Endometrial polyp in the uterus: causes, treatment, complications
The content of the article:
- The causes of endometrial polyps in the uterus
- Classification of endometrial polyps
- Possible endometrial polyp symptoms
- Effect of endometrial polyps on pregnancy
- Diagnostics
-
Treatment of endometrial polyps in the uterus
- Conservative therapy
- Operative intervention
- ethnoscience
- Prevention
- Possible consequences
- Video
Endometrial polyp is a benign nodular exophytic formation of the mucous membrane of the body of the uterus. It consists of a fibrous stroma, glands and a tangle of thick-walled blood vessels, looks like a round or oval growth on a thin stem or broad base. On average, its dimensions vary from 1–2 mm to 10–40 mm and more.
Endometrial polyps can vary in size and shape
There are both single and multiple polyps. In the second case, the diagnosis is made of polyposis of the inner layer of the uterus. This pathology is most common in nulliparous women over 35 years old.
Treatment tactics directly depend on the size, number and location of the growth. In most cases, the pathology proceeds without pronounced symptoms, which delays the process of its timely diagnosis. The disease can cause the development of intrauterine bleeding, the absence of pregnancy and spontaneous abortion.
It should be borne in mind that women over 45 years of age are more likely to develop life-threatening complications, including the degeneration of growths into malignant neoplasms.
The causes of endometrial polyps in the uterus
Conditions / diseases such as:
- endometriosis;
- diabetes mellitus and other diseases of the pancreas;
- adrenal disease;
- inflammatory process in the uterus, appendages or cervix of a chronic course;
- hormonal imbalance (especially with an excess of estrogen and a deficiency of progesterone in the second phase of the menstrual cycle);
- long-term use of sex hormones or glucocorticosteroids;
- hypertonic disease;
- the presence of frequent spontaneous or surgical abortions, curettage of the uterus;
- partial elimination of the placenta after abortion or childbirth;
- surgical interventions on the ovaries and uterus;
- prolonged use of an intrauterine device.
The risk group for the appearance of endometrial polyps are overweight women who smoke or abuse alcohol, who have inherited or acquired diseases of the hepatobiliary system, disorders of the ovarian-menstrual cycle or carbohydrate metabolism.
Classification of endometrial polyps
There are the following types of endometrial polyps:
| Name | Description |
| Fibrous | Formed mostly from cells of fibrous connective tissue. May contain collagen fibers and single glands lined with non-functioning epithelial cells |
| Glandular fibrous | It mainly consists of irregularly shaped glands of various lengths. Significantly more often accompanied by impaired blood circulation and inflammation than other polyps. In general, glandular formations are rare, mainly in patients with a stable menstrual cycle |
| Adenomatous | It is extremely rare in its pure form. Usually there are tumors with focal adenomatosis. This type of growths easily transforms into malignant tumors, especially in the period after menopause in the presence of endocrine and metabolic disorders |
Possible endometrial polyp symptoms
The development of formations usually proceeds without pronounced manifestations, however, it may be accompanied by nonspecific signs characteristic of many gynecological diseases. These include:
- white discharge from the vagina;
- too heavy menstruation;
- the appearance of spotting discharge from the genital tract during the intermenstrual period or after menopause;
- bleeding after vigorous exercise or intercourse;
- pain during intercourse (most often occurs with multiple formations, large polyps or their inflammation).
Effect of endometrial polyps on pregnancy
Growths, especially those that have formed in the isthmic section of the fallopian tube, in some cases cause infertility. This is due to the fact that being in the wall of the corner of the uterus, the growth prevents the passage of sperm through the fallopian tubes.
When planning a pregnancy, endometrial formation is best removed in advance, before conception
Large growths located close to the fundus or cervix can lead to improper attachment of the placenta. In some pregnant women, this leads to partial placental abruption, malnutrition of the fetus and, as a result, spontaneous abortion.
Considering the possible negative consequences of the presence of such growths on the endometrium during pregnancy, it is better to remove them in advance, before conception. Since the therapy of pathology with modern methods is less traumatic, as a rule, after 2–3 cycles after hormonal treatment or surgery, it is much safer to plan conception and give birth.
Diagnostics
In the presence of nonspecific symptoms, the gynecologist examines the patient. If there are suspicions of neoplasms, the doctor prescribes hysteroscopy, during which he examines the uterine cavity with a special device and, if necessary, takes a photo.
Ultrasound allows you to determine the presence of endometrial polyps and the place of their attachment
An ultrasound (ultrasound) scan of the pelvic organs may be required. This will allow you to determine the presence of growths, their number and place of attachment.
Also, a gynecologist may prescribe a diagnostic curettage of the uterine cavity followed by histology in cases where the patient complains of prolonged bleeding or frequent causeless pain in the lower abdomen.
Treatment of endometrial polyps in the uterus
Depending on the size and number of lesions, conservative treatment or surgical removal can be performed.
Conservative therapy
If the patient does not have painful sensations, and the size of the growths does not exceed a few millimeters, the pathology can be treated with the help of hormonal drugs, subject to constant medical supervision and regular ultrasound.
Taking into account the woman's history, her age and features of the course of the disease, the following drugs are used:
- oral contraceptives (Regulon, Janine, etc.): used in patients under 35 years of age, the doctor sets the regimen on an individual basis;
- gestagens (Utrozhestan, Dyufaston): prescribed for women over the age of 35;
- gonadotropin-releasing hormone agonists (Dipherelin, Zoladex): used for menopausal changes.
These medicines, when taken correctly, help to normalize hormone levels. Thanks to this, the growths gradually dissolve and leave the body with menstrual flow.
In cases where the development of formations was caused by infection or inflammation of the pelvic organs, the gynecologist may prescribe a course of antibiotic therapy.
Operative intervention
In the presence of large polyps, their treatment is carried out in two stages:
- removal of education by minimally invasive methods;
- anti-relapse therapy.
Most often, endometrial polyps are removed using minimally invasive methods
For the prompt removal of growths, diagnostic curettage of the uterus, hysteroscopy or hysteroresectoscopy are used. The material obtained during the interventions is subsequently sent for histological examination to exclude their malignant nature.
After removal of polyps, the patient is prescribed hormonal agents to normalize hormonal imbalance. This stage lasts on average 3 months, during which the woman regularly takes the medication prescribed by the doctor, without violating the recommended doses.
ethnoscience
According to the doctor's prescription, traditional medicine recipes can be used as an additional treatment to the main therapy. The following are considered the most effective for polyps:
- herbal infusion of calendula and propolis flowers: for douching;
- infusion of celandine, lingonberry, nettle or rosehip: for oral administration.
The proportions of the components for preparation, the frequency of use and the duration of use of home medicines are prescribed by the doctor on an individual basis. Self-selection of alternative medicine recipes is not recommended.
Prevention
Preventive measures that prevent the possible formation of endometrial polyps are as follows:
- timely diagnosis and treatment of various disorders of the ovarian-menstrual cycle and neuroendocrine syndromes;
- regular visits to the gynecologist;
- maintaining an active lifestyle;
- balanced diet;
- quitting bad habits (smoking, drug use, alcohol abuse);
- refusal of abortion, intrauterine interventions;
- detailed examination and treatment of hyperplastic processes at their initial detection.
Possible consequences
The presence of polyps, as well as their untimely started or incorrectly selected treatment, can lead to secondary changes that cause the development of complications of various severity.
In many patients, in such cases, inflammatory changes, infection, epithelial dysplasia, endometrial hyperplasia, squamous cell metaplasia and impaired blood supply in the formation with the development of necrosis and ischemic changes are noted.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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