Removal of a polyp in the uterus: conservative therapy and surgery

2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14

If a polyp is found in the uterus, treatment is prescribed. It consists in the removal of a pathological formation. But even such a radical measure does not always allow getting rid of it. This is due to the fact that any operation removes the consequences of the disease, but not its cause.

What are polyps? What are their symptoms?

This pathology is endometrial hyperplasia, when foci of mucosal growth occur. Formations are round, mushroom-shaped, with a thick base and a thin stalk, their color varies from pale pink to maroon, can be solitary and numerous.

Doctors say that the main cause of their occurrence is hormonal imbalance - mainly progesterone deficiency and excess estrogen.

Inflammatory processes of the reproductive system, mechanical damage, birth trauma, frequent abortions, and diagnostic curettage can be provoking factors.

Polyps are divided into several types:

• Fibrous;
• Glandular;
• Mixed;
• Adenomatous.

The first three types of formations are more common. In the process of diagnosis, histological examination is mandatory. It allows you to determine the state of cells of pathological tissue. If signs of proliferation are revealed in it (oncological processes arise), then the polyp is removed in the uterus and itself. This condition is considered the initial stage of cancer, so the operation is performed as soon as possible and involves such a radical intervention.

As for the symptoms, in the early stages of the development of the disease, they are practically absent. With polyposis (multiple formations) and large sizes, the first signs of pathology appear, since the contractility of the uterus and the natural process of rejection of its mucous membrane are disrupted.

The following symptoms are present:

1. Uterine bleeding;
2. Brown or bloody discharge in the middle of the cycle;
3. Pain during intercourse, lower abdomen, lower back;
4. Masses can interfere with pregnancy, interfere with conception, or lead to miscarriage.

Women planning to have children should first of all get rid of the pathology. Radical treatment and postoperative hormone therapy restore reproductive function.

Methods for surgical removal of the cervical polyp

The most effective and currently popular option is hysteroscopy followed by curettage of the cavity and cervix (polypectomy and curettage). The removed material is subject to histological examination. Other methods are also used - laser removal or separate diagnostic curettage.

The size of the formation, its structure, the woman's age, the state of the endometrium, the reasons for the development of pathology, the presence of metabolic and endocrine disorders - all these factors affect the choice of the method of treatment and the tactics of managing the patient:

• With fibrous formations, hormone therapy is necessary after surgery;
• In the presence of mixed, you can do without taking hormonal drugs, but provided that the hormonal background is normal, there is no obesity and diabetes mellitus;
• With adenomatous formations that can progress to malignant, as well as before or during menopause, extirpation of the uterus (removal) or supravaginal amputation with removal of the appendages and revision of the ovaries is indicated.

Hysteroscopy of the uterus - fast and effective removal of the polyp

This option is the least traumatic. In addition, the risk of complications after such surgery is minimal. We can say that this procedure belongs to the gentle methods.

The entire process of the operation is under the visual supervision of a doctor. An event is carried out after menstruation, no later than 10 days of the cycle. During this period, the best visualization of the organ cavity.

As a rule, the patient at this time is under general anesthesia, less often local anesthesia is used.

1. First, the doctor inserts a hysteroscope into the cervix, a thin, flexible tube with an attached video camera that transmits the image to a monitor.
2. Then the cavity of the organ is examined, the size of the formation, the place of its localization is determined.
3. After that, the polyp is removed and sent to the laboratory for histological examination.
4. Formations on the legs are "unscrewed", and the place where they were attached is cauterized by electrocoagulation or treated with a cryogenic method. In some cases, a laser is used. It destroys pathological tissues and prevents the recurrence of the disease. The hysteroscopy procedure takes 10-30 minutes.

Removal of the cervical polyp by curettage

If such a procedure is performed without the aid of a hysteroscope, it means that the doctor is working "blindly". There is a high probability that the pedicle of the formation will remain in place, then a relapse of the disease cannot be avoided. Therefore, you need to work very carefully and after removing the polyp, use coagulation of the place where it was.

The procedure is recommended to be carried out a few days before the onset of menstruation. During the operation, the cervix is dilated and the polyps are scraped from the walls with a special loop. The resulting tissues are sent for histological examination.

Surgery to remove polyps in the uterus with a laser

This type of surgical intervention does not leave scars and allows you to preserve reproductive function. In modern medical centers, in just a few hours, you can undergo a full examination, and then remove the formations. At the same time, the ability to work is not impaired, the uterus is not injured, there is no need to stay in the hospital. Pregnancy after laser removal of a polyp in the uterus can occur several months later.

The innovative methods include mini-hysteroscopy, which is characterized by the absence of cervical trauma and the need for anesthesia. The doctor chooses the method of treatment together with the patient. At the same time, mini-hysteroscopy allows you to get rid of fibroids, endometrial hyperplasia, intrauterine synechia.

• This method is gentle. The doctor can control the depth of laser penetration in layers, thereby preventing injury, reducing blood loss and recovery time.
• The laser seals the vessels, the connective tissue does not remain, which has a beneficial effect on future pregnancy.
• The rehabilitation period after laser treatment is from six months to 8 months.

What discharge appears after removal of a polyp in the uterus

After hysteroscopy, cramping pains will be present for some time. A slight discharge should be observed for about 2-3 weeks. A week after the operation, you need to undergo an examination. The doctor should prescribe restorative therapy, guided by the age of the patient, the cause of the formation of the polyp and its nature.

Consequences and complications after removal of a polyp in the uterus

1. If you have profuse bleeding, dark mucus with an unpleasant color, fever, sharp and severe pain, you should consult a doctor. In this case, a complication can be assumed - inflammation of the uterus, its perforation or a hematometer.
2. Inflammation occurs very rarely and is usually provoked by the fact that the operation was carried out against the background of a latent infection, an inflammatory process, or in the process of surgical intervention, the rules of antiseptic and septic were violated. Treatment for inflammation is with antibiotics.
3. Perforation is formed as a result of puncture of the organ wall. Such consequences arise due to the looseness of its structure or poor expansion of the neck. Small perforations are overgrown on their own, large ones are sutured.
4. Severe pain and a sharp cessation of discharge may indicate a spasm of the neck and the formation of a hematometer. Infection may occur. In this case, anti-inflammatory drugs and antispasmodics are prescribed.

After the operation, a woman should take her health more seriously, since discharge will be observed for several weeks, the rules of personal hygiene must be especially strictly observed. At this time, you can not take a bath, visit baths and saunas, swim in open water.

Shower only recommended, not hot. Overheating of the body increases bleeding. As for medicines, aspirin is prohibited. Excessive physical activity, heavy lifting are contraindicated throughout the month. Sexual contact and douching are excluded.