Causes, symptoms and removal methods of irrigation of the endometrium
The content of the article:
Endometrial polyps is a single or multiple entity, with a benign nature and localized in the uterine cavity. Endometrial polyps are hyperplastic in nature, then there is the growth of the inner lining of the uterus. The shape of the protuberances can be very diverse: and mushroom-shaped, and rounded, and the thin stem and wide base. In addition, uterine polyps vary in color, ranging from barely pink and to an intense Burgundy. Their maximum size is 3 cmthough often they are very small. Often in parallel with the endometrial polyps are detected polyps of the cervical canal. In gynecological practice to remove these formations, as they are considered precancerous. Although the frequency of malignancy is small and does not exceed 2%.
With regard to statistics, most often from endometrial polyps in women, crossed the line in 35 years. Although it is possible endometrial hyperplasia at a younger age. The incidence of the pathology varies from 6 to 20 %.
Symptoms of endometrial polyps
No matter what structure is uterine polyp, he gives a rather meager symptoms. Therefore, it is possible to detect only during the ultrasonic examination, especially if it is a small size.
However, the polyp in some cases, makes itself felt in the following symptoms:
- The menstrual cycle is disrupted. Highlight during menstruation becomes heavy (menorrhagia), which most often occurs in young women. In the intervals between cycles may appear spotting poor selection. As for the women who were in the postmenopausal period, they have a single uterine bleeding that they are often not associated with the polyps;
Frequent, and even more, profuse bleeding be a factor influencing the formation of anemia that is accompanied by dizziness, weakness and paleness;
- Lower abdominal pain may occur with colicky. They tendincrease during intercourse and after it. Women often complain of pain in the lumbar region;
- In the period between periods can appear abundant leucorrhoea, which often signals a fairly large polyps;
After intimacy, women may experience slight bleeding;
Education can hinder the process of conception and lead to infertility;
- If the polyp is not removed before the moment of conception, his presence in the uterus may cause miscarriage or premature birth.
Causes of endometrial polypsAbout what is the cause of the formation of endometrial polyps, have been put forward several hypotheses, including:
- Disruptions in hormonal sphere. Primarily on the formation of polyps is affected by increased blood levels of estrogen, as they contribute to the accelerated growth of the endometrium. The activity of the process also affects the level of another hormone – progesterone. The lower it is the faster growing polyps;
- The growth of blood vessels that permeate the uterus. This occurs most often when they are clogged. The growth of the vascular network surrounding the reproduction of epithelial cells;
- Cervicitis and endometriosis causing inflammatory reactions in the uterus. The strengthening of the immune system provokes an increase in the number of white blood cells trying to fight infection and, in parallel, cause the formation of polyps;
Poor circulation in the capillaries by reason of diabetes or hypertension. Strengthening of cell division occurs on the background hypoxia;
- Traumatic medical procedures. For example, it may be abortion or curettage;
- Diseases of the endocrine system. The growth of the endometrium is due to the relationship of the glands of the body to each other;
- Much of excess body weight. On the background of overweight almost always have metabolic disorders, which causes excessive formation of estrogen and the formation of polyps;
- Genetic predisposition. If the woman had endometrial polyps, it is likely that theyappears her daughter;
- The lack of physical activity. It is the lack of exercise leads to stagnation of blood in the pelvis, which negatively affects hormone production and on activities of endometrial cells;
- Taking certain medicines, particularly, Tamoxifen, which is used for the treatment of cancer;
- The intrauterine device (*device);
- Childbirth, in which there was a complete release of the placenta. The remaining clots and the fibrin is replaced by connective tissue that formed the polyp.
Types of endometrial polypsAll of education are divided as to its structure and location.
Depending on where there is growth, there are:
- Polyps of the cervix (with the help of legs are attached to the surface of the cervical canal);
Polyps of the uterus, which have a nodular shape and can be placed anywhere in the cavity of the body, but are mainly in the upper part.
Depending on what the structure is a polyp, and from what cell it is, there are:
- Fibrous formations which are formed of connective tissue have a dense structure and are often found in women of Mature age (over 40 years);
Glandular formations that are formed from the respective cells and often detected in young women, before the period of menopause (for structure to remind the cyst to be fluid filled);
- Adenomatous formations which are composed of atypical cells and have a high risk of degeneration into malignant tumor;
- Glandular-fibrous formation, which are formed simultaneously from the glandular cells and of connective tissue;
- Placental formation, which are formed from remaining in the uterine cavity particles of the placenta, most often polyps cause infection and are manifested by long and abundant bleeding.
Fibrous polyp of the endometrium
The fibrous formation can grow only from the connective tissue, they are imbued with a rare blood vessels, which makes them more dense structure. They can detect single cancer. Most often they are diagnosed in women who reach 40 years. These outgrowths are formed due to hormonal changes of the body.
These polyps are detectedless often than others. Usually they do not exceed 10 mmalthough rarely found fibrous growths of larger size. In addition, they are most often solitary. Clinical manifestations of these polyps do not have special differences. Beli can disturb a woman only when education has large size, or the background of the formation of necrosis.
Glandular-fibrous endometrial polyp
Education, with glandular-fibrous structure presented by the overgrown areas of the uterine mucosa and glandular epithelium. This is a benign polyp that grows into the uterine cavity. Most often it is found in adulthood and in older women.
Other polyps, this species is characterized by the presence of not only the connective tissue but glands, but in the structure of education slightly.
Glandular endometrial polyp
Ferruginous formation represented by stromal cells and glands of the endometrium. Stroma in polyp represented the connecting fabric having a loose structure. It is quite densely penetrated by blood vessels. As for the glands, they are located in a chaotic manner and vary in length and width. Sometimes in the thickness of this formation may show a cyst.
Most of these polyps are formed in women in reproductive phase. It is believed that the main reason for their occurrence is hormonal imbalance. Therefore when a woman reveals a glandular polyp, it is advisable to check for other hormone-dependent diseases. In size, these polyps do not exceed 15 mm. After glandular polyp removed, additional treatment is required.
With regard to clinical manifestations, they largely depend on what formed the polyp. If he emerged from the unchanged endometrium, the symptoms are often completely absent or observed meager discharge between periods. When education reaches a large size, the volume of menstrual blood increase.
The more intense growing cancer in the polyp, the higher the risk of degeneration in adenomatous type. Although the probability of such transformation is small, however, the risk exists, therefore, treatment should be timely.
Adenomatous polyp of the endometrium
This kind of pathology is a glandular formation, which detected abnormal cells. It has a high risk of malignancy that is threatening to develop into endometrial cancer. This is due to the need for urgent removal of a polyp and a more careful monitoring of sick woman.
Such growths can be diagnosed at any age, butthey most often appear in older women.
What is the danger of endometrial polyp?
The pathological formation in the uterus dangerous for its complications, including:
- The impossibility of conception during their reproductive years;
Disruptions of the menstrual cycle, during which it lost a significant amount of blood, which leads to the development of anemia;
The degeneration into a malignant tumor, causing cancer of the endometrium;
- The rejection of sexuality, which is associated with severe pain when large polyps.
Diagnosis of endometrial polypDuring the gynecological examination can be detected by the formation, localized to the cervix. They are well visualized on the mirrors. While endometrial polyps are difficult to palpate and visualize they are generally not available.
To detect polyps in the uterine cavity, it is necessary to conduct ultrasound of the pelvic organs. The doctor will note the extension on, the thickening of the endometrium and the proliferation of the mucous membrane.
However, for several reasons, ultrasound is not always informative method:
- Bad render in are those polyps that have a glandular nature, as they are similar in structure to the natural layer of the uterus – the endometrium;
- It is impossible to differentiate polypose education from myoma or adenomyosis;
- It is difficult to clarify the structure of the polyp, and therefore, it is impossible to confirm or deny the presence of atypical cells.
Diagnosis will require a hysteroscopy. This is standard procedure in cases of suspected endometrial polyps, it improves the accuracy of diagnosis carried out to 97%. Another method of diagnosing the disease is micrographia-radiography. The uterine cavity is introduced contrast agent, which allows you to see the existing seal under the influence of x-rays.
If you plan surgical removal of polyps, it is advisable revealing the hidden genital infections. Taken a swab for bacteriological, microscopic, and research and development.
Hysteroscopy when endometrial polyp
To realize hysteroscopy, require the introduction through the cervical canal of the devicewith a video camera. It allows to visually inspect all the education. This will give the physician a complete picture of what is happening in the uterine cavity: will determine the number of formations, their size, to assess the condition of the endometrium.
In addition, during this procedure, the removal of one of the growths to determine his character. This will make histological examination. Still for the fence fabrics can be applied diagnostic curettage.
Answers to common questions about endometrial polyps
- Do I need to remove an endometrial polyp? The vast majority of physicians are inclined to believe that resection is necessary to expose any detected in the uterus education. The same rule applies to polyps. Therefore they must be eliminated from the body, if there are no serious contraindications. In this case, an alternative method is hormonal therapy.
- Can you get pregnant with endometrial polyp? To conceive a child in the presence of polosnogo proliferation of the endometrium is possible, however, in some cases, this condition can cause infertility. Multiple education represented a mechanical obstacle for the fertilization and implantation of an embryo. In addition, fertility is influenced by the size of the polyps, and their malignant degeneration. Well as infertility causes overlap of polyps of the cervical canal.
- Is it possible pregnancy after curettage of the endometrium? Scraping of the endometrium is a fairly traumatic procedure on the technique of conducting similar to that of surgical abortion. For it doctor using a special curette, which after anesthesia and cleaned the uterine cavity. If you have violated the rules of the procedure and you did not use a hysteroscope, it can threaten a woman in such a complication, such as infertility. Therefore, this method try to apply as little as possible. If the transaction is a competent expert and not broken hardware it is running, then getting pregnant after the procedure.
- A delay period after removal of endometrial polyp – is this normal? An approximate recovery time of the menstrual cycle after was removed a polyp, is 30 days. It depends on the age of the patient, number of remote entities. Than a large area of tissue had to be processed, the longer it can be delayed. After the restoration of normal menstrual cycle should stop the pain and spotting in between.
Is it possible to have sex in the endometrial polyp? Most ofteneducation is not an obstacle to the entry into an intimate relationship.
However, sexual relations in the presence of polyps can be complicated by:
Increased risk of sexually transmitted infections, as protective power of the mucous membrane of the uterus is reduced.
The pleasure of intimacy is reduced, as the polyps can cause a decrease in secretion of natural lubrication.
The probability of getting pregnant decreases.
After intercourse and a woman may experience pain, especially when substantial amounts of the entities.
Increases the risk of bleeding as polyps are inside blood vessels and they are not so strong as around a woman's body.
- Can endometrial polyps to go to the bath? You should refuse to visit the baths, since such a diagnosis all thermal procedures are contraindicated.
- I found a small polyp of the endometrium during pregnancy. How polyps affect the fetus? Is it possible to get rid of it before birth? The formation of small size does not affect the fetus. Until that moment, until the baby is born, you should refuse any treatment.
Do endometrial polyps virgins? Polyps may be diagnosed in women who are not having sexual relations. Moreover, during puberty there is a serious hormonal changes in the body that causes an increase in the level of estrogen in your blood. That is excessive amount of of this hormone can cause the endometrium begins to grow, and there will be a polyp.
There are additional risks of developing polyps in puberty, including:
The high content of lipoproteins in the blood.
Urinary tract infection.
Treatment of endometrial polypIn some cases, the removal of a polyp using a surgical intervention is impossible. In this regard, can be sought medical treatment. It is sometimes possible to reduce the educationsizes, and sometimes even to get him to self-destruct. Doctors are always trying to get rid of the formation a non-surgical procedure, if the patient is of young age, because it can be diagnosed in girls as early as 11 years old.
For treatment using various drugs, which in each case are selected individually:
- For women under the age of 35 yearsthe use of the oral contraceptives with a combination of estrogen and progestogen. Among such funds Yarina, Regulon, Janine. They are accepted according to a certain scheme, which are discussed with your doctor. Should a long course of treatment. As a rule, it is at least six months;
- Women who crossed the line in 35 years, the most commonly used progestins, which also can be appointed only the doctor. Among these preparations a Monitor, the antiseptic and cough medicine. The rate of receipt of these funds is six months, the scheme is discussed with the physician individually;
- Antibacterial agents can be assigned to a female regardless of her age, if polyphonie sprawl is the result of the inflammatory process. Common instruments used in gynecological practice, are Gentamicin, Monomitsin, Setrole, etc.;
- During menopause, and women older than 40 years shows the acceptance of such funds, as the Zoladex, Diferelin, Leuprorelin. They are able to protect the uterus from the negative effects of estrogen. The course can be up to six months, the minimum term of reception of agonists gonadotropin releasing hormone – 3 months;
- Analgesic drugs taken as symptomatic treatment. However, they cannot be used long-term, as they contribute to the development of gastrointestinal diseases and other complications. Among such funds, Paracetamol, Diclofenac, Analgin, Ibuprofen;
- If a woman experiences heavy menstrual period, it is advisable to wash using antiseptic solutions, e.g., Collargol, Catalina, potassium Permanganate. This will allow to exclude the possibility of infection.
Removal of endometrial polyp
The most modern method of removing such entities today recognized as hysteroscopy and subsequent scraping of the cervical canal. In addition, possible resection of endometrial polyps by laser and the implementation of diagnostic curettage separately.
To determine the optimal method of treatment, the doctor should focus on the followingcriteria:
- When the patient detected multiple polyps, they are mandatory elimination;
- Hormone therapy after removal of the polyp will need to if you have been diagnosed with glandular-fibrous polyp;
- If it is detected adenomatous education, and women aged 40 years and older, then it is mandatory to remove the uterus.
After determine whether surgery is the choice of the methodology.
Minimal complications for the patient could face the modern technique of removal of endometrial polyps – hysteroscopy. To do this, the patient should contact the clinic where you have the equipment for such procedures, and also have experienced staff.
This technique is the most gentle, as the doctor can completely control your every move. Visualized the uterine cavity and the available it education. For best picture should be the operation immediately after the completion of menstruation. Prior to the intervention is required to refrain from eating and drinking 6 hours before.
Often hysteroscopy requires the introduction of General anesthesia. The uterine cavity is examined with the help of a hysteroscope, then there is removal of polyps. In the future, the biological material is transferred to the laboratory where required histological examination.
If it is detected that formation on the stem, Unscrew them, and the bed of the polyp cauterize with electrocautery or the cryogenic method. Sometimes, it is the laser. It is capable of destroying pathogenic cells, which will reduce the risk of recurrence of the disease. The procedure is short and takes less than an hour.
Diagnostic curettageSince the risk of recurrence of the polyp is large and is not less than 30%, the need to thoroughly carry out the coagulation of his bed. So if a woman is offered diagnostic curettage, and hysteroscopic equipment is missing, it increases the likelihood of tissue injury. This technique is used less often because the doctor does not see what he was doing in the process of scraping. Such an operation is practiced in hospitals with outdated equipment.
Modern medicine has recognized this procedure is completely useless as there is no possibility of burning the bed of the polyp. Diagnostic curettage should only be performed after hysteroscopy, orderto determine the presence or absence of atypical cells.
It can be done only on an emergency basis if the polyps cause bleeding that cannot be stopped in other ways. That is the purpose of scraping in this case is hemostasis, not the deliverance of the patient from the formation.
Laser removal of polyps
This modern technique is less traumatic and applicable to women planning to get pregnant. After the conference on the uterus does not remain scars remain fully intact reproductive function. The woman there is no need to go to the hospital. A few hours after the intervention, she can go home.
The penetration depth of the laser is fully controlled by the doctor that contributes to the rapid recovery of tissues, no bleeding, immediate sealing of blood vessels. In addition, six months after this intervention, the woman can plan pregnancy.
Treatment after removal of endometrial polyp
When education was removed from the uterus with hysteroscopy, the risk of complications is minimized. But despite the safety of the procedure, it is important to determine what is the cause of sprawl. This will allow to determine the tactics of further treatment and will serve as an excellent relapse prevention.
After the surgery was performed, the woman will need to take this muscle relaxant drug as Nospanum. The course is 3 days, three pills a day. This is necessary in order to avoid complications after the operation called "hematometra" (accumulation of blood in the uterine cavity).
Do not give up has a preventive anti-inflammatory therapy. Its necessity is due to the fact that the growths are often the result of the inflammatory process, which is subject to mandatory removal.
When the results of histological examination taken during curettage of the tissue, then they definitely need to discuss with watching a woman doctor. Most often the tests are done 10 days later.
If it was found that the growth of the endometrium is caused by a hormone imbalances in a woman's body, and they had a glandular or fibro-glandular structure, it is necessary to hormonal correction. This purpose can be the prescribed drugs-progestins: a Monitor, the antiseptic, cough medicine, or oral contraceptives: DIMIA, Regulon, yasmin, Janine, Jess.
To avoid the recurrence of the disease will help the following recommendations:
- Timely treatment of any infectious process of the urinary system;
- Permanent sexual partner;
- Maintain an active lifestyle;
- Exception of trauma the mucous membranes of the uterus;
Regular checkups at the doctor.
All of these activities will reduce the risk of re-growth of the endometrium, and therefore, will save the woman from having a new surgical intervention, even the most modern.
As for the forecast, it is often favourable, but the malignancy and the rebirth is exposed to not more than 1.5% of uterine polyps.