Diagnosis and treatment of endometrial polyps
Polyps of the endometrium is a disease in which the inner layer of the uterus (endometrium) grows, forming numerous benign growths – polyps. The disease is more frequently diagnosed in middle-aged women from 35 to 55 years. The polyp in its structure has leg and body, which consists of epithelial cells. The size of polyps may vary from a few millimeters to centimeters.
Causes of endometrial polyps
Among the main causes of endometrial polyps, are the following:
- Endocrine and hormone imbalances – excess estrogen. This is a group of female hormones that affect the development of genitals and preparation for motherhood, which includes estradiol, estriol, estrone. In particular, the estrone stimulates the development of the uterus and its mucous membrane, so the excess of this hormone primarily affects the structure of the tissues of the endometrium.
- Injury of the uterus during the abortions performed surgically at the wrong or long wearing of the uterine spiral
- Abortion and miscarriages, childbirth, in which part of the placenta may remain in the uterine cavity and be replaced by connective tissue.
Inflammation of the uterus and appendages, genital infections, etc.
Types of polyps
Depending on the structure and composition of tissue there are the following types of polyps:
- Ferrous – consist of Strom (based on of connective tissue, which has a fibrous structure and pass blood and lymph vessels) and glands tissues of the uterus.
- Fibrous – composed of connective tissue.
- Glandular-fibrous – is composed of a connective and a small amount of glandular tissue.
- Adenomatous – composed of glandular epithelium, but in its structure have changed cells with signs of the restructuring of the glands. Adenomatous polyps are considered pre-cancerous conditions and can in the presence of a number of reasons to switch in endometrial cancer.
- Placental – formed after the abortion or childbirth as a result tightly attached to the uterine wall blood clot or piece of placenta.
Diagnosis of polyposis
Quite often, the polyps can not be felt and do not cause any discomfort, that is, the polyps may be asymptomatic. But if you have the following symptoms, it is reason to seek medical attention:
- menstrual cycle, often spotting in mid-cycle, in young women periods can be very generous and take the form of menorrhagia (blood loss more than 150 ml).;
- cramping and pulling pain in the abdomen;
- the inability to conceive, miscarriages;
- allocation of blood from the genital tract after sexual intercourse;
- abundant leukorrhea.
It is important to remember that the above signs and symptoms are not specific for endometrial polyps. The disease is easily confused with uterine fibroids, endometriosis, therefore, the most reliable diagnosis is ultrasound examination of the uterus (sonography).
For accurate diagnosis of polyposis should contact the doctor who will carry out an initial examination and prescribe the additional methods of diagnostics. If polyps are not only in the uterus but also in the cervical canal, the doctor will be able to see them in the outer cervical OS of the uterus during a routine inspection.
In most cases, the use of such laboratory methods of diagnostics:
- Ultrasound of the uterus and pelvic organs. This method is very effective in identifying polyps are usually clearly shows the presence of formations in the uterus and the contour of the endometrium. Thus conceived, the uterine cavity is expanded.
- Hysteroscopy. This study is under visual control using a special optical instrument, which gives the opportunity to consider in detail the formation and conduct associated operations, for example, take the material for histological examination.
- Histological examination of scrapings of the endometrium. This study of the tissue of the polyp, a determination that it is important for the diagnosis of precancerous polyps.
Methods of treatment of polyposis
Methods of treatment of polyps depend on the diagnostic results.
Most often, polyps are removed during a surgery by hysteroscopy. After removal of the mucous membrane of the uterus vystavlyaetsya, and the base of the polyp prizhivaetsya for preventing a recurrence of the disease. A few days after the operation, the control ultrasound of the pelvic organs. After the operation, the woman should monitor their health and to avoid hypothermia, physical exertion. Sexual life can be resumed in 2-3 weeks.
Depending on the shape and size of the polyp, and kind, determined with histological study, is selected and the tactics of further treatment. When fibrous polyps treatment is to remove them surgically. When glandular and fibro-glandular patients prescribed therapy to regulate hormonal levels. The women of different ages prescribed different medicines. Estrogen-progestin drugs are prescribed to women to 35 years (e.g., Yarinu, Janine, Regulon). Progestin drugs are suitable for women after 35 years (antiseptic, cough medicine). Usually, hormones take 3 to 6 months.
In cases of adenomatous type of polyps are shown in more radical treatment, as these polyps are the precursors of cancer conditions. Women of reproductive age (45-50 years) prescribed hormonal therapy after surgery to remove polyps, the older women in premenopause and postmenopausal women, shows the removal of the uterus, in some cases, removal with appendages. After surgery a woman can be spotting up to 10 days.
Endometrial polyps and pregnancy
The presence of polyps in the uterus can have a negative impact on the reproductive capacity of women. Not detected in time and not remove a polyp may lead to infertility: the lack of timely ovulation, a mechanical obstacle to the consolidation of a fertilized egg. Therefore, for a normal pregnancy need to be examined and identify possible diseases. After removal of a polyp conception is possible during the same menstrual cycle, but doctors recommend to use protection for 1-2 months to the endometrium was able to recover.
If the polyp was discovered during a pregnancy, then you should not particularly worry: it prevents the birth of a healthy child and not dangerous at the already established pregnancy. If necessary, diagnosis and treatment of polyposis in this case, can be made only after giving birth. But if there is such a need, the removal of polyps possible in the early stages of pregnancy.
Prevention of polyposis
Among the most dangerous complications of the formation of polyps secrete infertility and malignant tumor of the endometrium. Therefore, polyposis, it is important to diagnose. But also polyps have the tendency to relapse, it is imperative to apply preventive measures. These include regular supervision at the gynecologist (at least once a year to undergo routine examination), diagnosis and treatment of inflammatory processes of the uterus and appendages, refusal of surgical intervention, taking combined oral contraceptives to regulate hormonal levels.
Remember that endometrial polyps are often asymptomatic, so the prevention of it, regular doctor visits and early detection of the disease can prevent serious consequences adenomatous polyps. Other types of polyps are successfully treated using modern methods of hysteroscopy with the subsequent recovery of reproductive function.