Whether to remove a polyp in the cervical canal. Polyp of the cervical canal - types of polyps and methods of removal (pluses / minuses). Complications after removal

A polyp of the cervical canal is a benign neoplasm that is caused by hyperplasia of the columnar epithelium. The main site of localization is the lumen of the cervix. Its attachment to the cervical lumen of the body of the uterus occurs due to the leg, it is equipped with a large number of capillaries and vessels through which its blood supply and nutrition occur.

This disease can be characterized by both the appearance of a single polyp and multiple manifestations. Sometimes, due to the lengthening of the stem, it can protrude into the vaginal lumen. This makes it possible to make a diagnosis during a gynecological examination.

This pathological process is considered the most common neoplasm. It is detected in 23% of women with diseases of the genital organs. Most often, a polyp of the cervical canal is observed in women in a state of premenopause.

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Classification of polyps affecting the cervical canal

According to the morphological structure, the following types of polyps can be distinguished:

It is especially customary to distinguish decidual types of polyps. They arise only during the development of pregnancy, have different morphology, and the stromal surface of an existing neoplasm is chosen as the location.

Also, polyps in the cervical canal can be:

True.
False (pseudopolyps), their characteristic feature is the absence of a leg at the point of attachment to the cervix. They join with the help of a modified endometrium.

Causes of the development of a polyp of the cervical canal

Despite how long this process has been studied, scientists have not been able to establish the exact cause of the appearance of polyps.

There are many risk factors that lead to their pathological growth:

Trauma of the cervical canal. The extent of the injury may be minimal. They result from:
- Diagnostic curettage.
- Conducting frequent abortions.
- Hysteroscopy.
- Biopsies by aspiration.
Changes in the structure of the surface layer. This condition is caused by the development of erosion or leukoplakia.
Frequent sexual infections., . This is an ascending type of infection, moving from the lumen of the vagina through the cervical canal, they contribute to the degeneration and hyperplasia of the mucous membrane.
Infections of a nonspecific nature. These are diseases such as:
- Cervicitis.
- Vaginitis.
Changes in the microflora of the vagina. Bacteria secrete toxins, disrupt the acidic microflora, and as a result of its imbalance, increased hyperplasia of the cell epithelium occurs.
Dysfunction in the work of the ovaries. It is this pathology that is accompanied by the appearance of:
Disorder of the function of the endocrine system. This contributes to increased production of estrogens, and they lead to increased hyperplasia and growth of epithelial tissues. Very often it appears with the following diseases:
- Diabetes mellitus of any type.
- Atherosclerotic vascular lesions.
- Overweight.
- Violation of the psycho-emotional state caused by overwork and stress.

Signs and main symptoms of polyps of the cervical canal

The main signs of polyp growth are:

It is worth noting that the clinical picture in this disease proceeds with a small number of symptoms. It is difficult to recognize this pathological process.

Its diagnosis very often occurs by chance, during routine medical examinations. Or when a woman turns to a gynecologist about a disease that is a consequence of a polyposis change.

Symptoms to watch out for are:

The appearance of vaginal bleeding after sexual contact. They arise as a result of trauma to the polyp.
If an inflammatory process occurs in the polyp, or it becomes necrotic, then between menstruation it begins, sometimes it is profuse.
In the event that the polyp has a large shape, and he became infected, the discharge from the vagina becomes mucopurulent.
Appearance, also indicate the presence of a large polyp, or its multiple growth.

If a polyp occurs during pregnancy, then it poses a real threat of miscarriage, or the onset of premature birth. Since it causes a reflex contraction of the smooth muscles of the uterus.

The morphological structure of the polyp variety has a significant impact on the manifestation of the symptoms of the clinical picture:

With glandular polyps, there is a large production of mucus, this provokes a large amount of mucous secretions in the period between menstruation.
If the structure of the polyp is fibrous in nature, then there will be few symptoms indicating its presence. This is due to the fact that it contains a very small content of blood vessels.
Polyps, which are based on glandular fibrous formations, give the most pronounced and vivid clinical picture, primarily due to their large size and pathological growth. In addition to bleeding, a woman complains of pain of a pulling nature, which are localized in the abdomen and lumbar region.

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Polyps of the cervical canal during pregnancy

At the heart of this pathology, it is customary to distinguish two factors:

Pathological outgrowths occur as a result of improper abortion, or with frequent diagnostic curettage.
Excessive synthesis of estrogen.

The course of the entire pregnancy depends on the level of mucus production. If it is produced a lot, then the risk of a threatened miscarriage greatly increases.

If the polyp does not interfere, does not tend to grow, and increase in volume, then it is better not to touch it until the end of pregnancy.

But if the diameter of the polyp exceeds 10 mm, this is the reason for the surgical intervention. For its implementation, the method of cryodestruction is used, followed by curettage. The main thing is that the legs of the polyp do not remain, otherwise the chance of a relapse increases. The occurrence of this pathological process sometimes requires the hospitalization of a woman to maintain pregnancy.

Diagnosis of polyps of the cervical canal

When a woman contacts a doctor, an anamnesis is initially collected - a visual examination of the patient. After a gynecological examination, there may be a thickening of the walls of the cervix, if the polyp has a long leg, it can be seen in the lumen of the vagina.

In addition, the patient is required to undergo cervicoscopy, this is the same examination, but an optical device is used for its implementation.

The advantage of this method is its ability to identify the morphological structure of the polyp, to recognize the presence of not only a large outgrowth, but also small neoplasms. In parallel with this manipulation, you can take the material on.

Assignment takes place:

Ultrasound examination of the organs of the retroperitoneal space.
, which allows you to determine the localization of the polyp.
. By correctly removing the polyp, it helps to establish an accurate diagnosis, study the histology of the polyp fragment and implement a reliable method for subsequent treatment.
The smear must be analyzed using the PCR method.
Bacterial culture also occurs, which helps to identify pathogenic microflora.

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Treatment of a polyp of the cervical canal

Methods that would give a 100% positive effect in the dynamics of the treatment of the cervical canal polyp do not exist today. Medications are prescribed to suppress the negative symptoms that occur after their appearance.

Sick patients are prescribed:

The use of folk medicine recipes for polyps of the cervical canal

The opinion of scientists on the use of medicinal herbs and traditional medicine recipes in gynecology is ambiguous. This is due to the fact that medicinal herbs are unable to eliminate the cause of the disease, and by eliminating the symptoms, they smooth out and mask the clinical picture. This creates a problem for establishing an accurate diagnosis.

They can be used after consulting a doctor.

Usually applied:

Grass celandine.
Bloodroot.
Chicory.

A decoction or infusion is prepared from them. Aloe, honey, onions, pumpkin seeds, lingonberries are also used for this therapy.

Surgical operations for the polyp of the cervical canal

There are many methods of surgical removal of polyposis outgrowths. But after applying any of the methods, there is a mandatory curettage of the cervical canal. Only in this case it is possible to achieve good treatment results, and to prevent the reappearance of the polyp.

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Diathermocoagulation

The basis of this method is the use of high temperatures. With the help of an electric knife, the body of the polyp is excised and cauterized. After that, as a result of a burn, it dies off and is excreted from the body of a woman in a natural way.

Contraindications to the use of this technique are:

Carrying a pregnancy.
Women who have not given birth (at a young age).
Diseases in which blood clotting is impaired.

This technique of surgical intervention is well tolerated by patients, but it also has its drawbacks:

As a result of a thermal burn, connective tissue changes occur in the area of the former polyp, they lead to the appearance of scars, and create problems for the course of pregnancy and childbirth.
The rehabilitation process takes a long time, and can last several months.
Sometimes there is a rejection of the upper crust of the surface of the wound. As a result, bleeding may occur.
During this procedure, women experience severe pain.

This is the exact opposite of the previous technique. To carry out this surgical intervention, liquid nitrogen is used, its temperature can be minus 80 degrees. When the polyp is exposed to negative temperatures, it is frozen and then it is excised.

This technique has become widespread due to the fact that:

That she is less traumatic.
Causes a minimum of side effects.
Does not cause profuse blood loss.
Relatively painless.
It is allowed to carry out to young women who have not given birth.

The disadvantages of this operation include a long period of rehabilitation, on average it is from 2 to 3 months.

When carrying out this method of therapy, the laser point is focused on the polyposis growth. With the help of a hysteroscope, the course of the surgical intervention is controlled, its deep effects and intensity are corrected.

The disadvantages of the laser method include:

The ability to remove only single polyps.
It is impossible to exclude the reappearance of the polyp.
Expensive cost in clinics

The big advantage of this operation is:

Reduced risk of unwanted perforation of the canal walls.
There are no problems with subsequent bleeding. Since the walls of blood vessels are instantly thrombosed.
The recovery process is very fast, vaginal discharge stops after three or four days.
Menstruation begins without failures and delays.

Removal of the cervix

This operation is performed in cases where there is a transition of the tumor from a benign to a malignant state. Or in the event that preliminary methods of treatment led to the appearance of relapses.

Surgical intervention is performed with a laparoscope, a part of the cervix (cone-shaped) and its mucous membrane are removed. The body of the uterus is not affected, which makes it possible for a woman to become pregnant.

This type of surgical intervention is carried out even for women who have not given birth.

The most popular, and widely used, surgical method for eliminating polypous growths. It does not injure the psyche of a woman (painless), with its use, the occurrence of relapses is unlikely.

The hysteroscope is used for the operation. It is introduced into the lumen of the vagina, with the help of a camera built into it, a visual examination of the cervical canal takes place. After that, a resectoscope or a loop is used to eliminate the pathological outgrowth.

If a loop is used, then the polyp is twisted. And if a resectoscope (scissors) is used, then it is watered, cut off at the very base. After removal of the polyp, curettage is necessarily performed.

The operation is performed only after the complete end of the menstrual cycle.

This technique cannot be performed:

In case of pregnancy.
Excessive narrowing of the lumen of the cervical canal.
Oncological neoplasms.

The most important thing in the postoperative period is to prevent the reappearance of cervical polyps and undesirable consequences.

To do this, a woman must follow the following rules:

Within 3 months, you should not visit baths, saunas, solariums. Increased heat stress can cause vaginal bleeding.
Minimize physical training, this also applies to doing housework.
Be sure to visit the gynecologist, at the time set by him.
Within a month, sex should be completely excluded.
To prevent the development of a concomitant infection, do not swim in open water.
When menstruation occurs, only pads can be used, tampons can injure the fragile walls of the cervical canal.
Douching and washing should be carried out using antiseptic solutions of Miramistin, or potassium permanganate.
If a woman is planning a pregnancy, then this may be, perhaps after six months.
Mandatory use of antibiotic therapy in the postoperative period.
If bleeding occurs, you should immediately consult a doctor.
In the postoperative period, the woman is put on a dispensary record.

You need to be examined by a gynecologist at least twice a year.

The prognosis always depends on the success of the operation, and on the behavior of the woman during the rehabilitation period. The recurrence rate of this pathology is no more than 30%.

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What is the danger of polyps of the cervical canal?

The pathological growth of polyps can lead to various complications in the female body:

To avoid the manifestation of undesirable consequences, it is best to remove the polyp of the cervical canal in a timely manner. After that, it is imperative to comply with all the rules and regulations that the doctor prescribes during the rehabilitation period.

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The cervical canal is the inner space of the cervix, which plays an important role in the process of conception and childbearing, and also protects the woman's reproductive system from infections.

A common pathology of this cavity is a polyp, which is a tumor-like formation that tends to increase into the lumen of the cervical canal.

In the early stages, it may not be noticeable to either the patient or the gynecologist during examination, but over time it becomes dangerous to the woman's health. The appearance of a polyp is provoked by the following reasons:

Violations of the endocrine system. A predisposition to the occurrence of neoplasms is observed with an increased level of estrogen in the blood.
Injuries to the cervix, which could occur due to childbirth, abortion or diagnostic curettage.
Endocervicitis, suggesting the development of inflammation of the mucous membrane of the cervical canal. The likelihood of a polyp increases if the disease has become chronic.
Pathologies of the organs of the reproductive system - ovarian cysts, endometrial polyps in the uterus.
Presence of STDs and human papillomavirus.

Classification of polyps (types)

Polyp of the cervical canal photo

According to the consistency, polyps are divided into several types. The approaches to the treatment of each of them are different, and the degree of risk of developing a malignant tumor is also different.

Glandular polyp of the cervical canal- occurs most often and is a capsule covered with endometrium and containing randomly located glands.

The neoplasm does not grow large (as a rule, its size does not exceed 1.5 cm), and its treatment does not cause any negative consequences for the patient.

Angiomatous polyp of the cervical canal- differs in the content of a large number of blood vessels. It is this type of neoplasm in the cervix that is most prone to bleeding, especially during menstruation.

Fibrous polyp of the cervical canal- consists of connective tissue, which makes it possible to see it during an ultrasound examination. It is found mainly in patients over the age of 50 years.

This is one of the most dangerous types of polyps, since its removal can provoke the development of a malignant tumor, but it cannot be left untouched either. To minimize the risks, doctors prescribe hormonal correction after excision of the neoplasm.

Glandular fibrous polyp of the cervical canal- can grow large and reach 2.5 cm in diameter. In addition to the endometrium, it consists of connective tissue, therefore it is dense and distinguishable on ultrasound.

The presence of such a polyp in the cervical cavity can cause discomfort and cause pulling pains.

During a gynecological examination, the doctor may notice certain changes in the cervical part of the uterus. These signs will indirectly indicate the presence of a polyp:

Thickening of the cervix
Swelling of the cervical canal
Pain on palpation of the cervix
Hypertrophy of the external os
When conducting cervicoscopy, neoplasms of a rounded shape are found, having a soft elastic consistency.

Even before a visit to the doctor, a woman can observe symptoms that will indicate pathologies in the cervical cavity:

Pulling sensations in the lower abdomen, not associated with the approach of menstruation.
Blood smearing a few days before and for a few days after menstruation. A similar symptom is observed with endometriosis, but in this case, spotting before the onset of menstruation will be scarce, without a tendency to gradually increase.
Drawing pains during the whole period of menstrual bleeding.
The appearance of bloody discharge after intense sexual contact (with angiomatous polyp).
Menstruation becomes scarce, but their duration increases. Most often this happens in the presence of large neoplasms that almost completely block the lumen of the cervix.
Leucorrhea, having a grayish tint and an unpleasant smell.

Small polyps usually do not show any symptoms and are found only during cervicoscopy.

Removal of a polyp of the cervical canal - methods, pros and cons

Tumor-like neoplasms of the cervical canal are subject only to surgical treatment, however, the doctor must first find out what type of pathologically altered epithelium he is dealing with.

Removal of the polyp of the cervical canal is performed in several ways - it all depends on where it is located and what size it is.

Surgical curettage

A hysteroscope is inserted into the cervix so that the gynecologist knows exactly where the tumor is. The neoplasm is twisted out, its leg is excised. The task of the doctor is to remove all parts of the polyp the first time, otherwise the disease may relapse. Incomplete removal can provoke the occurrence of a malignant tumor.

In some cases, the stalk of the polyp is located deep in the epithelial tissue. After the neoplasm is completely excised, the cavity of the cervical canal is scraped, which is carried out using a curette.

Advantages of the method: surgical curettage of a polyp is considered the most reliable method after which a high percentage is given that there will be no recurrence of the disease.

Flaws: the method is very traumatic, deeply damages the tissues of the cervical canal, so they try to use it only in cases where a large polyp is to be removed.

Polypectomy

Under the control of a hysteroscope, the doctor twists the polyp, and then separates it from the walls of the cervix. Further actions will depend on where the neoplasm is located. If it is localized far from the external pharynx, then after it is twisted and separated, the wall section is cauterized.

When the polyp is located close to the external pharynx of the cervix, it is excised, and sutures are placed at the site of surgical intervention.

A polypectomy is very similar to the removal method described above. The only difference is that in this case, complete curettage of the cervical canal is not performed.

Advantages of the method: less traumatic, involves less blood loss than with curettage.

Flaws: there is a risk of disease recurrence.

Cryodestruction

The method is actively used to remove small neoplasms. The polyp is fixed and then treated with liquid nitrogen. These manipulations lead to instant cell necrosis and detachment of the pathologically altered area from the wall of the cervical canal. The wound from removal is treated with a coagulator.

Advantages of the method: cryodestruction is effective, has a high protection against recurrence of the disease and is available in almost every medical center.

Flaws: the removed material cannot be sent for histological examination, so after the operation it is no longer possible to know whether the polyp was malignant or not.

Radio wave loop polypectomy

A loop is put on the polyp, through which the doctor passes radio waves. They pass through the cells of the neoplasm, completely destroying them, but not over the entire area, but only in the place where the loop is located.

As a result, the pathologically altered area of the epithelium is excised and removed from the cervical canal. With the help of radio wave coagulation, polyps of not only small, but also medium sizes can be removed.

Advantages of the method: remains material for histological examination. In addition, such removal is almost bloodless, painless and has a fast healing period.

Flaws: if coagulation is carried out unprofessionally, then there is a risk that the polyp will not be completely removed.

Laser coagulation

The doctor fixes the polyp and twists it so that its leg is clearly visible. A laser beam is directed at her and her cells are instantly destroyed. The polyp bed is then coagulated to prevent even minor bleeding.

Advantages of the method: laser coagulation allows the removal of very large polyps and is ideal for those patients who have difficulty with blood clotting.

Flaws: a somewhat long healing period during which you can not experience great physical exertion.

There are women who doubt whether it is necessary to remove the polyp of the cervical canal if it is small in size and does not manifest itself in any way.

It is important to know here that in order to prevent oncological diseases, all neoplasms that are subject to regular injuries and microtraumas must be excised. A cervical polyp is constantly damaged during menstruation, may be partially removed during childbirth, or become malignant under the influence of hormonal changes.

Cervical polyp and pregnancy

If the polyp does not completely block the lumen of the cervical canal, then the ability to conceive a child will remain. However, when carrying it out, serious problems can arise.

The neoplasm provokes frequent inflammatory diseases of the cervix and vagina.
There is a danger of premature discharge of the mucous plug.
There is a risk of premature shortening of the cervix and the occurrence of isthmic-cervical insufficiency (ICI).
The constant threat of termination of pregnancy due to the ajar cervix.
The risk of developing a malignant tumor under the influence of a sharp change in hormonal levels.

A polyp of the cervical canal during pregnancy does not involve removal if its diameter is less than 1 cm. If the neoplasm is large, the issue of its excision is decided on an individual basis.

Complications of the polyp

Polyps are more likely to recur. The reason for this is poor-quality removal, when the leg, which is localized deep in the tissues of the epithelium, is partially excised. As a result, after a while the tumor reappears.

If the pathologically altered area is left without treatment, then the neoplasm will continue to grow and manifest itself in the form of pain and contact bleeding. When a large polyp is removed, the wound healing period increases, which carries a certain risk of infection.

To avoid complications and deterioration of well-being, it is necessary to identify a tumor in the cavity of the cervical canal at an early stage of its development. To do this, you need to do an ultrasound scan 2 times a year and undergo an examination by a gynecologist, as well as contact a specialist when intermenstrual bleeding occurs.

The formation of a cervical polyp may not affect the well-being of a woman. However, there are also cases of pronounced signs of pathology:

Pain and pulling sensations in the lower abdomen, felt simultaneously in the lower back;
Abundant discharge of a yellowish tint during the entire period between menstruation;
Brown discharge with blood in the middle of the cycle;
Discomfort and pain during sex;
Severe pain in the abdomen during menstruation;
Infertility;
Miscarriages in cases of conception.

Removal of a polyp of the cervical canal is a surgical operation to remove the pathological growth of the mucous layer, which manifests itself as a growth in the lumen of the cervix.

The reasons for the latter condition have not been clarified by doctors. Most scientists tend to associate the inability to conceive and bear a child with hormonal instability during the development of a cervical polyp.

Preparing to remove a cervical neoplasm

Initially, the patient makes an appointment with a gynecologist, who diagnoses the presence of a neoplasm, finds out its size and stage of development. Without fail, before the operation to eliminate the polyp of the cervical opening, a colposcopy and a number of preoperative tests are necessary. The patient is referred for the following studies:

Cervical swab for analysis by polymerase chain reaction;
A smear for the presence of chlamydia, gardnerella, ureaplasma, mycoplasma, papillomavirus and trichomonas;
Cytological analysis of scrapings;
A smear from the cervix, the canal itself, the vagina and urethra for microflora;
Complete blood count, taking blood for sugar and platelets.

Also, before removing the polyp of the cervical passage, the blood is examined to determine antibodies to mycoplasma, chlamydia and ureaplasma.

At the second appointment, the doctor examines the data obtained and sets the date for the elimination of the polyp of the cervical opening of the cervix. The operation should be carried out either 1 day before the onset of menstruation, or immediately after it ends.

How is a cervical polyp removed?

To date, there are several physicians for the elimination of a polyp of the cervical canal, allowing this operation to be performed. The method of laser removal of a polyp is especially popular - the cervical passage is practically not injured. In addition, with such a removal of the cervical growth, the risk of infection during the procedure is distorted, which becomes a decisive factor when choosing a method for removing the cervical polyp.

Modern clinics offer several types of surgery to eliminate the polyp of the cervical canal at once:

radio wave procedure;
Scraping of the legs of the cervical polyp;
Removal by cryodestruction and electrolysis.

Since the growth of the cervical canal is something similar to a wart, the process of its removal is almost the same as the procedure for reducing papilloma.

The course of the operation to remove the cervical neoplasm

Removal of a polyp localized in the tissues of the cervical canal is always performed under general anesthesia. Once the anesthesia begins to take effect, the surgeon proceeds to locate the cervix using a speculum. After that, he captures the polyp with a terminal clamp and makes circular movements. Removal is carried out by twisting the growth from the cervical canal along with the leg.

After the removal of a large polyp from the tissues surrounding it is complete, the surgeon scrapes the cavity of the cervical canal, removing the remnants of the pedicle of the formation.

If the polyp is located in the upper parts of the cervical canal, its removal is carried out under hysteroscopic supervision. In cases where the neoplasm, on the contrary, is close to the external pharynx, it is excised wedge-shaped, after which a catgut suture is applied. With the repeated extraction of the polyp of the cervical opening after the detection of a recurrence of the disease, a cone-shaped amputation of the neck is performed.

After twisting the polyp of the cervical canal, the surgeon cauterizes its bed and sends the removed pathological tissues for histological examination. First of all, it is necessary in order to detect or exclude the presence of cancer cells in them. In addition, the results of the tests are necessary for the appointment of further therapy: antibacterial, hormonal or anti-inflammatory, necessary for the final treatment of the cervical polyp.

At the next stage, the place of the former localization of the build-up is processed according to the method chosen by the doctor. One of the treatment options is the Solkovagin preparation. After its use, a crust forms at the site of the operation, which later departs along with the discharge. The disadvantage of this method is that it is necessary to carry out a whole course of treatments.

Cryodestruction

The method of cryodestruction of the legs of the cervical polyp is more often used - the effect of extremely low temperatures on pathological cells in order to destroy them. The method requires experience and certain skills of the doctor, as he needs to choose the speed and depth of freezing to obtain the maximum effect.

radio wave removal

The radio wave method is considered the most gentle, the advantage of which is the rapid restoration of healthy tissues damaged during the operation. In the coming months, pregnancy can occur and proceed without complications.

Application of electric current

Another option is to cauterize the legs of the polyp of the cervical canal with an electric current. This method is rarely used today, since it is associated with a serious risk of complications.

Laser removal of cervical neoplasm

The advantages of laser exposure to the tissues of the polyp of the cervical passage are a quick recovery, the absence of scars on the cervix, the good condition of the reproductive organs after surgery, and minimal blood loss. Extraction of the cervical polyp occurs with maximum accuracy, healthy tissues are not damaged. Such an operation takes place on an outpatient basis - a few hours after it, the patient is discharged for home treatment.

At the same time, there are some disadvantages. So the laser beam can only be used to work with single formations. The rehabilitation period is accompanied by abundant discharge from the cervical canal.

If the presence of a cervical polyp is found in a pregnant woman?

If the growth occurred during pregnancy, the doctor chooses expectant tactics, monitoring the dynamics of the disease, instead of immediately setting the exact date for the removal of the cervical canal polyp. In some cases, it disappears on its own after childbirth, and then no intervention is required.

If in the process of bearing a child, the growth rapidly increases and exceeds 2 cm in diameter, one should resort to polypectomy or hysteroscopy. The doctor may also decide on the urgent removal of an overgrown polyp.

The rehabilitation period after the elimination of the cervical polyp

Within 10 days after removal of the neoplasm of the cervical canal, the patient is shown antibacterial treatment. At the same time, hormone therapy may be prescribed. It is prescribed by a doctor in the case when a woman has a hormonal failure.

It is mandatory to be observed by a gynecologist in the next few months after the removal of the polyp in order to exclude an early recurrence of the disease and avoid the consequences of a possible infection.

Sexual intimacy in the first 10 days after the operation is strictly contraindicated. Within 10 days, it is necessary to abandon the procedures associated with immersion in water: taking a bath, swimming in the pool and natural reservoirs.

It is forbidden to douche and use tampons for hygienic purposes. To protect linen from secretions, use only pads.

A few weeks after the removal of the cervical polyp, you can not lift weights. It is better to give up sports, especially if it is associated with strength training. If the polyp removal procedure was carried out in the warm season, the patient is instructed to limit the time spent in the sun. It is necessary to pay attention to the psycho-emotional state - nervous shocks and stress are contraindicated until full recovery.

Considering that wound healing after removal of a cervical polyp requires rest for the whole body, a woman should avoid shaking and the slightest overload. It is impossible to plan road and rail trips, as well as air travel for several weeks following the elimination of the neoplasm of the cervical canal. The best option is to stay at home for a while.

Planning for pregnancy after the elimination of the polyp of the cervical passage is possible only when the sanious discharge completely stops. As a rule, it is 2-3 weeks. If blood or mucus stops flowing during this period, then a complication of the cervical polyp extraction procedure can be suspected. It is better to see a doctor as soon as possible.

The total time of the rehabilitation period, taking into account the prescribed hormonal or anti-inflammatory therapy, is about six months. If there is no hormonal imbalance, the recovery period is reduced to 1-2 months.

Complications and side effects of polyp removal

As a rule, complications after this procedure are not observed. In rare cases, patients experience the following problems:

Bleeding from the cervical canal;
Loss of the ability to conceive;
Thermal burns;
Pathological narrowing of the cervical canal and cervix.

Sometimes it happens that the removal of cervical polyps is not completed completely - the leg is not completely removed. Often, incomplete removal of the polyp stem leads to the appearance of new formations. Accordingly, the symptoms recur. In such a situation, an urgent additional consultation with a doctor and the appointment of a new operation are required.

Is it possible to reduce the likelihood of recurrence of cervical polyps?

So that the operation on the polyp in the cervical canal does not have to be repeated, the doctor prescribes prophylaxis. These are standard measures to support the immune system and the body's ability to resist viruses. To this must be added recommendations for compliance with hygiene and care standards.

If the polyp in the cervical canal is not removed?

In the absence of proper treatment and surgery of the cervical canal, the probability of degeneration of polyp cells into malignant neoplasms is high. Sexually acquired infections and other infections can provoke a change in cells. The decisive factor in the development of cervical polyps can be medical manipulations: childbirth, curettage for the purpose of abortion and diagnosis, installation of intrauterine devices. At risk and women in adulthood. Often, a disease of the cervical canal develops before menopause due to hormonal changes.

Therefore, at the first alarming signs of polyps in the canal, you should consult a gynecologist. You can not neglect the planned preventive examinations, which must be done at least once a year. Particular attention should be paid to the issue of planning a future pregnancy - if you want to have a baby, you need to be examined by a gynecologist. Women should also undergo prophylaxis of cervical polyps, whose age is approaching the menopause.

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 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.

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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 general 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 even more expensive in complex cases.

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

Removal of a polyp of the cervical canal- a minor surgical operation used in gynecology as the main method of treating benign focal growths in the cervical canal. The polyp of the cervical canal is an absolute indication for its removal by mechanical, endoscopic, radio wave, cryodestructive or laser vaporization. The traditional technique of the operation involves "unscrewing" the polyp with a surgical clamp, followed by scraping the canal with a sharp curette under the control of cervicohysteroscopy. Laser removal of the polyp of the cervical canal is based on the effect of thermal vaporization and burning of the stromal component of the formation. The technique of radio wave polypectomy consists in targeted excision of the formation of radio loops and coagulation of its base with a buttoned electrode.

One of the first tools proposed for the removal of a cervical canal polyp is a conchot - a type of biopsy forceps. For polypectomy, a fenestrated clamp, forceps, abortsang, Raeder's loop and other devices are also used. The frequency of recurrence after removal of the polyp by the traditional method - by unscrewing it and scraping the endocervix is 6-10%. This fact contributed to the introduction into gynecological practice of new innovative techniques aimed at eliminating the pathological formation and at the same time ensuring the preservation of the anatomical structure of the cervical canal after invasive intervention.

The gold standard for diagnosis and treatment by endo-instrumental high-energy electrosurgical impact on the base of the polyp in order to remove it is considered surgical cervicoscopy using modern surgical minihysteroscopes. Laser and radio wave surgery are new trends in gynecology and are widely used to remove the polyp of the cervical canal. These technologies are among the highly effective low-traumatic techniques, which allows them to be used as a method of choice in the treatment of young nulliparous women.

Indications and contraindications

The polyp of the cervical canal is an absolute indication for surgical intervention. Dysplasia and malignancy of cervical polyps is observed in 0.1-10% of cases. With a routine gynecological examination and colposcopic examination, it is not possible to make a differential diagnosis between a true polyp and malignant tumors emanating from the cervical canal. Only histological analysis allows us to make a final diagnosis, so surgical removal of the cervical canal polyp is the main method of treating this disease.

The main clinical signs that make the gynecologist suspect a malignant process are recurrent polyps, areas of necrosis, ulceration, and contact bleeding. Such formations must be immediately removed with an urgent morphological study. With a recurrent polyp of the cervix, as well as in patients older than 45 years, polypectomy is usually supplemented with separate diagnostic curettage of the mucous membrane of the cervical canal and the uterine cavity under hysteroscopy control.

During the gestation period, polyps of the cervical canal can cause isthmic-cervical insufficiency, provoke a threat of abortion due to reflex irritation of the cervix. In addition, with the localization of the polyp in the neck, conditions are created for the development of cervicitis, ascending infection and chorioamnionitis. Indications for the removal of a cervical canal polyp during pregnancy are its size more than 1 cm, the growth of education, the presence of necrotic and destructive changes, accompanied by a pronounced inflammatory reaction and bleeding. Polypectomy is performed at any gestational age by an instrumental or radio wave method.

Contraindications to the removal of a cervical canal polyp are acute and subacute inflammatory diseases of the vagina, cervix and internal genital organs, infectious diseases in the acute period (ARVI, influenza, etc.), severe somatic pathology in the stage of decompensation. For patients with a pacemaker, radio wave treatment is contraindicated.

Preparing to remove a polyp

Before the operation, a laboratory and instrumental examination of the patient is carried out in a polyclinic. The examination program includes clinical blood and urine tests, a blood test for RW, hepatitis and HIV, a study of vaginal discharge for purity, a cytological smear from the cervix, tests for sexually transmitted diseases, simple and advanced colposcopy. A transvaginal ultrasound scan of the pelvic organs is performed to exclude intrauterine pathology. In 30% of cases, a combination of endocervix and endometrial polyps is observed, therefore, if changes in the uterine mucosa are detected according to the echogram, the patient is prepared for polypectomy and hysteroscopy with WFD. Also, the gynecologist can prescribe cervicohysteroscopy, which allows you to establish the exact localization of the formation and perform targeted endoscopic removal of the cervical canal polyp even at the diagnostic stage. Cervicohysteroscopy makes it possible to identify a long-stalk endometrial polyp that protrudes into the cervical canal.

Direct preparation for the operation includes shaving the vulva, emptying the bladder before the procedure. Removal of the polyp of the cervical canal is carried out under local application, infiltrative, paracervical anesthesia or using general intravenous anesthesia. When planning intravenous anesthesia, the patient should be treated on an empty stomach. To prevent the occurrence of endometriosis and a better course of reparative processes, surgical intervention is performed in the first phase of the menstrual cycle.

Methodology

The patient is placed on a gynecological chair. The cervix is taken out in the mirrors, treated with an antiseptic solution and the front lip is fixed with a bullet holder. The base of the polyp stem is grasped with a terminal clamp or forceps and unscrewed by rotating the instrument in one direction. To prevent the recurrence of the disease in the long term, a necessary condition is the thorough removal of the "stump" or the base of the polyp, which is achieved by scraping the endocervix. Curettage of the cervical canal is performed with a sharp curette No. 2 in the direction from the internal to the external pharynx along all walls. The operation can be performed under the control of cervicoscopy. The removed polyp and scraping of the endocervix are placed in separate containers with formalin and sent to the laboratory for histological diagnosis. The duration of the procedure for removing the polyp of the cervical canal is 5-10 minutes.

Polyps on a wide base or with a thick stem, located in the depths of the canal, are removed endoscopically using an operating cervicohysteroscopy. The tube of a surgical minihysteroscope or fibrohysteroscope is inserted into the cervical canal, the localization of the pedicle of the formation is visually determined. Removal of the polyp of the cervical canal is carried out with thin flexible instruments passed through the operating channel of the hysteroscope. The polyp is cut off with endoscopic scissors, forceps or a cutting loop, followed by electrocoagulation of its bed.

radio wave removal

The operation is performed in a small operating room in compliance with the general rules of asepsis and antisepsis under local anesthesia. The radiosurgical apparatus is turned on and the passive electrode is placed under the patient's buttock. The vaginal portion of the cervix is exposed with the help of mirrors and the anterior lip is fixed with bullet single-tooth forceps. Removal of the polyp of the cervical canal by radiosurgery during pregnancy is performed without prior fixation of the neck with bullet holders. Cervical mucus is removed with a dry cotton swab, the neck is treated with a disinfectant solution. The polypoid formation is removed with a loop electrode using the “cut and coagulation” operating mode of the apparatus. The effect of the incision is achieved with the help of heat generated by the resistance of tissues to the penetration of high-frequency radio waves. The radio loop is brought under the base of the polyp and the formation is excised by continuous movement of the electrode. The bed of the removed polyp is additionally coagulated with a spherical electrode. The duration of the radiosurgical operation is on average 5 minutes.

laser removal

The procedure is performed under local anesthesia under aseptic conditions. Mirrors are inserted into the vagina, cervical mucus is removed, and the cervix is fixed with bullet forceps. Removal of the polyp of the cervical canal by its vaporization is carried out under the control of a hysteroscope or a colposcope at low magnification with an adapted laser device. When performing an intervention by means of hysteroscopy, the laser guide is inserted through the operating channel of the hysteroscope. The emitting end of the laser light guide is applied to the base of the polyp (contact method) or kept at a small distance from the formation (non-contact method). Due to the conversion of high-energy laser radiation into thermal energy, instantaneous evaporation of the cellular and extracellular fluid, combustion of the stromal component of the formation occurs. The disadvantage of laser vaporization is the lack of material for histological examination. The duration of the operation is 5-10 minutes.

After polyp removal

The intervention is performed on an outpatient basis or in hospital-replacing gynecological departments. After removal of the polyp of the cervical canal (regardless of the chosen method of intervention), in a satisfactory condition, the patient is allowed to go home after 2 hours. Antibacterial and anti-inflammatory therapy is prescribed. For 7-10 days, it is recommended to exclude sexual intercourse, the use of vaginal tampons. After 10-15 days, the patient is prescribed an appointment with the attending gynecologist to discuss the results of the histological conclusion.

The use of modern technologies (laser, hysteroscopic and radio wave surgery) makes it possible to avoid the recurrence of the disease due to the effective cauterization of the bed of the removed polyp. Possible complications of the operation are the stricture of the cervical canal, the development of endometriosis, bleeding, thermal burns.

The cost of removing the polyp of the cervical canal in Moscow

The price of the operation primarily depends on the type of intervention. Traditional “twisting” with a clamp costs less than laser removal or radio wave polypectomy. Public hospitals usually offer a more affordable cost compared to private medical institutions. In addition, the price of removing a cervical canal polyp in Moscow is affected by the type of anesthesia (local, infiltrative, paracervical, general), the list of drugs used in the pre- and postoperative period, and the availability of additional services.