Cervical polyps Flashcards
What are cervical polyps?
Benign growths protruding from the inner surface of the cervix
What percentage of women are estimated to have cervical polyps?
2-5%
How do cervical polyps occur?
Focal hyperplasia of columnar epithelium in the endocervix
- chronic inflammation
- Abnormal response to oestrogen
- Localised congestion of cervical vasculature
Who are cervical polyps more common in
Multigravidae
50-60yrs old
Describe the clinical features of cervical polyps
Often asymptomatic
Abnormal vaginal bleeding - menorrhagia, post menopausal bleeding, post-coital, intermenstrual bleeding
Increased vaginal discharge
Infertility if large enough to occlude the cervical canal
What can be seen on speculum exam in the case of cervical polyps?
Polypoid growths projecting through the external os
What must you exclude in the case of cervical polyps?
Endometrial carcinoma
STIs
Cancer
What are the investigations for cervical polyps?
Histological diagnosis after removal
Triple swabs if suggestion of infection - endocervical and high vaginal
Cervical smear to rule out cervical intraepithelial neoplasia
Ultrasound to assess endometrial cavity as they may occur alongside endometrial polyps
What do cervical polyps have a risk of undergoing?
Malignant transformation
How are cervical polps managed?
Removal - polypectomy forceps and twist several times, any bleeding cauterised with silver nitrate
Large polyps may require removal by diathermy loop excision in colposcopy clinic or under GA if large
Send any excised polyp off for histological examination
What are the complications of removing a polyp?
Infection
Haemorrhage
Uterine perforation
