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Uterine polyp

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Uterine polyp

  1. 1. UTERINE POLYPS INTRODUCTION Uterine polyps are growths attached to the inner wall of the uterus that extend into the uterine cavity. Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps, also known as endometrial polyps. These polyps are usually noncancerous (benign), although some can be cancerous or can eventually turn into cancer (precancerous polyps). Uterine polyps range in size from a few millimeters — no larger than a sesame seed — to several centimeters — golf-ball-size or larger. They attach to the uterine wall by a large base or a thin stalk. DIFFERENT TYPE OF POLYPS Mucus Fibroid Placental De Novo SecondaryChanges Of Benign Polyp Benign polyp is a clinical entity referring a tumor attached by a pedicle. Mucus the commonest type of benign uterine polyp is mucus one. It may arise from the bodyof the uterus or from the cervix. Fibroid polyp may arise from the bodyof the uterus or from the cervix. Placental polyp retained bit of placental tissue when adherent to the uterine wall get Organized with the surrounding blood clots. PATHOGENESIS Body The part of the thick endometrium project into the clarity ultimately attains a pedicle.It seems to arise from the basal endometrium surrounded by the functional zone. responsiveness to hormone. Multiple polyposis in endometrial hyperplasia Due to hyperoestrogenism is excluded from such discrete polyp. Nakedeye appearance - show a small polyp size of about 1-2 cm , look reddish and feel soft
  2. 2. Polyp may at times be long enough to make the polyp protruded from the cervix. Microscopically The core contents stromal cells , glands, and large thick walled vascular channel the surface is lined by endometrium may undergo squamous metaplasia Rarely smooth muscle invade the polyp and is then called adenomyoma. Cervical The polyp arrived from the endocervix and rarely from the ectocervix . The stimulus of Epithelial growth is probably due to hyperoestrogenism. Nakedeye appearance showthe polyp of usually small size exceeding 1-2 cm , single and Red in colour .the pedicle may at times be long enough to reach the vaginal interoitus Microscopically The stroma consists of fibrous connective tissue with numerous small blood vessels and Cervical gland the lining epithelium is tall columnar like that of endocervix. stroma dense and Fibrous and the term fibroadenomatous poly is used CLINICAL FEATURES There may not be any symptoms  Irregular menstrual bleeding — for example, having frequent, unpredictable periods of variable length and heaviness  Bleeding between menstrual periods  Excessively heavy menstrual periods  Vaginal bleeding after menopause  Infertility  Contact bleeding if the polyp is situated at or outside the cervix  Excessive vaginal discharge which may be offensive DIAGNOSIS 1-History collection 2-Physical examination per vaginal examination the uterus is bulky with the patulous cervical canal.
  3. 3. 3-Sound test to differentiate a fibroid polyp from chronic inversion, sound test is done if an uterine sound is fast all-round between the pedicle and dilating cervical canal it is a polyp incomplete chronic inversion the sound cannot be passed. 4-Transvaginalultrasound. A slender, wand-like device placed in vagina emits sound waves and creates an image of uterus, including its interior. See a polyp that's clearly present or may identify a uterine polyp as an area of thickened endometrial tissue. A related procedure, known as hysterosonography involves having salt water (saline) injected into your uterus through a small tube threaded through vagina and cervix. The saline expands uterine cavity, which gives a clearer view of the inside of uterus during the ultrasound. 5-Hysterosalpingography to detect the filling defect in fibroid polyp. 6-Hysteroscopy 7-D&E examination under anaesthesia and exploration of the uterine cavity by curette aur ovum aur ring forceps 8-Endometrial biopsy. MANAGEMENT  Watchful waiting. Small polyps without symptoms might resolve on their own. Treatment of small polyps is unnecessary unless at risk of uterine cancer.  Medication. Certain hormonal medications, including progestins and gonadotropin-releasing hormone agonists, may lessen symptoms of the polyp. But taking such medications is usually a short-term solution at best — symptoms typically recur once stop taking the medicine.  Mucous polyp a) Endometrial polyp are usually removed by uterine curettage b) In case of recurrence hysterectomy
  4. 4. Cervical polyps are removed by twisting of the pedicle the base of the pedicle should be cauterized to prevent recurrence  Fibroid polyp a) Removal politician by cutting the anterior wall of the uterus anterior hysterotomy b) Uterus to be removed hysterectomy is done with the fibroid polyp in situ.  Did fibroid line in the vagina remove by morcellement followed by transfixation sutures on the pedicle