Gynaecological polyp

Question 1

What is the normal epithelium of the cervix?

Answer 1

endocervix (columnar) -> transformation zone -> ectocervix (squamous)

Question 2

What is cervical ectropiaon?

Answer 2

ectocervical migration of columnar epithelium which is linked to oestrogen (like pregnancy or COCP)

Question 3

What are the S/S of cervical ectropion?

Answer 3

present with IMB, PCB, increased discharge

Question 4

What is the Ix of cervical ectropion?

Answer 4

speculum

Question 5

What is the management of cervical ectropion?

Answer 5

Reassurance, cauterisation, cryotherapy

Move from oestrogen-based contraceptives

Question 6

What is cervical polyp?

Answer 6

Overgrowth of endocervical columnar epithelium; benign; solitary

Can also be linked to oestrogen

Question 7

What are the S/S of cervical polyp?

Answer 7

Bleeding
Pain
Cycle changes

Question 8

What is the Ix of cervical polyp?

Answer 8

Histology

Question 9

What is the management of cervical polyp?

Answer 9

Reassurance

Generally advised to remove (twist off if small or surgery)

Send for histology

Question 10

What is the Ix of endometrial polyp?

Answer 10

§ TVUSS

§ Outpatient hysteroscopy (OPH) and saline infusion sonography (SIS) are the most accurate

Question 11

What is the management of endometrial polyp?

Answer 11

§ May resolve spontaneously (if small)

§ Polypectomy to alleviate AUB symptoms, optimise fertility and exclude hyperplasia/cancer

· Day-case under GA or under LA in OPD