What does uterine endometrial polyp mean? Endometrial polyp: symptoms, diagnosis, treatment

One of the neoplastic diseases of the female genital area is polyposis of the uterine cavity. With such a pathology, it is required surgical treatment to remove the polyp.

What is an endometrial polyp?

Endometrial polyp in the uterus - benign neoplasm , which is an overgrowth of the basal layer of the endometrium. This layer lines the inside of the uterus, so polyps begin to grow into its cavity or are localized in the cervical area. The disease belongs to the group of hyperplastic pathologies, while polyps are single and multiple.

The disease can occur in women of any age, but women 35-50 years old and women in menopause are more at risk. In the structure of polyps, a leg and a body are distinguished, their sizes - from a couple of millimeters to several centimeters. Polyps of different histological types are diagnosed:

After childbirth, a woman may develop a placental polyp - it is caused by the presence of placental cells in the uterine cavity.

Causes of the disease

The exact causes of polyposis have not been established. It is assumed that the etiology is associated with ongoing inflammatory changes in the endometrium, as well as with hormonal disruptions in the body.

Also, theoretically, the cause of the disease can be called an increase in the growth of vascular tissue in the uterus.

If the level of estrogen in the blood rises, in some cases the body's response may be the growth of glandular or fibrous tissue.

In the presence of polyps in young women, hyperestrogenism and ovarian hormonal dysfunction are recorded in most cases. Such conditions are typical for:

• uterine fibroids;
• mastopathy;
• polycystic ovary;
• adenomyosis.

Neoplasms can develop with a decrease in production progesterone, with frequent abortions, diagnostic curettage with trauma to the uterus. Heredity plays a role in the onset of polyposis. Risk factors are diabetes mellitus, obesity, diseases thyroid gland, a sharp decrease in immunity, hypertension. Of the chronic inflammatory pathologies, the following diseases are dangerous for the subsequent development of polyposis:

• oophoritis;
• endometritis;
• adnexitis;
• STIs.

Long wearing intrauterine device, long-term use of hormones and drugs Tamoxifen is also recognized as dangerous for the appearance of uterine neoplasms.

Symptoms of polyposis

A small polyp may not show any signs of itself. But larger formations, as well as multiple polyps, always appear unpleasant sensations... The severity of sensations is not the same, depending on the severity of the course, the individual characteristics of the organism.

The main feature is violation menstrual cycle ... Menses can become irregular, and between them there is a spotting, brownish, bloody tint. Beli, or transparent selection from the vagina, also become more intense, thick, frequent. Other possible symptoms polyposis:

• bloody or white discharge after intercourse;
• anemia;
• dizziness;
• fatigue;
• weakness;
• aching abdominal pains.

With menopause, a woman may resume periods that have long ended. V individual cases patients suffer from periodic cramping pains in the groin, lower abdomen.

Pain during sex usually occurs if the polyp is located on the cervix or at the bottom of the body of an organ.

The main complication of the pathology is infertility. Polyps can interfere with the embryo's attachment to the uterus. Also, a number of neoplasms pose a threat of cancerous degeneration and must be urgently removed.

Diagnosis and treatment of polyps

Usually, the diagnosis of polyposis for an experienced gynecologist is not difficult. If benign tumor located on the neck, it will be visible even on examination in the mirrors. Externally, the polyp has pink tint protrudes over a healthy mucous membrane.

And yet, to detect most formations, additional diagnostic steps should be taken:

It is necessary to differentiate endometrial polyposis with endometriosis, uterine myoma, frozen pregnancy, and other uterine tumors.

Drug treatment is indicated to regulate the cycle and is usually carried out after the tumor has been removed. The drugs of choice can be:

1. Oral contraceptives estrogen-progestogenic type. Prescribed up to 35 years of age (Yarina, Zhanin).
2. Gestagens... Suitable after 35 years in the presence of polyposis (Utrozhestan, Dyufaston).
3. Spirals with levonorgestrel (Mirena). Set for 5 years if the woman is not planning a pregnancy.

Also, the therapy of concomitant diseases - diabetes, thyroid diseases, etc. is mandatory.

Surgery for endometrial polyposis

Most often, curettage of the polyp from the uterus is done. It involves the mechanical removal of the inner layer of the organ under the local, general anesthesia, resembles an abortion technique. The disadvantage is the frequent recurrence, because the legs of the polyps remain in the endometrium. It is most advisable to do such an operation for postmenopausal women.

Other operational methods treatment:

1. Treatment hysteroscopy... Under anesthesia, a camera and instruments are inserted into the uterus, and the polyp is excised with the stem without damaging healthy tissue. For large formations, the polyp leg is twisted.
2. Cryodestruction... Involves the freezing of small neoplasms liquid nitrogen.
3. Laser therapy and radiodestruction... Polyps are removed using one of the minimally invasive techniques - a laser beam or a radio knife. Relapse after these treatments is unlikely.

If an adenomatous polyp is detected after 45-50 years, removal of the uterus is indicated. If there are serious endocrine disorders or a high risk of cancer, the uterus is excised with the appendages. In young women, only the neoplasm is removed, after which they are closely monitored for the condition reproductive system.

Traditional treatment

Folk remedies are unlikely to completely remove the polyp, but you can normalize hormonal background and prevent new formations from emerging. There are also known cases of reduction in size of polyps, especially glandular ones.

It is impossible to use aggressive agents (onions, garlic, etc.) against polyposis - they can burn the mucous membrane and greatly harm.

The most popular treatment is boron uterus ... 5 tablespoons of herbs should be poured with 500 ml of vodka, insist in the dark for 2 weeks. Drink 40 drops three times / day before meals for a month. You can also prepare a collection of equal parts:

Cook a tablespoon of the collection in 400 ml of boiling water for 15 minutes, cool. Drink 1/3 cup three times / day for a month.

Endometrial polyp during pregnancy

In pregnant women, such neoplasms are often found. Most often, they appear even before conception, but during pregnancy they can begin to grow in size. Removal of polyps in pregnant women is usually not performed; the operation is planned after delivery. The risk of interruption of gestation is with multiple and large formations.

Also, in many patients, neoplasms become the cause of infertility, therefore, it is best to be thoroughly examined at the planning stage. To do this, you need to go through:

• Ultrasound or MRI;
• blood tests for estrogen and progesterone.

After polypectomy, it is recommended to abstain from pregnancy for a year. Sometimes a woman who has given birth develops a polyp from the tissues of the placenta. In this case, after childbirth, more prolonged than normal, uterine bleeding, profuse, accompanied by abdominal pain, is disturbing. Polyps are removed with the remnants of the placenta, and then curettage is done.

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- focal hyperplasia of the endometrium, characterized by pathological proliferation of the mucous membrane of the uterine cavity in the form of single or multiple neoplasms on a broad base or pedicle. Polyps of the uterus are manifested by uterine bleeding, recurrent pain, infertility. Uterine polyps are diagnosed during a comprehensive gynecological examination - examination, ultrasound, hysteroscopy, histological examination. Treatment of uterine polyps is surgical, including polypectomy and curettage of the uterine cavity, sometimes - supravaginal amputation or extirpation of the uterus.

General information

Uterine polyps, or endometrial polyps, are local benign outgrowths from the basal layer of endometrioid cells that rise above the uterine lining in the form of separate tubercles. The size of uterine polyps varies widely - from a few millimeters (the size of a sesame seed) to several centimeters (a golf ball). Endometrial polyps can be either single or multiple, associated with the wall of the uterus with a thin stalk or a wide base. In the case of multiple endometrial polyps, they speak of uterine polyposis.

Endometrioid polyps usually do not spread beyond the uterine cavity, but in rare cases they can grow through the cervical canal into the vagina. Uterine polyps are detected in patients with various age groups- young girls, women of middle and climacteric age; the frequency of pathology ranges from 6 to 20%. Endometrial polyps are often combined with polyps of the cervical canal. Uterine polyps in gynecology are regarded as a precancerous condition and must be removed.

Classification of uterine polyps

The structure of the uterine polyp is represented by three main components: the endometrial glands, the endometrial stroma and the central vascular canal. The surface of the polyp is covered with epithelium, the pedicle includes the fibrous stroma and thick-walled vessels. Polyps of the uterus can ulcerate, become infected, necrotic, and undergo cellular metaplasia.

According to the morphological structure, it is customary to distinguish polyps of the uterus of the glandular, glandular-fibrous, fibrous and adenomatous types. Polyps of the uterus of the glandular type are formed by the endometrial tissue containing the glands; develop more often in young age... Glandular fibrous polyposis formations are microscopically represented by the endometrial glands and connective tissue(stroma); are found in women of mature age. Fibrous type uterine polyps are formed mainly by dense connective tissue, in which there are single glands; such polyps are usually diagnosed in women over 40. Adenomatous polyps of the uterus consist of glandular epithelium with signs of proliferation, structural reorganization of the glands; have the prerequisites for the transition to endometrial cancer, therefore, they require increased attention.

Among the polyps of the uterus, placental polyps are distinguished separately, formed from fragments of the placenta that has not been removed completely due to complicated abortion, childbirth, spontaneous abortion, frozen pregnancy. Placental polyps of the uterus appear long-lasting, profuse bleeding, which in the future can lead to infection and infertility.

Reasons for the development of uterine polyps

In the genesis of uterine polyps the main role is assigned to neurohormonal influence and inflammatory changes endometrium. Polyps of the uterus, as a rule, develop against the background of hormonal dysfunction of the ovaries and hyperestrogenism, which are accompanied by focal hyperplasia endometrium in the form of polypoid growths of the mucous membrane. Along with uterine polyps, such patients may also have other diseases caused by estrogenism - glandular hyperplasia of the endometrium, uterine fibroma, adenomyosis, mastopathy, polycystic ovaries, etc.

The occurrence of uterine polyps is promoted by chronic genital infections and female inflammatory diseases(endometritis, adnexitis, oophoritis), trauma to the uterus by surgical abortion, endometrial scraping, prolonged wearing of the IUD. The risk group for the development of endometrial polyps includes women with arterial hypertension, obesity, thyroid diseases, diabetes mellitus, immune disorders, neuropsychic trauma.

Symptoms of uterine polyps

Regardless of the structure of the uterine polyps, they all cause similar symptoms. After a period of asymptomatic course, dysfunctional uterine bleeding occurs, which can be cyclical or acyclic. With polyps of the uterus, menorrhagias are noted - profuse menstruation, bloody premenstrual discharge, smearing bleeding outside of menstruation and after intercourse, metrorrhagia, bleeding in menopause. Constant blood loss often leads to significant anemization, accompanied by pallor. skin, dizziness, weakness.

For uterine polyps large sizes the appearance of pathological mucous leucorrhoea, cramping pains in the lower abdomen, discomfort and pain during intercourse is typical. Among women reproductive age endometrial polyps often cause infertility, in pregnant women - they increase the risk of miscarriage and premature birth.

The symptoms of uterine polyps are similar to the manifestations of endometriosis, uterine fibroids, and the threat of miscarriage, therefore, they require a professional examination by a gynecologist.

Diagnosis of uterine polyps

Examination for uterine polyps includes collecting a gynecological and reproductive history, vaginal examination, pelvic ultrasound, hysteroscopy and metrography, separate diagnostic curettage with histological examination of the endometrium.

With a fibrous structure of the uterine polyp and the absence of menstrual dysfunction, treatment is limited to polypectomy with curettage of the uterus. Glandular or glandular fibrous polyps of the uterus after their removal at any age require additional hormonal treatment... To normalize hormonal processes, a selection is made oral contraception(COC - ethinyl estradiol in combination with dienogest or desogestrel), setting the hormonal intrauterine device Mirena, treatment with gestagens (progesterone, norethisterone, dydrogesterone).

If adenomatous polyps of the uterus are detected, more radical treatment... For women of premenopausal and postmenopausal age, the removal of the uterus is performed - supravaginal amputation or hysterectomy. In case of oncological alertness or the presence of endocrine disorders, pangysterectomy is indicated - removal of the uterus with adnexectomy.

Forecast and prevention of uterine polyps

A feature of the course of uterine polyps is their tendency to relapse. Recurrent uterine polyps in 1.5% of cases are susceptible to malignant transformation; the greatest risk of developing endometrial cancer is associated with adenomatous polyps. Therefore, after the end of treatment for uterine polyps, the patients remain under the supervision of a gynecologist. In the absence of treatment for uterine polyps, anemia and infertility develop. The presence of endometrial polyps increases the likelihood of miscarriage and requires taking this factor into account during pregnancy.

Prevention of endometrial polyps consists in timely and careful treatment of inflammatory diseases of the uterus and appendages, correction of ovarian dysfunction, and careful intrauterine manipulation.

The main symptoms are:

An endometrial polyp is a neoplasm that develops from the cells of the endometrium lining the uterus. The disease usually occurs in women aged 35 and older, and the number of polyps in the uterus can be either single or multiple. When several polyps occur, it is said that the fair sex has endometrial polyposis. The method of treatment of this pathology is mainly hysteroscopy with curettage.

Varieties

Neoplasms of a benign nature in the organ cavity differ in their appearance, and are oval, round and oblong, as well as:

• on the leg;
• on a broad basis.

Taking into account the peculiarities of the cellular structure, such neoplasms are:

• fibrous;
• glandular;
• adenomatous;
• glandular fibrous.

The endometrial glandular polyp consists of stromal cells with small inclusions of other tissues. Fibrous includes only fibrous cells, and no others. If we talk about the glandular fibrous polyp of the endometrium, then, as the name implies, its structure includes fibrous and glandular cells. But its basis is still fibrous cells. But the adenomatous polyp of the endometrium is a rather serious pathology, since it tends to degenerate into cancerous tumor... It is based on glandular cells, some of which are atypical.

In young women, predominantly glandular formations are found, but in women in premenopausal and menopause predominantly fibrous and adenomatous appear, therefore in mature age it is extremely important to regularly visit a gynecologist, which allows you not to miss the appearance of a neoplasm.

As for the size, the neoplasms are small, medium and large. Usually, small polyps are asymptomatic and are discovered incidentally during prophylactic gynecological examination patients. Medium and large polyps have pronounced manifestations, however, the symptoms of the pathology are similar to the symptoms of other diseases of the genital area, therefore, when they are detected, a thorough examination is required to make the correct diagnosis.

The causes of polyps

Endometrial polyposis - pathological condition not uncommon, and the reasons for its appearance are well understood. So, very often a glandular polyp of the endometrium can occur in a woman who is faced with hormonal disorders. That is, when there is not enough progesterone in her body, and, conversely, there is too much estrogen. Such hormonal disbalance can occur during adolescence or onset, and at any age in women taking hormonal contraception or other hormonal drugs.

Hormonal disruption occurs in the body of the fair sex during pregnancy, therefore, the first signs of the disease may appear during this period. Or, endometrial polyposis can develop after pregnancy, when the body is recovering.

Also, very often endometrial polyposis develops after traumatic injuries the walls of the uterus, which can occur when:

• miscarriages;
• closed and open injuries;
• abortion;
• long-term use of the IUD;
• diagnostic curettage.

This category of reasons for the development of such a pathology as endometrial polyposis includes childbirth with incomplete removal of the placenta. The blood clots and fibrin remaining in the uterine cavity are eventually replaced by connective tissue and turn into a polyposis neoplasm.

There are other reasons that can cause endometrial polyposis in women. In particular, a polyp can occur due to constant and nervous strain, especially in women with a labile nervous system.

Chronic inflammatory processes in the organs of the reproductive system, such as inflammatory processes in the appendages, genital infections, etc., can cause pathology.

With various endocrine disorders, the formation of polyps in the uterus is also not uncommon. For example, women who suffer or have thyroid pathology face this. is also a predisposing factor - overweight women suffer from the appearance of polyps in the uterus more often than women of asthenic physique. And of course, the disease can appear as a result of a general decrease in immunity. Not the least role is played by heredity in the development of this pathology.

Symptoms

Depending on what type of polyp a woman has and what size it is, there are different symptoms diseases. At the same time, there is general symptoms characteristic of neoplasms in the uterine cavity. These include:

• the appearance of blood between periods (bloody bleeding or heavy bleeding, reminiscent of menstruation);
• painful periods that are irregular;
• pain in the lower abdomen, which has the character of aching;
• soreness (mild to severe) during intercourse;
• bleeding after sexual intercourse;
• the appearance of discharge with unpleasant odor, which may have a yellowish tinge (this symptom occurs when a polyp in the uterine cavity becomes infected and inflamed).

Due to the fact that polyps can bleed, the patient usually develops, which is characterized by pallor of the skin, dizziness, general weakness and increased fatigue... Tinnitus and irritability may also appear.

In women, after the onset of menopause, the symptoms of this disease are manifested by the appearance of uterine bleeding (reminiscent of menstruation). The impossibility of pregnancy can also be one of the symptoms of endometrial polyposis. Therefore, women who are unable to conceive a child must undergo a complete examination, including in order to exclude the presence of polyps in the genital organ.

If we talk about the symptoms of pathology in accordance with the type of polyps, then it should be noted that each type has its own characteristics of clinical manifestations. So, if a woman has a glandular polyp of the endometrium or adenomatous polyp, then they are formed against the background of endometrial hyperplasia and are hormone-dependent neoplasms. Accordingly, such women have other symptoms characteristic of hormonal disorders, these are:

• obesity;
• and other diseases.

Unfortunately, this type of polyps occurs in 70% of women with this pathology and, since they are prone to malignancy, after their detection, an urgent removal of the endometrial polyp is required.

The second type is autonomous. These include fibrous and glandular fibrous polyps of the endometrium. Symptoms in this case are not supplemented by other signs of a violation of the activity of organs and systems of the body.

Diagnostics and treatment features

The main diagnostic method to detect an endometrial polyp in women is an ultrasound scan. With its help, you can determine the size of the neoplasm, its location and even the structure. That is, ultrasound can give a complete picture of the pathology, which will allow the doctor to choose the most effective method treatment.

The disadvantage of ultrasound is the difficulty of determining neoplasms in the uterus if a woman has a glandular polyp of the endometrium, since with such a neoplasm its structure is similar to that of the endometrium, which is why it is poorly visualized.

Also, for the diagnosis of the disease, laboratory research, taking a Pap smear and hysteroscopy - examination with a hysteroscope of the mucous membrane of the uterus. Hysteroscopy is the most reliable research method, since it gives the doctor the opportunity to examine the entire uterine cavity and detect all neoplasms in it, as well as examine their structure. Hysteroscopy is performed under general anesthesia.

If a woman has an endometrial polyp, treatment without surgery will not give the desired results, so surgical removal is the only justified method. If a woman has a polyp during pregnancy, then she needs careful medical supervision, therefore, she is placed in a hospital. After pregnancy, removal of the polyp is shown, which can be carried out by the method of hysteroscopy - removal of the neoplasm using a special apparatus, followed by scraping the entire uterine cavity.

Hysteroscopy is performed only when the polyp is small, but if it is large, the endometrial polyp is removed by polypectomy.

Further therapy is determined after a control ultrasound scan, which is performed on the third day after the operation. Usually, if a woman has a glandular fibrous polyp of the endometrium or fibrous, and after the operation she does not have menstrual irregularities, the treatment does not imply the appointment of any drugs, in addition to antibiotics, to prevent the addition of a secondary infection.

If the representative of the fair sex has adenomatous or glandular polyp (which are hormone-dependent), hormone therapy is required. So, treatment after removal of the endometrial polyp in such cases will include the reception hormonal contraceptives for young women and gestagens for mature patients.

During pregnancy, treatment is not carried out, and after childbirth, when the polyp can be removed, certain medications can be prescribed, provided that the woman does not breastfeed the baby. Or the doctor postpones the hysteroscopy until the mother stops feeding the baby, and then the operation and subsequent treatment are performed.

Is everything in the article correct from a medical point of view?

Only answer if you have proven medical knowledge

What is uterine endometrial polyposis in women? A qualified gynecologist will answer this question. Endometrial polyposis is one of the most common pathologies of the female body. This problem refers to benign formations that form in the endometrial layer. Almost all women can be affected by this ailment, including girls who have begun puberty, but most often women from 35 to 60 years old suffer.

What is endometrial polyposis

Over time, when this problem appears, the first symptoms appear, by which pathology can be determined. If a woman has suspicions, it is worth seeking advice.

What is uterine polyposis? Very often, neoplasms called polyps can appear on the lining of the uterus. In medical terminology, such a defect is called polyposis of the endometrium of the uterus.

Each neoplasm is a round growth on a thick base, in other words, a body with a leg. The surface of such a polyp is porous, burgundy, sometimes with a yellowish tint.

The size of the neoplasm can be from 2 m to 3 cm. It can be either one or many, it is these properties that distinguish polyposis.

This defect in a woman is located in the uterine cavity and, in very rare cases, can give rise to growth in the vagina.

What are the types of polyps of the endometrium of the uterus in women?

What are the types of uterine polyposis? As described above, this defect is benign, but sometimes it can develop into a malignant stage. Research in this area says that only 2% of all cases were reborn in malignant neoplasms.

By structure, the following types of polyps can be distinguished:

• glandular growths;
• fibrous;
• glandular fibrous;
• placental;
• adenomatous.

Separately, it should be noted that it is the last species that is the most dangerous, since it is the fastest transforming into malignant tumor... It is generally accepted that this type is a precancerous condition.

Sometimes, with endometrial polyposis, pregnancy occurs. As a rule, these conditions are practically incompatible, since due to this defect, a woman cannot become pregnant. But if this happened, then it is worth knowing that such a pathology is a direct threat to the bearing of a child, and in some cases, defects in the unborn child.

What are the reasons for this defect? To date exact reasons the appearance of endometrial polyposis is not known. There are a number of doctors who are inclined to several theories that the following factors provoke the onset of this pathology:

• hormonal disorders the female body;
• trauma resulting from abortion;
• inflammatory processes;
• premature birth or miscarriage;
• diseases endocrine system;
• diabetes;
• hypertension;
• heredity;
• the body's response to treatment for other tumors.

How can this pathology be detected in most women?
At the very beginning of the development of this ailment, there are practically no symptoms. And basically, such neoplasms are detected by chance, for example, when visiting a clinic or a routine examination by a gynecologist.

When polyps begin to grow, the first symptom that a woman experiences is menstrual irregularities. The patient has frequent delays in menstruation, the discharge may be scanty or, conversely, too abundant. And quite often, after menstruation, the patient may have discharge of ichor.

Another symptom is the appearance of pain. They can be cramping or aching in nature. Quite often, sexual intercourse is accompanied by pain and discomfort, and the woman's condition worsens, dizziness, drowsiness, fatigue and pallor of the skin appear. Anemia also gradually develops.

How is the patient diagnosed? To start curative therapy, it is necessary to conduct an inspection. The doctor conducts a visual examination, then a detailed survey of the patient's complaints takes place. Polyps are clearly visible using gynecological mirrors. Thanks to this, the primary diagnosis is established.

The next step is a hysteroscopy examination. This method helps to perform a detailed examination and taking a sample of the polyp for examination.

This device is a flexible tube that is inserted into the cavity through the cervical canal.

In parallel, an ultrasound scan of the small pelvis, smears and blood sampling are prescribed. Full examination includes an x-ray of the uterine cavity. In this way, it is possible to obtain detailed pictures with all the neoplasms and their features. This kind diagnostics helps to determine the degree of damage to the cavity with polyps.

How is the treatment of polyposis of the endometrium of the uterus

How is polyposis treated? A woman can receive adequate treatment after complete diagnostics this problem. The most effective method today is surgery. A procedure that has proven itself with the best side, Is an endoscopic polypectomy - curettage of all neoplasms and cauterization of all cleaned areas. When the surgery is successful, there will be slight bleeding for two weeks and may appear pain like spasms. This is a normal process, and soon all alarming symptoms will go away.

When the operation is performed, a course is assigned drug therapy... This course consists of hormonal, immune drugs and vitamins. Which ones exactly medicines appoint a woman - this is a purely individual approach. It all depends on the age of the patient and her tolerance of certain components contained in the medicines.

It is important to understand that ethnoscience will not be able to help in such a situation, but aggravate this problem will turn out doubly. It must be remembered that if we are talking about the adenomatous form, then this is a precancerous degree. Unfortunately, this form of the disease can be cured more radically. Therefore, an urgent need to see a doctor.

How is the prevention of the disease carried out in women? There are 2 most dangerous complications that polyps give - infertility and cancer. That is why it is so important to timely identify this defect and start a fight with him. But the saddest thing is that polyps tend to come back, in other words, a relapse may occur.

Therefore, it is very important to take preventive measures. The list also includes a scheduled examination by a gynecologist, which is sufficient once a year. It will also be important timely treatment of all inflammatory processes in the uterus and appendages. Also, regular use of oral contraceptives is mandatory, as they will help regulate hormonal levels.

Women Health it is very important not only for the woman herself, but also for relatives. Endometrial polyposis is a very complex pathology that must be identified and treated in time. Every woman, especially one who is preparing to become a mother, is simply obliged to monitor her health and well-being for the sake of the health of the unborn child.

Content

Recently, more and more often women undergoing a planned gynecological ultrasound, learn about the presence of a polyp in the uterus. This pathology arises from different reasons, representing the multiplication of glandular and fibrous tissue. An endometrial polyp in the uterus with a small size does not give any symptoms at all, but when it grows, the operation is a mandatory stage of therapy, since there is a high risk of the neoplasm developing into cancer.

What is a polyp

A focal proliferation of the uterine mucosa of a benign nature, which is an outgrowth of the mucosal layer, is called an endometrial polyp (ICD-10 code). The foci can be both single and multiple. Most often, the growths are small, only a few millimeters, but sometimes they reach several centimeters in size. Multiple lesions or re-formed after resection indicate the development of a disease such as endometrial polyposis. The proliferation of uterine tissues is found in women of any age, but is more often diagnosed after 35 years.

How fast does a polyp grow?

The sizes of the growths can be different, but more often they do not exceed 10 mm. The glandular fibrous polyp of the endometrium may not cause trouble for a woman for a long time, but if there are provoking factors, for example, pregnancy, curettage of the uterine cavity, surgical abortion, progesterone deficiency, then polyposis formations can increase due to the large production of secretory fluid. The growth rate depends on the patient's state of health. The danger of growths is not in size, but in the possibility of transforming their cells into malignant neoplasms.

Symptoms

Single growths of small size are formed without any symptoms. Mostly they are an accidental find during ultrasound examination uterine cavity. The main signs of an endometrial polyp are infertility or non-occurrence of the desired pregnancy against the background general health the female body. After the growth of neoplasms, the following symptoms appear:

• abundant painful menstruation;
• uterine bleeding that occurs in the middle of the cycle;
• bloody discharge after intercourse outside of menstruation;
• enlarged leucorrhoea of ​​a thicker consistency with a whitish tinge.

Causes of occurrence

Doctors cannot give a definite answer to this question. It is only obvious that the endometrial growth occurs against the background of a hormonal disorder, which is in the nature of a lack of progesterone. However, this condition is the onset of many other diseases. If an endometrial polyp is found in the uterus, then the reasons may be as follows:

• ovarian problem;
• endometrial injury due to surgery;
• difficult labor, dysfunctional pregnancy, after which foreign tissues remain in the uterus;
• endocrine pathologies;
• lingering stress;
• inflammatory diseases of the genital organs of the chronic form.

Kinds

The mucous membrane of the uterus consists of two layers - the basal (germ), located on the myometrium, and the functional (external), facing the organ cavity. Polyps are formed mainly from the cells of the basal layer in the form of glandular growths. Their classification implies subdivision according to the type of location: bottom, walls, cervix and histological structure:

• glandular;
• fibrous;
• glandular fibrous;
• cystic;
• adenomatous.

Complications

If you delay the diagnosis or visit a doctor, then if the polyp in the uterus is not treated in time, some complications may arise. Among them:

• severe post-hemorrhagic anemia;
• bleeding hazardous to health;
• infringement of the build-up;
• overgrowth of the endometrium to a large size;
• uterine fibroids;
• polyp necrosis with ischemic changes;
• endometrial cancer.

Polyposis during pregnancy

In most cases, in the presence of a polyp, the long-awaited pregnancy does not occur, so the operation to remove it immediately resolves the issue of infertility. If the woman nevertheless becomes pregnant, then the surgical intervention is postponed for postpartum period... No dangerous influence polyposis does not affect the health of the mother and the full development of the child. However, if they form in the cervical canal in a pregnant woman, then she is prescribed antimicrobial therapy.

Diagnostics

In modern conditions, it is not difficult to determine the presence of endometrial polyposis. If polyps are located in a woman in the cervical canal, then they can be seen when examining the cervical pharynx as a neoplasm Pink colour... However, it is not always possible to see them during the examination. In most cases, polyposis is diagnosed with additional research methods:

1. Ultrasound of the pelvic organs. This method is informative if the patient has glandular fibrous or fibrous neoplasms. In this case, the uterine cavity is expanded and echo signs of endometrial hyperplasia are determined.
2. Histology of scrapings from the uterine cavity. The method allows you to identify the presence of a polyp and determine its structure.

Hysteroscopy

This is a gynecological procedure in which a probe with LEDs and a video camera is inserted into the uterus. When diagnosing endometrial growths, the doctor examines the condition of the mucous membrane in order to refute or substantiate the alleged diagnosis. Operative hysteroscopy involves removing the polyp. The indications for such a diagnosis are:

• suspicion of malignant neoplasms;
• overgrowth of mucous membranes (endometriosis);
• the assumption of the presence of a tumor (fibroids);
• fragments of the fetal membrane remaining after childbirth in the cavity;
• excessive profusion or irregularity of menstruation;
• infertility or repeated miscarriages;
• vaginal bleeding outside the cycle.

Treatment

The polyp can resolve on its own after the onset of menopause. In all other cases, it must be treated. Therapeutic methods have three schemes: constant monitoring of a small build-up, the use of medications, excision surgically... When choosing a method of treatment, the doctor takes into account the type and size of the formation, the patient's age, symptoms, her wishes for future pregnancies and the ability to bear a child. If surgical removal is chosen, then hormone therapy is prescribed in parallel.

Without surgery

Surgical treatment is indicated only for atypical and fibrous polyps. In all other cases, drug treatment is possible. Conservative methods can be appointed nulliparous women, with contraindications to surgery or with a categorical refusal of the patient from surgery. For the treatment of mucous glandular and placental polyps, it is allowed to use folk recipes... After treatment of formations in the uterus, a woman should be observed by a gynecologist, because relapses of the disease may again appear.

Medication

Conservative treatment phased and multidimensional. It includes drug therapy, hormones, homeopathy. Conservative treatment is aimed at suppressing the growth of uterine tissue, the disappearance of the neoplasm, and reducing the risk of complications. Popular medicines include:

1. Janine. Combined oral contraceptive, restoring the balance of hormones, stimulating the production of progesterone. Take pills from the first to the last day of menstruation. The duration of treatment is determined by the doctor individually. During the use of the medication, it is possible side effects: depression, decreased libido, stomach discomfort.
2. Duphaston. Gestagen, active substance which is the female sex hormone progesterone. The drug restores homeostasis, improves the menstrual cycle, normalizes progesterone levels, and improves the functioning of the endocrine system. They drink tablets 1 pc / day for 3-6 months. The drug is not prescribed for patients suffering from lactase deficiency.
3. Nafarelin. A drug from the group of agonists. Nafarelin is an analogue of gonadotropin-releasing, which stimulates the release of pituitary hormones. Reduces the amount of estrogen that provokes the growth of the endometrium. The course of treatment is from 3 months to six months. Daily dose- 400 mcg. Among adverse reactions possible reddening of the face, vaginal dryness, a decrease in the size of the mammary glands, emotional lability.

Folk remedies

To help female body cope with the disease faster, doctors recommend along with drug treatment use products that contain natural ingredients:

1. Infusion of celandine. Liter jar plants collected during flowering, pour 1 liter of boiling water, cover with a towel, leave for 4 hours. At the end of the time, strain the infusion and take orally 3 times / day half an hour before meals. The course of treatment is 2 weeks. It is recommended to repeat the treatment after 7 days. You need to start drinking the medicine with small doses - 1 tsp. Gradually, a single dosage is increased to 3 tbsp. l.
2. Kalina. During the month, every day you need to eat 3 handfuls of berries. Viburnum should be eaten by the piece, chewing thoroughly.

Removal of the endometrial polyp

Surgery to remove a polyp in the uterus is called polypectomy. Exactly this effective treatment polyposis, in contrast to conservative and traditional therapy... Removal is carried out at the request of the patient immediately after its diagnosis. If the woman is pregnant, then the operation is scheduled after childbirth. Surgical intervention carried out in a hospital under anesthesia using hysteroscopy.

The doctor preliminarily examines the uterine cavity, identifies the size and location of the growths, and then removes them. For prophylaxis, the site of excision is cauterized with liquid nitrogen or electric shock... Large pedunculated polyps are removed by unscrewing. After the operation, the uterus is scraped out, and the resulting material is sent for histological examination.

Treatment after removal of the polyp

At the end of the operation, to exclude recurrence, the patient is shown repeated hysteroscopy and supportive treatment. When choosing a tactic, the nature of distant education, concomitant diseases of the reproductive system are taken into account. In the presence of menstrual irregularities, hormone therapy is performed. If uterine fibroids are present, the doctor advises to establish a hormonal coil. Anti-inflammatory treatment is also carried out, in which a course of antibiotics is prescribed.

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