Cervical polyps

Definition

Cervical polyps are fingerlike growths originating from the mucosal surface of the cervix or endocervical canal. These small, fragile growths hang from a stalk and protrude through the cervical opening (the os).

Causes, incidence, and risk factors

The cause of cervical polyps is not completely understood, but they are frequently the result of infection. They may be associated with chronic inflammation, an abnormal local response to increased levels of estrogen, or local congestion of cervical blood vessels.

Cervical polyps are relatively common, especially in women over age 20 who have had children. Only a single polyp is present in most cases, but sometimes two or three are found. They are rare before menarche (onset of menstrual periods).

Symptoms

• Abnormal vaginal bleeding
  • After intercourse (postcoital)
  • After douching
  • Between periods
  • After menopause
• Abnormally heavy periods (menorrhagia)
• White or yellow mucous discharge (leukorrhea)
• Polyps often are asymptomatic

Signs and tests

A pelvic examination reveals smooth, red or purple, fingerlike projections from the cervical canal. A cervical biopsy typically reveals mildly atypical cells and signs of infection.

Treatment

Removal is typically done as a simple, outpatient procedure. Gentle twisting of a cervical polyp is frequently enough to remove it, but normally a polyp is removed by tying a surgical ligature around the base and cutting it off. Removal of the base is done by electrocautery or laser vaporization.

Because many polyps are infected, an antibiotic may be administered after the removal, either prophylactically or with any early signs of infection. Although most cervical polyps are benign, the excised tissue should be sent to a pathologist for microscopic examination.

Expectations (prognosis)

Typically, polyps are benign and easily removed. Regrowth of polyps is uncommon.

Complications

Some cervical cancers may first appear as a polyp. Infections may occur after removal.

Calling your health care provider

Call for an appointment with your health care provider if you are a woman, age 20 or older, and have had no prior pelvic examination and Pap smear.

Call for an appointment with your health care provider if you have not obtained a Pap smear at recommended intervals of:

• Every year initially
• For women up to age 35 or 40: every 2 to 3 years after having three negative, consecutive annual Pap smear tests and a single sexual partner or no sexual partner
• Every year for women over age 35 or 40
• Every year for women who have had multiple sexual partners
• Every year for women who are taking oral contraceptives (birth control pills)
• Every year for women who have a history of HPV (genital warts)
• Every year for women who were prenatally exposed to DES
• The frequency recommended by your health care provider after an abnormal Pap smear

Prevention

Because of the potential role of chronic inflammation, infections should always be treated in a timely manner.

Illustrations

Female reproductive anatomy

Cervical polyps

Uterus

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