Removal of cervical canal polyps (cervical polyps)

The loyalty program applies to surgical interventions in the inpatient department, making treatment even more affordable.

Bloody discharge between menstruations or after sexual contact may occur due to changes in the area of the cervix. One of the possible causes is a cervical canal polyp. Often, it does not bother a woman and is detected during a routine examination, but under certain conditions, the doctor may recommend its removal.

At the «Oxford Medical» medical center, the diagnosis and removal of cervical polyps are performed by experienced gynecologists using modern minimally invasive techniques. The inpatient department is equipped with expert-class equipment for diagnostic and minimally invasive gynecological procedures.

A cervical canal polyp — is a localized growth of the mucous membrane inside the cervix. Usually, it has a stalk or a broad base and may protrude from the external opening of the cervix into the vagina. Most such formations are benign, but after removal, a tissue sample is sent for histological analysis to accurately determine its structure and exclude malignant cell changes.

Doctors at «Oxford Medical» explain: cervical polyps are quite common and predominantly benign in nature. According to National Library of Medicine, they are detected in approximately 2–5% of women, most often after the age of 20, while malignant changes occur in only 0.1–0.2% of cases and more often — after menopause.

The exact causes of the appearance of cervical canal polyps have not been definitively established. Their occurrence is associated with several factors:

• chronic inflammatory processes of the cervix;

• hormonal changes, in particular the influence of estrogens;

• disturbance of local blood circulation;

• changes in the tissues of the cervix after pregnancy and childbirth.

None of these factors means that a polyp will necessarily form. It is often detected in women without obvious preconditions, so it is impossible to establish a specific cause in each case.

According to a review by Canadian Family Physician, the most characteristic symptoms of cervical polyps are intermenstrual and contact bloody discharge, although a significant proportion of formations remain asymptomatic.

Doctors at «Oxford Medical» recommend not attributing the appearance of blood solely to the presence of a polyp. Such symptoms may also accompany other diseases of the cervix and endometrium, so their cause must be established during the examination.

Not every polyp in the cervical canal needs to be removed immediately after detection. If the formation is small, does not cause symptoms, has a typical benign appearance, and the cervical screening results are normal, the doctor may recommend observation. According to a study published in PubMed, removal of asymptomatic cervical polyps with normal cervical examination results is not considered necessary.

Removal is more often recommended:

• in case of bloody discharge between menstruations or after sexual contact;

• if the formation is large, has an atypical appearance, or bleeds frequently;

• in case of recurrence of the polyp after previous removal;

• after menopause, especially in the presence of bloody discharge;

• if it is not possible to accurately determine the origin of the neoplasm or its nature based only on the examination results.

Whether a cervical canal polyp needs to be removed is determined by the gynecologist after the examination.

Polypectomy is considered a minimally traumatic gynecological intervention, but in some situations the procedure needs to be postponed.

Possible contraindications include:

• pregnancy;

• acute inflammatory diseases of the pelvic organs;

• acute infection with an increase in body temperature;

• pronounced blood clotting disorders;

• severe decompensated diseases of the internal organs.

Most such restrictions are temporary. After treatment of the infection, elimination of the inflammatory process, or stabilization of the general condition, the possibility of performing the procedure is assessed again.

Doctors at «Oxford Medical» note: polyps detected during pregnancy require a special approach. The decision on observation or intervention is made individually, taking into account the symptoms, characteristics of the formation, and course of pregnancy.

Diagnosis begins with a consultation with a gynecologist. The doctor clarifies the nature of the discharge, the characteristics of the menstrual cycle, the presence of bleeding after sexual contact, and examines the cervix using a speculum. If the formation protrudes from the cervical canal, it can often already be seen during the examination.

To clarify the diagnosis, the doctor may recommend:

• colposcopy — examination of the cervix under magnification using a special optical device;

• transvaginal ultrasound of the pelvic organs — helps assess the condition of the cervix, uterus, and endometrium;

• cervical cytology — a Pap test, during which cells from the surface of the cervix and cervical canal are examined to detect possible precancerous changes;

• testing for high-risk oncogenic human papillomavirus (HPV);

• discharge tests if there are signs of an inflammatory or infectious process.

Doctors at «Oxford Medical» explain: cytology and histology have different purposes. A Pap test helps assess cervical cells and detect possible precancerous changes, but does not determine the structure of the formation itself. Therefore, after the formation is removed, its tissue is sent for histological examination, which makes it possible to accurately determine the nature of the formation and exclude atypical or malignant changes.

Removal is performed using polypectomy — a minimally invasive procedure during which the formation is removed through the vagina and cervix, without incisions on the abdomen. The specific method depends on the shape of the polyp, the thickness of its stalk or the width of its base, and its location in the cervical canal.

For the removal of cervical polyps, the following may be used:

• Mechanical method — the polyp is grasped with a special instrument and separated from its attachment site. This method is suitable if the formation is clearly visible and has a thin stalk.

• Electrosurgical method — the tissue is excised using an electrosurgical instrument. It may be used with a thick stalk or broad base. Simultaneous coagulation of blood vessels helps reduce bleeding.

• Cryodestruction — the pathological tissue is exposed to a low temperature, as a result of which it is destroyed. This method is used less often.

If the formation is located deeper in the cervical canal and the doctor cannot fully see its base during a routine gynecological examination, hysteroscopic intervention may be required. A thin optical device with a camera — a hysteroscope — is inserted through the cervix. The image is transmitted to a monitor, so the gynecologist can see the site of attachment of the polyp and remove it under visual control.

The gynecologist chooses the method of intervention after the examination. It is important not only to completely remove the formation, but also, if possible, to obtain tissue for histological examination.

Before the procedure, the gynecologist assesses the location of the formation and determines the extent of the intervention. Removal of a polyp on the cervix is a short outpatient procedure and often does not require general anesthesia. If necessary, local anesthesia is used. If hysteroscopic intervention is required, the procedure may be performed under intravenous sedation.

The operation to remove a polyp in the cervical canal takes place in several stages:

1. Examination of the cervix. The doctor inserts a gynecological speculum and determines the exact location of the formation.

2. Removal of the polyp. The gynecologist removes the formation using the selected method. If hysteroscopic control is required, a thin device with a camera is inserted through the cervix to see the cervical canal and the site of attachment of the polyp on the monitor.

3. Treatment of the attachment site. If necessary, the doctor coagulates the blood vessels or additionally treats the base of the polyp to stop bleeding.

4. Histological examination. The removed tissue is sent to a laboratory, where its structure is determined and it is checked for the presence of atypical or malignant changes.

If changes are detected during the examination not only in the cervical canal but also in the uterine cavity, hysteroresectoscopy may be required. During such an operation, the doctor sees the inner surface of the uterus on the monitor and can precisely remove the detected formations. Unlike traditional uterine curettage, the intervention is performed under visual control, so the doctor works specifically with pathologically altered areas.

After a standard polypectomy, prolonged recovery is usually not required. If the procedure was performed without sedation, the patient may leave the clinic shortly after the intervention. After hysteroscopy under medication-induced sleep, it is necessary to remain under the supervision of medical staff for some time.

Doctors at «Oxford Medical» explain: in the first days after the procedure, slight bloody or brown discharge and mild pulling sensations in the lower abdomen may appear. Usually, they gradually decrease and do not require treatment.

After removal, it is recommended:

• during the first day, avoid significant physical exertion and then return to usual activity;

• refrain from sexual contact for approximately 7 days or until the bloody discharge has completely stopped;

• until the discharge ends, use sanitary pads instead of tampons;

• for several days, do not take a hot bath or visit a sauna or swimming pool;

• do not use vaginal suppositories or creams and do not perform douching without a gynecologist’s prescription.

If uterine polyps were removed at the same time during hysteroscopy or other manipulations were performed in the uterine cavity, bloody discharge and the recovery period may last longer.

In most cases, removal of the formation proceeds without complications. Slight bloody discharge and moderate discomfort in the first days after the procedure are considered a normal tissue reaction and gradually pass.

Possible complications include:

• heavy or prolonged bleeding;

• infectious inflammation of the cervix or pelvic organs;

• damage to the tissues of the cervix.

Doctors at «Oxford Medical» recommend consulting a gynecologist if, after the procedure, the bleeding becomes heavy, the pain intensifies, the body temperature rises above 38 °C, or the discharge develops an unpleasant odor. Such symptoms may indicate the development of a complication and require examination.

The cost of removal depends on the size and location of the formation, the selected method of intervention, the type of anesthesia, and the need for histological analysis. You can find the current price of the procedure here. The gynecologist will provide you with more precise information about the cost of medical services after the examination and diagnosis. To make an appointment for a consultation with a gynecologist, call the contact center or use the online appointment form on the website.

The information is for informational purposes and does not replace a doctor’s consultation.

Sources:

• US National Library of Medicine

• PubMed

• American College of Obstetricians and Gynecologists