cervical polyps
Introduction
Introduction to cervical polyps Cervical polyps are a clinical manifestation of chronic cervicitis in common gynecological diseases. It is because the chronic inflammation stimulates the local proliferation of the cervical mucosa tissue, and because the uterus itself has a tendency to reject, the hyperplastic mucosa gradually changes from the basal to the external cervix and forms a polypoid change, so it is also called the cervix. Membrane polyps. Generally, the volume is small, the diameter is less than 1 cm, single or multiple, bright red, soft, easy to bleed, slender and slender, and the appearance of water droplets forms an oblate body. Another type of cervical polyp occurs in the cervicovaginal region. This polyp is superficial and protrudes to the surface. The base is wide, the color is reddish, and the texture is tough. Most of the uterine polyps are benign, and there are very few malignant changes. The malignant rate is 0.2-0.4%. If the cervical polyps are removed, they often relapse. basic knowledge The proportion of illness: 1.3% Susceptible people: good for adult women Mode of infection: non-infectious Complications: cervicitis cervical erosion
Cause
Causes of cervical polyps
Inflammatory factors (30%):
It is generally believed to be caused by long-term stimulation of chronic inflammation. Long-term inflammatory stimulation promotes hyperplasia of the cervical mucosa. In addition, the uterus has a tendency to exclude foreign bodies, so that the proliferating mucosa gradually protrudes from the basal to the external cervix to form polyps.
Endocrine disorders (20%):
In particular, estrogen levels are too high, estrogen promotes the development of the vagina, uterus, fallopian tubes and ovaries themselves, while the endometrium proliferates to produce menstruation. It can also promote the accumulation of subcutaneous fat, promote the retention of sodium and water in the body, and the deposition of calcium in the bone.
Pathogen infection (15%):
Usually caused by childbirth, miscarriage, puerperal infection, surgical operation or mechanical stimulation, sexual intercourse damage the cervix, pathogen invasion and infection.
Prevention
Cervical polyp prevention
Cervical polyps can be prevented, in addition to the menstrual period, postpartum or post-abortion health care, daily life, pay attention to the genital hygiene, prevent vaginal inflammation and cervical erosion, while maintaining sexual hygiene, in addition, to be diligently It is advisable to wear cotton underwear and wash and change frequently. On this basis, regular inspection of women's diseases is also very important.
Complication
Cervical polyp complications Complications Cervicitis Cervical erosion
Large polyps or polyps that protrude into the neck tube are prone to secondary infections and necrosis, and cause bloody secretions of irregular bleeding and malodor.
Symptom
Cervical polyp symptoms Common symptoms Polyp leucorrhea increased cervix has a painful cervical mucus purulent discharge cervical bleeding contact bleeding
Cervical polyps are easily overlooked. Because more than one third of the patients lack obvious symptoms.
1, bleeding
Mainly a small amount of bleeding, bright red, or a small amount of bleeding after sex, sometimes mistaken for "return", a small number of people with bleeding similar to menstruation. Can also be expressed as postmenopausal vaginal bleeding.
2, abnormal leucorrhea
Some patients usually have yellow leucorrhea, most of them have odor, or bloody leucorrhea.
3, unmarried patients are often manifested as vaginal discharge with masses
The most common type of cervical polyps is a localized intimal mass that protrudes from the uterine cavity, single or multiple, gray-red, shiny, generally small in size, with an average diameter between 0.5 and 2 cm. The small one is only 1 to 2 mm in diameter, and the large and multiple can fill the uterine cavity. The thickness of the pedicle is different, and the length can be different. The elderly can stand outside the cervix. Some pedicles are short and diffuse. Hemorrhagic necrosis often occurs on the surface of polyps, and may also be associated with infection. If the pedicle is reversed, hemorrhagic infarction occurs.
Due to the narrow pedicle, the blood supply is reduced and the polyps are highly variable. It is most prone to intravascular thrombosis of polyps, which becomes dark purple due to blood stasis, often begins to develop necrosis at the top, and may eventually rot and fall off.
Examine
Examination of cervical polyps
Gynecological examination
Acute inflammation, visible cervical congestion and edema or erosion, purulent discharge from the cervical canal, touch the cervix can have pain, or see the cervix mouth with purulent secretions, palpation of the cervix is as hard as cervical erosion or polyps, There may be contact bleeding.
2. Pathological examination
It can be seen that the center of the polyp is the longitudinal axis formed by a fibrous connective tissue. The blood vessels are dense and dense. There are tissues inherent to the cervix, including glands and interstitial. The surface is covered by cervical mucosa. The tissue composition and structure are basically the same as normal cervical tissues. This is a typical polyp tissue phase.
3. Colposcopy
There are two types of images under the colposcope depending on the epithelium covered by the surface of the cervical polyp.
(1) It is formed by hyperplasia of cervical mucosa. The polyps under colposcopy are bright red with a certain luster. The single hair has a thin pedicle. The multiple hairs are clustered, the base is wider and the pedicle is shorter.
(2) Polyps originating from the squamous epithelium on the surface of the cervix, the polyps are pink, protruding from the squamous epithelium of the cervix, the base is wider, and a few have a thin pedicle, and the texture is tough.
4. The cervical scraper shows Pap II.
5. Patients with severe disease can do cervical biopsy to confirm the diagnosis.
Diagnosis
Diagnosis and diagnosis of cervical polyps
It can be diagnosed based on clinical manifestations and gynaecological examinations.
Differential diagnosis of cervical polyps
1. Differentiation of cervical polyps and early cervical cancer: Cervical cancer has bloody or contact bleeding in the early stage, and may have papillary processes. The cervical polyps are flat or water-like red mites, soft and brittle, easy to bleed, and slender. The pathological examination of the cervical biopsy can be confirmed.
2, cervical polyps should be differentiated from submucosal uterine fibroids: submucosal uterine fibroids protrude from the surface of the uterine mucosa in the uterine cavity, its pedicle long. After the uterus contracts, the fibroids can be discharged from the cervix and suspended in the vagina. Generally, fibroids are pedicled in the uterine cavity, and the palpation is harder and rounder; while the cervical polyps have pedicles connected to the cervix, the texture is soft, and the larger one can be exposed to the outer neck.
3, cervical polyps must be identified with uterine submucosal fibroids, once diagnosed and then treated. In addition to the appearance of the traits, it can be checked by means of a probe. If the pedicle is deep and does not adhere to the neck tube, cervical polyps should be excluded, and the method of excision of cervical polyps should not be taken rashly.
