Endometrial polyp refers to benign neoplasms that can occur in women of any age. Due to the increased risk of degeneration of the neoplasm into cancer cells, special attention is paid to the timely treatment of this disease. Along with the main surgical intervention, there is a treatment of fibrous endometrial polyp with non-surgical methods.
Endometrial polyp - what is it
The endometrial polyp is the proliferation of cells in the uterine lining. One to several polyps from 1 millimeter to 5 centimeters in size can be observed. Most often, they appear in women aged 40 to 50 years. By structure, the polyp consists of the body and the vascular pedicle, by which it attaches to the uterine wall. It has a complex internal structure, which can be represented by glands and fibrous tissue. In the event that atypical cells are present in the composition , the polyp considers adenomatous (precancerous). Depending on the structure, 4 types of endometrial polyps are distinguished:
• Fibrous.
• Glandular.
• Iron-fibrous.
• Adenomatous.
A functional endometrial polyp is also distinguished, consisting of epithelial cells and changing during the menstrual cycle, and the basal type of polyps arising from a pathologically altered basal layer of the uterus. It is possible to determine the exact structure of education using histological analysis of the removed element. Most often, polyps remain inside the uterine cavity, in rare cases they grow into the cervix or vagina. The method of treatment is selected depending on the age of the patient and the characteristics of pathological changes. Surgery is the main method of control if an endometrial polyp is detected. Treatment without surgery with medicines is possible if the patient refuses surgery.
Causes
There are various versions of the origin of the endometrial polyp. The main one is hormonal disorders caused by excessive estrogen levels with progesterone deficiency. This conclusion was made on the basis of a study of the response of endometrial polyps to estrogen stimulation. The likelihood of pathology due to infectious diseases of the inner layer of the uterus, as well as mechanical damage to the endometrium due to artificial termination of pregnancy, abortion, miscarriage, curettage, wearing an intrauterine device for a long time, incomplete removal of the placenta during childbirth, resulting in blood clots and fibrin overgrow with connective tissue and turn into a polyp. Do not neglect the likelihood of the growth of the polyp due to the increased growth of blood vessels in the uterine cavity. Endocrine processes in a woman’s body associated with diabetes mellitus, metabolic disorders, hypertension, and thyroid dysfunction affect the risk of developing a disease. Mental disorders can be provoked by mental disorders, depression, feelings, stressful situations, as well as a decrease in immunity and a lack of vitamins in the body.
Symptoms of the endometrial polyp
In the event that the growths of the epithelium take small forms, then the signs of the endometrial polyp are most often absent. Therefore, it is diagnosed, as a rule, with ultrasound of the small pelvis. Upon reaching significant size, the following clinical picture is observed:
• the number of pathological whitish discharge (leucorrhoea) increases;
• the menstrual cycle is violated;
• profuse menstrual flow;
• acute pain in the form of contractions when the polyp reaches the cervical canal;
• bleeding occurs during the intermenstrual period;
• discomfort and pain during sexual intercourse;
• infertility at a young reproductive age;
• failures during IVF;
• the appearance of bloody discharge during menopause. Therefore, polyp removal is most often prescribed for such symptoms of endometrial pathology. Patient reviews after surgery indicate that surgical treatment contributes to the disappearance of symptoms completely and women feel significant relief.
Diagnostics
During the examination, the gynecologist can see a functional endometrial polyp that extends into the cervix and vagina. Therefore, the main method of research is an ultrasound scan. In the event that the polyp is not clearly visualized, hysterosonography is performed, which is the same ultrasound, but with the introduction of saline into the uterus by means of a catheter. This technique allows a more detailed study of the polyp, its size and shape. For a more detailed diagnosis, hysteroscopy is performed, during which it is possible to accurately determine the location of the polyp, and using this method it is possible to precisely remove the polyp along with the leg. The technology of its implementation is a minimally invasive technique. An optical instrument with a small cross-sectional diameter is introduced into the uterine cavity, which allows the sampling of bioptic material, as well as endometrial curettage. After removal of the polyp, it is sent for histological examination, which allows you to identify structural features, the presence of atypical cells and prescribe further treatment. When detecting the presence of cancer cells, a specialist examination in gynecological oncology is prescribed.
Treatment methods
There are two main methods of treatment - this is surgery and non-surgical techniques.
Surgical techniques
• Of the operational methods, the most effective is hysteroscopy, which, thanks to an optical device (a hysteroscope containing micro-tools in a tube), allows you to more closely examine the location of the polyp and accurately remove it and has more preference than blind curettage. The operation can be performed without anesthesia and anesthesia and does not take much time - 5-20 minutes, depending on the nature of the pathological changes.
• Hysteroresectoscopy - is a complete surgical operation. The only way out in case of a serious pathology of the endometrium is the removal of the polyp. The reviews of patients who underwent surgery indicate that the operation is painless, as it takes place under general anesthesia.
Conservative methods
• Surgery is not the only option, if an endometrial polyp is diagnosed, treatment without surgery is possible in various ways, primarily hormonal drugs.
• Antibacterial treatment for genital infections.
Hormone treatment
In the event that an endometrial polyp is detected, treatment without surgery is prescribed by the following hormonal drugs:
• Progestogens, the content of progesterone (means "Utrozhestan", "Dufaston"). Drugs are prescribed for a period of 3-6 months in the 2nd phase of the menstrual cycle.
• Complex oral contraceptives are prescribed for women under the age of 35 years who have a uterine endometrial polyp. The treatment lasts for 21 days.
• Gonadotropin releasing hormone agonists
Non-surgical treatment with Chinese tampons
If it is impossible to conduct surgery in order to remove the endometrial polyp, treatment without surgery is carried out by conservative methods - Chinese tampons. They are also used as a prevention of relapse. The most famous swabs are Clean Point, Beauty Life. For the course of treatment you will need 10-12 tampons, for prevention - 2 tampons per month. They consist of natural plant components with a wide spectrum of action, normalize hormonal levels and fight against infectious diseases. Folk remedies, along with medical methods, there are unconventional methods to remove the endometrial polyp, folk remedies show low treatment effectiveness. One way is to use garlic - it must be crushed, wrapped in a bandage, formed into a tampon and tied with a thread. The tampon is administered overnight into the vagina for one month. Many who have tried this method criticize the alternative treatment of endometrial fibrous polyp; reviews suggest that it is very difficult to withstand even four hours, not to mention the whole night. In this way, you can burn the vaginal mucosa.
Prevention of endometrial polyp
As a prophylaxis of the endometrial polyp, the following recommendations should be followed:
• Be attentive to infectious and inflammatory diseases of the female genital organs and conduct effective treatment.
• Regularly be examined by a gynecologist.
• When the first symptoms appear, consult a doctor.
• Normalize hormonal levels
Relapses of endometrial pathologies occur if it was not completely removed during surgery. As a prophylaxis of recurrent diseases, hormone therapy is used, stressful situations, abortions should be avoided, proper nutrition and monitoring of the state of health and the immune system.