canal. Moreover, the first and last during visual inspection can be confused if the polyp has reached a size of several centimeters. In this case, having a base in the uterine cavity, it hangs down into the lumen of the cervix. Precise localization helps to establish ultrasound.

It is difficult to say what led to the appearance of such a pathology. But, in general, the reasons are called:

Injuries during childbirth and during operations;
Inflammatory processes;
Infections of the reproductive system;
Endocrine failures;
Inherited predisposition.

Even excess weight and vascular diseases, for example, with hypertension, can become a provocateur of formations in the cervical canal. More often, several causes work against the patient in the aggregate.

Clinic of polyps in the cervix

The symptoms of the pathology are not unique and only speak of a problem in the female reproductive system:

Pain and cramps in the lower abdomen, and sometimes in the lower back;
Blood after exercise, sexual intercourse or gynecological examination;
Frequent inflammation with infected yellow discharge;
Abundant and painful periods;
Problems with conception and pregnancy.

Attention! Small formations of a few millimeters do not cause negative symptoms, so they are found by chance during routine examinations.

Why do cervical polyps need to be removed?

There must be good reasons for any operation. Such a pathology is reasonably solved in such a radical way:

Often growths become the culprits of infertility. They purely mechanically prevent sperm from entering the uterine cavity. In addition, as a foreign body, the polyp leads to spasmodic contractions of the myometrium, which causes the fetus to fall off.
Adenomatous, and some other types of formations can degenerate into a cancerous tumor of the cervical canal. It is believed that this is only a matter of time and circumstances.
The polyp is easily damaged, which is manifested by spotting bloody discharge of red, brown and pink. This is not only an inconvenience for the patient, but also a high risk of infection. Pathogenic microorganisms are even normally present in the vagina. Their reproduction and penetration into the wound can lead to tissue abscess, sepsis. In severe cases, the issue is resolved by amputation of the cervix, uterus, and sometimes all female organs.
In the presence of a polyp, the surrounding tissues are in a state of constant inflammation. Over time, they lose elasticity, which can lead to severe injuries of the cervical canal and cervix during childbirth.

Attention! Small single formations up to 5-10 mm in the absence of rapid growth are not an indication for removal.

How to prepare for the operation?

If surgery is necessary, the doctor will prescribe some examinations:

Vaginal smear. It is studied not only by a simple microscopic method, but also by PCR to identify all viruses, bacteria, fungi that are present in the microflora of the genital organs.
Ultrasound is performed immediately after menstruation. This is necessary for better visualization of the uterine cavity, where the base of the polyp or other formations may be located additionally. At this time of the cycle, the endometrium is smaller and does not hide anything from the doctor's eyes. It is important to determine the localization, where is its base, in the uterus or in the cervical canal, as well as the size. Sometimes a series of studies is carried out to evaluate the dynamics. If the polyp grows rapidly, then the operation is prescribed immediately.
According to the protocol, before removal, an assessment of the general state of health is carried out, an ECG is done, and the last fluorography is applied.
Women with thrombophlebitis and varicose veins should visit a phlebologist. They are at high risk of detachment or advancement of blood clots. It is usually recommended to wear compression stockings for the operation.
If the ultrasound does not give a clear picture, a diagnostic hysteroscopy may be prescribed. The same procedure, only for inspection without removal.
General blood and urine tests, biochemistry, tests for HIV, CSR, hepatitis are standard tests before surgery.

If an infection is detected, a full course of treatment is carried out with subsequent control tests;
For a week, vaginal sanitation is prescribed with antibacterial suppositories, for example, Terzhinan;
3 days before removal, do not take blood-thinning drugs. This effect has acetylsalicylic acid;
The day before the operation, remove the hair in the genital area;
For 12 hours, if anesthesia is supposed to be used, you can not eat or drink.

Attention! Surgical intervention in the female genital area is usually prescribed in the first half of the cycle, immediately after menstruation. But it is possible to remove polyps on any day, except for menstruation.

General description of the procedure

This operation is called hysteroscopy by the name of the equipment. The difference between all methods is only in the tool that is used to directly separate the polyp from the wall of the cervical canal. Otherwise, all manipulations are the same:

Depending on the severity of the case, the operation is performed either on an outpatient basis or in a hospital. This is determined by the surgeon-gynecologist.
The patient is placed on the gynecological chair and, if necessary, anesthesia is administered, which we will discuss later.
The external genitalia are treated with antiseptics, the vagina is sanitized.
The neck is opened and fixed with a special device. In some cases, drugs are used to relieve spasm so that the expansion of the channel goes better.
Insert a hysteroscope. This is a complex device equipped with a camera to monitor the progress of the operation, and also allows you to insert tools to remove the polyp.
During manipulations in the uterine cavity, it is filled with saline to straighten the folds. This is not required for cervical canal surgery.
Removal of education is carried out in the chosen way.
Examine the entire cervix mucosa for the presence of other polyps.
In most cases, a complete curettage of the surface layer is performed to prevent recurrence.
All removed materials are sent for histology.
The operating field is re-treated with antiseptics.
Instruments are removed from the cervical canal.
The patient is sent to the intensive care unit until awakening from anesthesia.
In a satisfactory condition, after 2-4 hours, the woman is allowed to go home.

Interesting fact! The whole procedure takes about 30 minutes, and the excision of the polyp itself is about 30-60 seconds.

Methods for removing polyps inside the cervical canal

Today, all such operations are carried out under the control of a video camera. Old-fashioned methods with complete curettage of the cervix blindly are used only in very remote corners of the country, where there is no modern equipment. In this case, the probability of recurrence of polyps is 70-80%. In addition, cervical injuries, bleeding and infection are possible. But fortunately, there are modern methods of removal with a hysteroscope, which are available in all regional and district centers, both in private and public clinics:

Classic polypectomy. Education twist to separation from the wall of the cervical canal. The base is cleaned with a curette or cauterized by current. This method is used for polyps up to 30 mm in size.
Laser removal has the best effect. Evaporate the tissues of the legs until the complete separation of the body of the polyp. The vessels are sealed at the same time, so no bleeding occurs. The advantage of the method is that during healing after surgery, there is no scarring that can interfere with normal childbirth later.
The radio waves of the Surgitron device are not inferior to the laser in all characteristics. A special scalpel does not cut, but melts tissue with radiation. Surgeons consider such equipment the safest and most convenient to use, in addition, scars after healing also do not form.
Cryodestruction. Liquid nitrogen is applied to the base, which destroys tissues and promotes the separation of the polyp body. Only suitable for small formations. A high level of professionalism is required to calculate the amount of nitrogen and not damage the healthy tissues of the cervical canal.
Diathermocoagulation or diathermoexcision is a method in which a loop is put on the polyp, tightened and current is applied. As a result of cauterization, the growth falls off. The equipment is available in almost every clinic. But during healing, scars form, which is undesirable for women who plan to give birth again.

Png" class="lazy lazy-hidden attachment-expert_thumb size-expert_thumb wp-post-image" alt="">

Expert opinion

Olga Yurievna Kovalchuk

Doctor, expert

A competent doctor himself will tell you which method of removal is suitable in your case. And also explain where nearby you can carry it out. But often self-interest leads to unreliable recommendations, so when in doubt, it is better to consult with several specialists. Although laser and radiosurgical removal of cervical polyps is suitable for everyone.

Is anesthesia necessary?

Despite the fact that, according to the law of the Russian Federation, medical workers are required to use anesthesia by all available means, it often happens that such operations are carried out “live”. Of course, in a paid clinic, the patient will be provided with the best anesthesia. This possibility should be discussed with the government agency in advance. Usually, short-term general anesthesia is used to remove polyps in the uterus or cervical canal. It lasts about 30 minutes, the patient quickly recovers and almost does not feel side effects in the form of nausea, confusion, dizziness, etc. Local anesthesia is performed on an outpatient basis.

According to the reviews of patients who underwent surgery under short-term general anesthesia, they did not feel anything. Women who survived the removal of polyps live say that only the opening of the cervix hurts, and the removal of the formation itself is practically not felt. Those who went through the removal with local anesthesia also experienced discomfort during the installation of the equipment.

Attention! For some patients, anesthesia is contraindicated, so a consultation with an anesthesiologist is required.

What happens after polyp removal?

The rehabilitation period usually lasts until the next menstruation, which is about 4-5 weeks. To prevent relapses and complications, the following measures are taken:

Immediately after the operation, vaginal sanitation is prescribed with antibacterial suppositories of complex action. The course depends on the drug from 5 to 7 days.
If, according to the results of histology, an adenomatous or glandular type of polyp is detected, then a hormonal treatment plan is developed. It can last from 3 to 12 months. The medicine is chosen according to the age and plans for pregnancy in a woman.
If cancer cells are found in a polyp, an oncologist's consultation is required.

Also, for the patient, some restrictions are set for the period of rehabilitation after removal. Prohibited:

Sex;
Tampons;
douching;
Carrying weights;
Intense physical activity;
High temperatures. For example, sauna;
Immersion in water;
A lot of ultraviolet radiation from both the natural sun and in the solarium.

Attention! At the end of rehabilitation, control examinations are carried out every month for six months.

When is the operation not allowed?

There are certain restrictions and prohibitions on the removal of polyps:

Menstruation. The intervention is prescribed for 1-2 days after it;
Pregnancy. In some cases, expectant mothers undergo elimination of formations in the cervical canal after the end of the 1st trimester;
When oncology of the female genital area is detected, the issue with a cancerous tumor is first resolved;
Bleeding from the uterus must be eliminated before surgery;
Infections are necessarily treated before removal;
Inflammatory processes in the genitals of a woman also need to be eliminated before the intervention;
Severe damage to the liver, kidneys, heart and other common diseases require a special approach. In this case, the decision to remove polyps in the cervical canal is made not only by the gynecologist, but also by another specialized specialist.

Cost of the procedure

The compulsory medical insurance policy entitles the patient to receive a service for the removal of polyps in the cervical canal for free. Another thing is what equipment is available in the institution to which the woman is attached. If everything is in order with this, then it should be clarified whether the procedure will be carried out with anesthesia. Which is also included in the scope of free medical care.

Otherwise, you can find a private clinic and choose the method of removal and the option of anesthesia as you wish. Electrocoagulation is the cheapest and costs about 2000-3000 rubles, radiosurgery with the Surgitron apparatus - 5000-7000, laser removal is available only in a few clinics and will cost 15-20 thousand, and in difficult cases even more expensive.

Attention! It should be borne in mind that the cost of treatment will include consultations, tests, postoperative monitoring, and not just the removal of polyps. So how much you have to spend depends on many factors.

What complications arise when removing polyps?

Such operations in the cervical canal are carried out strictly according to the protocol, which avoids serious consequences. But there is still a small chance of a problematic outcome of the removal. This might happen:

Adhesions and scars. Occur during cauterization by current or mechanical excision. Dangerous narrowing of the cervical canal, up to complete blockage of the lumen. The connective tissue is not elastic, therefore, during childbirth, severe ruptures occur in such a place, which is dangerous for bleeding.
Infection. When sanitizing before, during and after the operation, this possibility should be reduced to zero, but there are cases. Usually this happens when hygiene and other recommendations are not followed by a woman after the removal of formations.
Bleeding. Even when expanding, the lumen of the cervical canal does not give room for manipulation, so it is easy to damage the delicate mucosa during the operation, which will lead to severe bleeding, as there are many small and large vessels.
Allergic reaction to anesthesia. Such a risk is prevented by observation after removal in the intensive care unit under the supervision of an anesthesiologist. The problem is quickly stopped by antihistamines.
Hemometer is a complex postoperative condition when the cervix spasms and blood accumulates in the uterine cavity. There is pain when moving, infection with a high temperature may occur. Urgent medical attention required.
Relapse. With the use of modern methods, the risk of recurrence of polyps is significantly reduced and depends on the case and the chosen method of removal.
Oncology. The operation can provoke the growth of a cancerous tumor in the cervical canal. This happens extremely rarely if atypical cells were already present in the formation itself. Therefore, for reinsurance, doctors scrape the entire inner layer of the cervix.

Attention! Bleeding often occurs from physical exertion, sexual dysfunction, overheating, so you need to follow the recommendations of the rehabilitation period.

Conclusion