Signs of an endometrial polyp on ultrasound. What does a polyp look like in the uterus on ultrasound. How does uterine growth affect pregnancy

Polyps in the uterus are benign areas of endometrial hyperplasia that can progress in growth and cause a number of unpleasant symptoms in a woman - bleeding, pain in the lower abdomen, iron deficiency anemia, infertility.

Predisposing factors for endometrial hyperplasia or its individual sections are:

• hormonal changes;
• obesity;
• diabetes;
• chronic inflammatory processes in the uterus and appendages;
• abortions;
• miscarriages in the early stages;
• carried out diagnostic curettage of the contents of the uterus;
• heredity.

Preparation and conduct of the procedure

It is recommended to do a pelvic ultrasound immediately after the end of menstruation, that is, approximately on the 7-8th day of the cycle. If a woman has any complaints, for example, heavy bleeding, prolonged menstruation, pain in the lower abdomen, then you can sign up for an examination on any day of the cycle.

Special preparation for the study is not required, but in order for the doctor to better examine the uterine cavity, it is recommended to fill the bladder before the procedure. The study is carried out transvaginally to examine the cervix and cervical canal and transabdominally - examine the uterine cavity and appendages.

Signs of a polyp on ultrasound

On the monitor screen, the uterine polyp looks like a separate neoplasm with clear contours - with or without a stalk. Neoplasms of a very small size (no more than a couple of mm) can be seen as a thickening of the endometrium at the site of the polyp. In order for the study to be as informative as possible, diagnostics should be carried out no later than the 7-8th day of the cycle, when the endometrium is still thin.

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Zhumanova Ekaterina Nikolaevna

Head of the Center for Gynecology, Reproductive and Aesthetic Medicine, Candidate of Medical Sciences, Doctor of the Highest Category, Associate Professor of the Department of Restorative Medicine and Biomedical Technologies, A.I. Evdokimova, Member of the Board of the ASEG Association of Specialists in Aesthetic Gynecology.

• Graduated from the Moscow Medical Academy named after I.M. Sechenov, has a diploma with honors, passed clinical residency at the Clinic of Obstetrics and Gynecology named after. V.F. Snegirev MMA them. THEM. Sechenov.
• Until 2009, she worked at the Clinic of Obstetrics and Gynecology as an assistant at the Department of Obstetrics and Gynecology No. 1 of the Moscow Medical Academy. THEM. Sechenov.
• From 2009 to 2017 she worked at the Medical and Rehabilitation Center of the Ministry of Health of the Russian Federation
• Since 2017, she has been working at the Center for Gynecology, Reproductive and Aesthetic Medicine, JSC Medsi Group of Companies
• She defended her dissertation for the degree of candidate of medical sciences on the topic: "Opportunistic bacterial infections and pregnancy"

Myshenkova Svetlana Alexandrovna

Obstetrician-gynecologist, candidate of medical sciences, doctor of the highest category

• In 2001 she graduated from the Moscow State University of Medicine and Dentistry (MGMSU)
• In 2003 she completed a course in obstetrics and gynecology at the Scientific Center for Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences
• He has a certificate in endoscopic surgery, a certificate in ultrasound diagnostics of pathology of pregnancy, fetus, newborn, in ultrasound diagnostics in gynecology, a certificate in laser medicine. He successfully applies all the knowledge gained during theoretical classes in his daily practice.
• She has published more than 40 works on the treatment of uterine fibroids, including in the journals Medical Bulletin, Problems of Reproduction. He is a co-author of guidelines for students and doctors.

Kolgaeva Dagmara Isaevna

Head of Pelvic Floor Surgery. Member of the Scientific Committee of the Association for Aesthetic Gynecology.

• Graduated from the First Moscow State Medical University. THEM. Sechenov, has a diploma with honors
• Passed clinical residency in the specialty "obstetrics and gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov
• She has certificates: an obstetrician-gynecologist, a specialist in laser medicine, a specialist in intimate contouring
• The dissertation work is devoted to the surgical treatment of genital prolapse complicated by enterocele.
• The sphere of practical interests of Kolgaeva Dagmara Isaevna includes:
  conservative and surgical methods for the treatment of prolapse of the walls of the vagina, uterus, urinary incontinence, including the use of high-tech modern laser equipment

Maksimov Artem Igorevich

Obstetrician-gynecologist of the highest category

• Graduated from the Ryazan State Medical University named after Academician I.P. Pavlova with a degree in General Medicine
• Passed clinical residency in the specialty "obstetrics and gynecology" at the Department of Clinic of Obstetrics and Gynecology. V.F. Snegirev MMA them. THEM. Sechenov
• He owns a full range of surgical interventions for gynecological diseases, including laparoscopic, open and vaginal access
• The sphere of practical interests includes: laparoscopic minimally invasive surgical interventions, including single-puncture access; laparoscopic surgery for uterine myoma (myomectomy, hysterectomy), adenomyosis, widespread infiltrative endometriosis

Pritula Irina Alexandrovna

Obstetrician-gynecologist

• Graduated from the First Moscow State Medical University. THEM. Sechenov.
• Passed clinical residency in the specialty "obstetrics and gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• She is a certified obstetrician-gynecologist.
• Possesses the skills of surgical treatment of gynecological diseases on an outpatient basis.
• He is a regular participant in scientific and practical conferences on obstetrics and gynecology.
• The scope of practical skills includes minimally invasive surgery (hysteroscopy, laser polypectomy, hysteroresectoscopy) - Diagnosis and treatment of intrauterine pathology, pathology of the cervix

Muravlev Alexey Ivanovich

Obstetrician-gynecologist, oncogynecologist

• In 2013 he graduated from the First Moscow State Medical University. THEM. Sechenov.
• From 2013 to 2015, he underwent clinical residency in the specialty "Obstetrics and Gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• In 2016, he underwent professional retraining on the basis of GBUZ MO MONIKI them. M.F. Vladimirsky, majoring in Oncology.
• From 2015 to 2017, he worked at the Medical and Rehabilitation Center of the Ministry of Health of the Russian Federation.
• Since 2017, she has been working at the Center for Gynecology, Reproductive and Aesthetic Medicine, JSC Medsi Group of Companies

Mishukova Elena Igorevna

Obstetrician-gynecologist

• Dr. Mishukova Elena Igorevna graduated with honors from the Chita State Medical Academy with a degree in general medicine. Passed clinical internship and residency in obstetrics and gynecology at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• Mishukova Elena Igorevna owns a full range of surgical interventions for gynecological diseases, including laparoscopic, open and vaginal access. He is a specialist in providing emergency gynecological care for such diseases as ectopic pregnancy, ovarian apoplexy, necrosis of myomatous nodes, acute salpingo-oophoritis, etc.
• Mishukova Elena Igorevna is an annual participant of Russian and international congresses and scientific and practical conferences on obstetrics and gynecology.

Rumyantseva Yana Sergeevna

Obstetrician-gynecologist of the first qualification category.

• Graduated from the Moscow Medical Academy. THEM. Sechenov with a degree in General Medicine. Passed clinical residency in the specialty "obstetrics and gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• The dissertation work is devoted to the topic of organ-preserving treatment of adenomyosis by FUS-ablation. He has a certificate of an obstetrician-gynecologist, a certificate in ultrasound diagnostics. He owns a full range of surgical interventions in gynecology: laparoscopic, open and vaginal approaches. He is a specialist in providing emergency gynecological care for such diseases as ectopic pregnancy, ovarian apoplexy, necrosis of myomatous nodes, acute salpingo-oophoritis, etc.
• Author of a number of publications, co-author of a methodological guide for physicians on organ-preserving treatment of adenomyosis by FUS-ablation. Participant of scientific and practical conferences on obstetrics and gynecology.

Gushchina Marina Yurievna

Gynecologist-endocrinologist, head of outpatient care. Obstetrician-gynecologist, reproductive specialist. Ultrasound doctor.

• Gushchina Marina Yuryevna graduated from the Saratov State Medical University. V. I. Razumovsky, has a diploma with honors. She was awarded a diploma from the Saratov Regional Duma for excellent academic and scientific achievements, and was recognized as the best graduate of the SSMU. V. I. Razumovsky.
• She completed a clinical internship in the specialty "obstetrics and gynecology" at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
• He has a certificate of an obstetrician-gynecologist; doctor of ultrasound diagnostics, specialist in the field of laser medicine, colposcopy, endocrinological gynecology. She repeatedly took advanced training courses in "Reproductive Medicine and Surgery", "Ultrasound Diagnostics in Obstetrics and Gynecology".
• The dissertation work is devoted to new approaches to differential diagnosis and tactics of managing patients with chronic cervicitis and early stages of HPV-associated diseases.
• He owns a full range of minor surgical interventions in gynecology, performed both on an outpatient basis (radiocoagulation and laser coagulation of erosions, hysterosalpingography), and in a hospital setting (hysteroscopy, cervical biopsy, conization of the cervix, etc.)
• Gushchina Marina Yurievna has more than 20 scientific publications, is a regular participant in scientific and practical conferences, congresses and congresses on obstetrics and gynecology.

Malysheva Yana Romanovna

Obstetrician-gynecologist, pediatric and adolescent gynecologist

• Graduated from the Russian National Research Medical University. N.I. Pirogov, has a diploma with honors. Passed clinical residency in the specialty "obstetrics and gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the Medical Faculty of the First Moscow State Medical University. THEM. Sechenov.
• He has a certificate of an obstetrician-gynecologist, an ultrasound diagnostician, a specialist in laser medicine, pediatric and adolescent gynecology.
• He owns a full range of minor surgical interventions in gynecology, performed both on an outpatient basis (radiocoagulation and laser coagulation of erosions, cervical biopsy), and in a hospital setting (hysteroscopy, cervical biopsy, cervical conization, etc.)
• Participant of congresses and scientific-practical conferences on obstetrics and gynecology.
• Author of 6 scientific publications.

Ivanova Olga Dmitrievna

Ultrasound doctor

• Graduated from the Moscow Medical Academy. THEM. Sechenov with a degree in General Medicine
• Passed clinical internship in the specialty "Ultrasound diagnostics" on the basis of the Research Institute for Emergency Medicine named after A.I. N.V. Sklifosovsky
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Owns methods of performing ultrasound examination:

• Abdominal organs
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Kruglova Victoria Petrovna

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• Kruglova Victoria Petrovna graduated from the Federal State Autonomous Educational Institution of Higher Education "Peoples' Friendship University of Russia" (PFUR).
• Passed clinical residency in the specialty "Obstetrics and Gynecology" on the basis of the Department of the Federal State Budgetary Educational Institution of Additional Professional Education "Institute for Advanced Studies of the Federal Medical and Biological Agency".
• He has certificates: an obstetrician-gynecologist, a specialist in the field of colposcopy, non-operative and operative gynecology of children and adolescents.

Baranovskaya Yulia Petrovna

Doctor of ultrasound diagnostics, obstetrician-gynecologist, candidate of medical sciences

• Graduated from the Ivanovo State Medical Academy with a degree in General Medicine.
• Passed an internship at the Ivanovo State Medical Academy, clinical residency at the Ivanovo Research Institute. V.N. Gorodkov.
• In 2013 she defended her Ph.D. thesis on the topic “Clinical and immunological factors in the formation of placental insufficiency”, and was awarded the degree of “Candidate of Medical Sciences”.
• Author of 8 articles
• He has certificates: doctor of ultrasound diagnostics, doctor of obstetrician-gynecologist.

Nosaeva Inna Vladimirovna

Obstetrician-gynecologist

• Graduated from Saratov State Medical University named after V.I. Razumovsky
• She completed an internship at the Tambov Regional Clinical Hospital with a degree in obstetrics and gynecology
• He has a certificate of an obstetrician-gynecologist; doctor of ultrasound diagnostics; a specialist in the field of colposcopy and treatment of cervical pathology, endocrinological gynecology.
• Repeatedly took advanced training courses in the specialty "Obstetrics and Gynecology", "Ultrasound Diagnostics in Obstetrics and Gynecology", "Fundamentals of Endoscopy in Gynecology"
• He owns the full range of surgical interventions on the pelvic organs, performed by laparotomy, laparoscopic and vaginal accesses.

One of the most common gynecological diseases is the endometrial polyp. In such cases, it is recommended to undergo an ultrasound examination, because the uterine polyp on ultrasound can be examined in detail and its location can be identified. It is a frequent reason for visiting a doctor or a specialized diagnostic center. Depending on the causes of occurrence, the types of neoplasms, their nature and appropriate methods of treatment are distinguished. The main method of diagnosis is the transvaginal ultrasound method of examination.

Ultrasound diagnostics is an effective and safe way to find out about the presence of a disease or inflammatory processes in the pelvic organs, in particular in the uterus. The method is available and effectively reveals the pathological process in the early stages of development, which allows you to immediately begin the stage of treatment.

A benign formation does not bother a woman for a long time, but over time, the disease can develop into a malignant tumor, which is why it is so important to get diagnosed in a timely manner.

Are polyps visible on ultrasound of uterine structures, and how best to identify them - only an experienced specialist can decide. Since benign neoplasms do not exceed 5-6 mm, a transabdominal examination will not give accurate results.

Even if all the requirements of ultrasound are met, the doctor will be able to see only the ball of the endometrium, but not small formations. Therefore, in most cases, a transvaginal examination method is used, which makes it possible to detect even inconspicuous formations that do not exceed 3 mm. Ultrasonic waves are perfectly reflected from the smallest structures of the endometrium and give a clear photo of the entire cavity.

Polyps are benign neoplasms that have formed from the upper epithelial balls of the uterus. The fallopian tubes and fundus become the most common places where benign formations form.

Most often, formations occur in a single case, but with multiple pathologies of the endometrium, the disease is called polyposis. Polyps are a kind of response of the reproductive system to a change in the hormonal background, the amount of progesterone. At the base, it captures a vast place, and towards the end it narrows a little, forming a semblance of a leg.

Neoplasms most often grow up to 3-5 mm, but in advanced cases or with severe inflammation they can reach 1-2 cm in length. This disease often occurs in women of childbearing age, and after 35 years. Depending on the type of tissue, polyps are divided into categories (glandular, glandular-fibrous, fibrous).

Clinical picture

With a small size of a benign formation, characteristic symptoms are not observed. The pathological process is asymptomatic, so it can not be noticed immediately.

• frequent uncharacteristic discharge and blood clots, regardless of the monthly cycle;
• pulling pains in the lower abdomen;
• possible signs of anemia (dizziness, nausea, lethargy);
• heavy menstruation, which are accompanied by pain and cause discomfort to the girl;
• bleeding after intercourse
• during menopause, there may be slight bleeding.

A number of these symptoms are accompanied by concomitant factors. Based on this, a woman should immediately do an ultrasound, despite the menstrual cycle. Untimely removal of the formation causes cancer, infertility and serious inflammatory processes.

There are several ways to find out about the presence of polyps in the uterus. For this, even a blood test can be used, the characteristic composition of which will indicate the presence of benign neoplasms. But this is considered ineffective and uninformative diagnosis.

Most often, an ultrasound method is prescribed for examining the pelvic organs, which allows you to recreate a detailed picture of the general condition of the uterus and the presence of formations on its mucosa. The study is carried out in one of two ways: either transabdominally, through the outer integument of the skin, or transvaginally, using a special vaginal probe.

Vaginal examination is performed for girls and women who have begun to live sexually. When a girl is a virgin, the doctor examines through the anterior abdominal wall.

During a transvaginal examination, a specialist scans the entire area of ​​\u200b\u200bthe uterus with a vaginal sensor (transducer). The organs being examined are shown on the screen, and the doctor records all the necessary data. This method is considered the most effective, since with the help of a transducer, the doctor accurately measures the size of the uterus, its cervix and ovaries, and also accurately assesses the condition of all structures.

In 90% of cases, transvaginal ultrasound reveals polyps from 2.5 mm. Transabdominal ultrasound is less effective when the examination is carried out through the anterior abdominal wall. Ultrasonic waves pass through the skin and allow the doctor to examine all the internal organs.

But when small benign formations are detected, examination through the external integument is 48% effective. Therefore, with obesity, gas contamination and poor visibility of the uterus or ovaries, the percentage of effectiveness decreases, which forces the doctor to conduct a vaginal or rectal examination.

The most accurate method is hysteroscopy. It is based on the use of a hysteroscope, which allows the doctor to directly examine the entire endometrium of the uterus. The device is inserted vaginally, and a fixed video camera displays an enlarged image of the uterus and its structures on the monitor. This method is used for both diagnosis and treatment.

Hysteroscopy allows you to avoid large-scale surgical intervention, while using devices that allow you to perform microsurgical operations.

Every month, the entire reproductive system of a woman changes its hormonal background, which is why the structure of the genital organs also changes. The uterine endometrium grows during menstruation, therefore, choosing one of the methods, it is important to know on which day of the cycle it is better to do the examination.

A transabdominal examination is prescribed for a woman on days 7-14 of the monthly cycle, when the bleeding has stopped. Vaginal scanning is best done in the second part of the menstrual cycle, when the endometrium returns to its previous state.

Hysteroscopy is performed on 7-10 days from the onset of menstruation, when the endometrial ball is the thinnest, and visibility allows you to see all the smallest details. During menopause or unusual bleeding that is definitely not menstruation, a woman can see a doctor at any time.

How to prepare for an ultrasound if you suspect an endometrial polyp?

External ultrasound examination requires preliminary preparation. To do this, the woman must fill the bladder with fluid as much as possible so that it displaces the intestines from the examination area.

It is enough to drink about 1-2 liters of water 1-2 hours before the procedure. It is better to choose water without gases and not to eat food that causes them to accumulate. This includes dairy products, legumes, fresh fruits and carbonated drinks. These products adversely affect the effectiveness of the method.

A vaginal examination is performed on an empty bladder. This is an important factor during the procedure. A few hours before the diagnosis, it is necessary to stop drinking water and products that cause flatulence. If a person suffers from these disorders, then medications should be taken that will reduce the amount of gases. For example, Espumizan, Loflatil or Bobotik.

During an ultrasound examination, an endometrial polyp can be detected by the following signs:

1. In places of localization of the neoplasm, hypoechogenicity is observed, that is, dark gray spots are visible. In this case, the formations stand out among the overall picture of the endometrium.
2. Small formations take a rounded shape. With their increase, it becomes a little oval.
3. Formations violate the integrity of the lines of the ball of the endometrium.
4. The leg is distinguished on ultrasound by reduced blood flow resistance. The specialist detects vascular blood flow in the entire formation if its dimensions exceed 8-10 mm.

Depending on the type of tissue, the formations will look different on the scan. The glandular ones consist of a glandular component that perfectly beats off ultrasonic waves.

Various inclusions of different echogenicity are possible, which are visible during the examination. Polyps of this type are difficult to detect in the first days of the menstrual cycle, since the neoplasm tissue merges with the common endometrium.

Iron-fibrous have different types of tissues that create hypoechogenicity, and also do not have an internal homogeneous structure. Therefore, such formations are best diagnosed on days 10-14 of the menstrual cycle, when the endometrial ball is the thinnest.

Over time, glandular tissues can become fibrous. This phenomenon often occurs with advanced diseases and in women during menopause. Fibrous neoplasms are characterized by increased echogenicity and heterogeneous internal composition. At the same time, they can be accurately seen and identified on the video in the first phase of the menstrual cycle, since they differ from the entire ball of the endometrium and reach a length of 5-6 mm.

If there are inflammatory processes or other pathological conditions of the endometrium in the uterus, then the diagnosis is unsuccessful, since these factors will negatively affect the effectiveness and accuracy of detection.

There are many reasons why this pathogenic condition occurs:

1. Hormonal imbalance. If the production of progesterone and other important hormones necessary for a woman is disrupted, inflammatory processes and malfunctions in the entire reproductive system can occur.
2. Violation of the ovaries.
3. Growth of the endometrium.
4. Injury to the inner layer of the uterus.
5. Infectious diseases, sexually transmitted.
6. Metabolic disease.
7. Difficult childbirth, surgery or abortion.
8. Erosion of the uterus or acute inflammatory processes.

These reasons are the main ones that cause pathology.

Polyps in the uterus and how can they be dangerous?

As soon as the diagnosis is confirmed by a doctor, it is necessary to begin immediate treatment, since a benign tumor can develop into a malignant tumor or cause serious diseases.

• infertility;
• anemia that occurs after severe blood loss;
• persistent bleeding;
• oncological tumors;
• uterine fibroids;
• endometriosis.

Untimely treatment leads to complications that have a significant impact on the entire reproductive system and health.

One of the causes of infertility is polyposis, so its removal is directly related to the resumption of reproductive power and the onset of ovulation. If the girl is pregnant, but at the same time the specialist has identified a polyp in the uterine cavity, then its surgical removal is transferred until the childbirth takes place.

You should not be afraid of possible complications, since the pathological process does not affect the development of the fetus and its vital functions. When the formation is located on the mouths of the fallopian tubes, the doctor prescribes a course of antimicrobial drugs.

Treatment with folk remedies

If the polyp is small in size and the woman identified it at the initial stage of development, then it is possible to cure the pathological condition using the folk method, with the help of medicinal plants.

It is best to consult with a gynecologist or your doctor before using herbal raw materials to determine if you are allergic to certain types of plants, and whether this method of treatment will be effective.

One of the effective plant components is celandine. It has established itself as a poisonous plant with strong toxic and antibacterial effects.

Celandine has pronounced oncological properties, so it is often used as a unique folk remedy for internal pathologies.

To prepare a decoction from a plant, you need to pour 150 grams of celandine with 1 liter of boiling water. After insisting for 12 hours and cool to room temperature. It is best to insist in a thermos or a jar wrapped in a towel. When the infusion has cooled, keep in the refrigerator.

Before you start taking an infusion of celandine, you need to accurately set the dosage of herbal raw materials and consult your doctor about possible risks and side effects.

After consultation, the infusion of celandine should be taken one teaspoon on an empty stomach. Every week the dosage increases. Therefore, in the third week, one tablespoon of infusion is drunk, and in the fourth - two tablespoons.

After a month of use, it is necessary to begin to reduce the amount of decoction to the initial one tablespoon, observing the same pace. The entire treatment should take several months.

douching

In folk medicine, douching with decoctions of medicinal herbs is also accepted. Some plants have a pronounced antimicrobial and antibacterial effect, so a combination of several herbs helps to eliminate the pathological process and serves as a prevention of diseases of this nature.

For decoction, chamomile and calendula flowers, plantain and sage leaves, oak bark and yarrow are used. Take 1 tablespoon of each vegetable raw material, mix and boil for about 5 minutes. When the broth has cooled, you can douching.

Hysteroscopic polypectomy is the most modern and common method of removing a benign growth. This microsurgical intervention allows you to quickly and efficiently perform the operation and remove the polyp.

Hysteroscopy requires a minimum amount of time and preparation. A woman needs only 4-6 hours to refuse to eat so that she does not cause the urge to vomit. Removal is carried out after the end of menstruation. The doctor injects a drug intravenously, which later allows the operation to be painless for the patient.

After that, a hysteroscope is inserted vaginally, at the end of which a video camera is fixed, which will give an accurate description of the location, shape and nature of the formation. At the other end, a tool will be fixed that will remove the neoplasm itself. After that, the doctor must stop the bleeding and conduct an analysis so that a malignant formation does not occur in its place.

Removal of polyps by diagnostic curettage

Another way to remove a pathological growth is considered a separate diagnostic curettage. The doctor performs the removal with a special tool that captures a small part of the endometrium and removes it.

The specialist does not have the opportunity to see the required area, so the method is considered less effective. Quite often, relapses occur when the polyp grows again in the same place.

Curettage itself is carried out during menstruation, when the endometrial ball reaches its maximum width. This is due to the fact that the tool causes severe damage to the uterine mucosa.

After the operation, unforeseen consequences may occur, since the body of each woman is individual, it is difficult for him to endure surgery. If during the surgical intervention sanitary standards were violated or the patient had infectious diseases, then inflammation occurs after the removal of the formation. In this case, you should immediately consult a doctor to prescribe a course of antimicrobial drugs.

During the operation, spasms of the cervix occur, due to which the secreted fluid and blood is stopped and does not leave the uterus. At this moment, the woman has sharp pains in the lower abdomen and there is absolutely no vaginal discharge. In this case, it is better to consult a doctor in a timely manner to confirm the diagnosis and further treatment.

To prevent this disease from occurring, doctors recommend undergoing a diagnostic examination every year. In the event of inflammatory processes of the endometrium of the uterus, it is necessary to carry out qualified medical treatment in time. Also, a girl should monitor her hormonal levels, since her reproductive health depends on it.

The widespread introduction of ultrasound diagnostic methods makes it possible to detect pathology at an early stage, at which there is no clear clinical picture and other diagnostic methods are ineffective. It is also possible to detect an endometrial polyp on ultrasound in the early stages, when clinical data and examination data do not allow it to be diagnosed.

General characteristics of education

A polyp is a glandular formation of the epithelial layer of the uterus, which is of a benign nature. At the stage of formation, the formation has a wide base, then, in the process of development, the formation of the stem occurs. Favorite localization in the fundus of the uterus and at the mouth of the fallopian tubes. By the number of education can be single (most often) and multiple (polyposis).

Ultrasound classification includes three types: glandular, glandular-fibrous, fibrous. Fibrous polyps appear as a result of the reverse development of glandular types, when the glandular epithelium is replaced by fibrous tissue. The size of the formation can reach 1 cm. The minimum size that can be determined by ultrasound is 3-4 mm.

Clinical picture

In the case when the polyp is single and its size is small, then the symptoms may be absent. Failure of the menstrual cycle (discharge of a smearing character between menstruation, soreness and profusion of menstrual bleeding) is the main sign of an endometrial polyp in reproductive age. More rare symptoms are pain in the lower abdomen, spotting after sexual intercourse. During menopause, education can manifest itself as acyclic spotting.

There is no clearly proven relationship between the presence of an endometrial polyp and infertility, but it has been found that its removal increases the chances of pregnancy.

Large polyps can be diagnosed with a pelvic exam. At the same time, they may look like tumor-like dense formations, the cervix (its external pharynx) gapes, and the formation itself may protrude beyond the uterine cavity.

Choice of research method.

.

Glandular fibrous polyps have two ultrasonic variants, depending on the predominance of one of the components - glandular or fibrous.

With the predominance of the glandular component, as well as with an equal ratio of tissues, the polyp has a moderately reduced echogenicity, a heterogeneous layered internal structure. If the study is carried out in the first phase of the cycle, then the formation, due to fusion with surrounding tissues, is not detected.

If the fibrous part of the formation predominates, then the echogenicity of the formation becomes increased, heterogeneity is preserved due to hypoechoic inclusions. Polyps of such a structure are better visualized in.

It should be borne in mind that this division is very conditional and the ultrasound method does not allow reliable differential diagnosis of glandular and glandular-fibrous polyps.

Fibrous polyps most common in women after menopause. They are the result of the involution of glandular formations. During ultrasound, a fibrous polyp is a clear formation of high echogenicity and density with a small size (usually up to 6 mm). The internal structure of the formation is homogeneous, without inclusions.

In the case when the uterine cavity is filled with pathological contents, the visualization of polyps is significantly improved. Most often this is observed in postmenopausal women (as in the presented video).

Diagnosis against the background of unchanged endometrium is usually not difficult. However, if there is a concomitant pathology (for example, endometrial glandular hyperplasia), then the diagnosis becomes extremely difficult. In these cases, it is desirable to conduct several ultrasound examinations in one menstrual cycle.

Polyposis is a multiple form of the disease. Ultrasound signs are the same as in the solitary form, but several polyps are found in the uterine cavity. Their number can reach 10, but this option is rare. The photo shows a clinical example.

Differential Diagnosis

The diagnosis of an endometrial polyp in experienced diagnosticians is not difficult. But there are options when other diseases similar in clinic and ultrasound picture should be excluded. First of all, it concerns.

Diagnostic criteria for HPE.

In addition, it also requires differential diagnosis. In order not to confuse these diseases, a different clinical picture should be taken into account. On ultrasound, the myomatous node is always associated with the myometrium, and the polyp comes out only from the endothelial layer.

A nabothian cyst located in the isthmus, closer to the endometrium, can also mimic a formation. To distinguish between these pathologies, attention should be paid to the presence of dorsal echo enhancement, which is present in the cyst and cannot be present in the presence of a polyp.

It is not difficult to determine a polyp or the onset of pregnancy on ultrasound, although sometimes there are diagnostic errors. This is especially true for diagnosing pregnancy in the early stages in women in the premenopausal period. The uterus during pregnancy is enlarged, which is not observed during education. has low echogenicity (or anechoic), the effect of dorsal signal amplification is traced, and there is also a hyperechoic rim of shells along the periphery. Excluding or confirming pregnancy, it is also necessary to take into account the data of the clinic and other studies (pregnancy test, hCG level in the blood).

Tactics in identifying

When an endometrial polyp is detected, it is shown. After the operation, the biological material is sent for cytological examination, which allows you to accurately determine the type of formation.

If glandular or glandular-fibrous polyps are detected, subsequent hormone therapy is prescribed for up to six months. It is aimed at normalizing the hormonal background of a woman, regulating the menstrual cycle and preventing relapses of the disease. Preparations are selected individually by a gynecologist. If fibrous polyps are detected, further treatment is not required.

Any ultrasound examination requires great care and professionalism from the researcher. The study protocol should include accurate comprehensive information, which is the basis for timely and correct treatment.

Is it possible to see a uterine polyp on ultrasound? It is possible to find pathology in the female genital organ thanks to the diagnostic functions of ultrasound. Not all methods can find neoplasms in the uterus, and they are practically ineffective. The most important fact of ultrasound is the early detection of an endometrial polyp. When the clinical data don't say anything.

If you study the classification of ultrasound, there are three types:

• Fibrosing.
• Glandular.
• Mixed.

Fibrous polyps arise as a consequence of the degeneration of a glandular neoplasm. Glandular polyps gradually begin to become covered with a membrane of fibrous origin. The length of the polyp can be up to one centimeter. On the ultrasound machine, polyps in the uterus with a size of 3 mm can be detected.

The most important method of examining a woman with a suspected polyp in the endometrium of the uterus is ultrasound. But its effect depends on the correctness and accuracy of use. If this diagnostic method is carried out through the abdominal cavity, then the chances of identifying any neoplasm is 55-60%, no more. If ultrasound is used in this way, it is possible to detect polyps ranging in size from 7 mm. But after all, polyps are also smaller, so you can not detect such neoplasms in time. Ultrasound polyp of the uterus: what day can be carried out? This issue is decided for each patient individually.

It is most effective to conduct ultrasound diagnostics transvaginally. It is possible to determine the smallest polyps with a certain accuracy, since the method is specific. The sizes of polyps can be determined, which are 1.5 - 3 millimeters. Transvaginally, ultrasound, according to statistics, finds about 95% of all polyps in the uterus. Based on this, this method is popular among radiologists. If there is some suspicion that a woman has a cervical polyp, ultrasound is indicated.

Execution Method

What does a polyp look like in the uterus on ultrasound? The picture shows that a polyp can look different depending on the cycle. On what day is an ultrasound of the uterine polyp done? The most favorable time for diagnosing ultrasound is the phase of the cycle at the second level. During this period, the endometrium has the greatest thickness. If, for example, an ultrasound is performed when the first period is observed, then some polyps may not be detected. Less than 6 mm polyps in the uterus can be seen very poorly on ultrasound.

So, the signs of an ultrasound examination of any type of polyp are:

• Puffy round shape.
• A sharp decrease in echogenicity.
• Cardinal delimitation of the polyp from the endometrium.
• The level of blood flow resistance is about 0.6 (measured in indices).
• The presence of a leg through which the vessel passes.
• Some changes on the part of the mucosa, when the integrity of the closure is broken.

Usually, the presence of polyps can be detected on an absolutely calm endometrium. If the polyp is small, then it is round in shape. But as soon as growth occurs, the shape changes to an oval. Some decrease in echogenicity is observed on the periphery of the rim. The homogeneity of the neoplasm is typical for the ultrasound picture. There are practically no other inclusions on the polyp, which makes it possible to differentiate with other processes in the organ.

If an ultrasound scan shows a polyp of glandular origin, the echogenicity is somewhat reduced, and the structure of the neoplasm is heterogeneous. It depends on some layering of the polyp. As mentioned above, if an ultrasound is performed for the first cycle, then due to fusion with nearby tissues, a polyp of any origin may not be detected.

If there is an increase in the level of echogenicity of the neoplasm, we can safely say that this is a polyp of fibrous origin. This is due to the increased number of inclusions. Ultrasound of the uterine polyp - on what day of the cycle can it be carried out? In this case, it is better to carry out such an examination tactic for the first phase of the menstruation cycle.

But, in any case, quite clearly, ultrasound cannot differentiate the type of polyp. But the fact that the ultrasound method will reveal a polyp is already a result.

Very typical is the clinical picture that fibrous polyps are diagnosed in women as soon as menopause overtakes. This process occurs due to the involution of polyps of glandular genesis. There is a small polyp on the anterior wall of the uterus (about 5 mm), an increased level of density and echogenicity. The structure of the polyp is typical homogeneity, without any inclusions.

If there is a content of pathological origin in the uterus, then the polyps are sharply expressed on the ultrasound screen. In the postmenopausal period, this is extremely pronounced and clearly visible.

If a woman is not sick with anything and the endometrium is not changed, then an ultrasound examination is easily performed. But if various concomitant pathological processes or diseases are observed, then it is somewhat difficult to conduct this research method. Therefore, it is necessary to resort to a dynamic study of ultrasound for one period of the menstrual cycle. If polyps on the cervix, the ultrasound shows a clear localization.

If a multiple number of polyps is observed on the ultrasound screen, then this is a polyposis. The ultrasound picture is the same as with single ones, only the presence of polyps is observed about 7-9 pieces. But such a phenomenon, given the statistics, is extremely rare.

Tactical approaches

As soon as a polyp is detected on ultrasound, you should immediately get rid of it. For this, it is necessary to perform a polypectomy using hysteroscopy. After this procedure, the removed material must be sent to the laboratory. It is necessary to take biomaterial to determine the type of polyp, as mentioned above, there are several of them.

If it was a glandular polyp, then hormonal therapy is prescribed. This is necessary to prevent the appearance of new or the revival of other polyps. The attending physician chooses the right drug for each patient separately. If a polyp of fibrous origin was diagnosed, then conservative treatment is not needed.

Ultrasound examination depends not only on the apparatus, but also on the experience of the doctor. After the procedure, all the results identified are described in the protocol, which is necessary for the subsequent treatment of the patient.

Polyps of the uterus are called focal hyperplasia of the endometrium, which is clearly visible on ultrasound. In most cases, polyps are classified as benign neoplasms. They can cause heavy bleeding, pain, anemia, and other symptoms.

Polyps in the uterus: what is it, is it visible on ultrasound?

Usually, patients are interested in whether polyps are visible on ultrasound in the uterine mucosa (endometrium) and cervical canal. The answer to it is unequivocal - polyps are clearly visible on these examinations. Usually a polyp looks like a fungus, which is attached to the wall of the uterus with a leg. The size of the neoplasm can vary from a few millimeters to several centimeters.

Polyps may not affect the patient's health in any way, but sometimes they provoke a number of symptoms. These include spotting between periods, irregular cycles, irregular and prolonged periods.

Is it possible to see a uterine polyp on ultrasound if the disease is asymptomatic? Can. Signs of an endometrial polyp in the uterus are diagnosed on or on an examination of the endometrium.

Causes of polyps

For the appearance of neoplasms, a whole complex of reasons is needed. This is a change in the hormonal background (for example, hyperestrogenism) and inflammatory diseases. Often polyps appear due to chronic genital infections or damage to the walls of the uterus.

Unfortunately, the disease is common and often has mild symptoms. Therefore, patients are advised to visit a doctor, telling him about all the symptoms that may indicate the appearance of polyps in the uterus, and to do an ultrasound in the first referral of a specialist.

Which uterine polyps are the most dangerous?

There are several types of uterine polyps: glandular-fibrous, fibrous, glandular, placental and adenomatous. The glandular glands are formed by the glandular tissue of the endometrium. These neoplasms are more common in young women. Glandular fibrous polyps are formed by the growth of the endometrium with the content of connective tissue, fibrous polyps mainly consist of connective tissue. Neoplasms of these types are more common in patients in adulthood.

Placental polyps are formed by fragments of the placenta left after childbirth, missed pregnancy or complicated abortion. Neoplasms can cause heavy and prolonged bleeding. Over time, due to placental polyps, infection and even infertility can occur.

The most dangerous are adenomatous polyps, consisting of epithelium. Neoplasms have glands with signs of restructuring and are predisposed to the transition to cancer.

How is the ultrasound procedure performed?

To diagnose uterine polyps, an ultrasound of the endometrium and cervical canal is performed. The examination can take place abdominally and transvaginally. In the first case, the patient takes off her clothes to the waist and lies on her back. The examination takes place through the abdominal wall; for greater information content, the patient must be with a full bladder.

In order for the polyp in the uterus to be better seen on ultrasound, they prefer to do an examination. Before the procedure, the woman takes off all clothes below the waist, lies on her back and bends her knees. The sensor is inserted into the vagina in a special disposable sheath. The examination takes up to 15 minutes and does not cause pain.

Signs of an endometrial polyp in the uterus on ultrasound

A uterine polyp on ultrasound looks like a neoplasm with a clear contour. Another sign of it may be the expansion of the cavity and thickening of the wall of the uterus.

For the diagnosis of neoplasms, 5-7 days of the menstrual cycle are best suited. At this time, the endometrial layer will be thinner, which will make the signs of an endometrial polyp in the uterus more visible on ultrasound.

Treatment of the endometrial polyp

If the neoplasms are benign and do not exceed a few millimeters in diameter, the specialist prescribes conservative treatment. In this case, the patient needs to constantly monitor the condition of the polyps in the uterus, undergo examinations by a specialist and do an ultrasound scan.

Large and malignant polyps are removed surgically. After the operation, the patient is prescribed hormonal treatment.

How is a polyp removed?

After a polyp in the uterus is detected using ultrasound, the specialist prescribes additional examinations to confirm the diagnosis and plan surgery. The operation can be performed by diagnostic curettage or using a hysteroscope.

The first method involves a “blind” operation, in which the doctor cannot see the polyp and control its complete removal. With the help of a hysteroscope, the removal occurs "pointwise". The specialist sees the polyp with a camera and removes it with a tool built into the hysteroscope. After that, the place of removal is cauterized by the method of electrocoagulation or processed by a cryogenic method.

Soreness of the procedure

The operation can be painful. Therefore, the intervention is performed under general anesthesia, less often under local anesthesia.

Recovery after polyp removal

After removal of polyps in the uterus, it is necessary to undergo additional treatment and do an ultrasound of the endometrium to exclude recurrence. Treatment consists in taking hormonal drugs, vitamin complexes and iron-containing drugs. Full recovery after surgery can take several months.