Polyps in the uterus are formations from the endometrium that appear from the age of 9. Most often found before menopause in 40 - 50 years. Polyp refers to benign neoplasms, but if you do not take any measures to treat it, with certain conditions, he may become malignant. The probability of such a degeneration is 1 - 2%.
Polyps are single on a broad base or on a pedicel, and multiple (polyposis).
Polyps in the uterus are found in women approximately in 10% of cases. Among gynecological diseases are 25% of cases, which indicates a widespread prevalence of the problem.
Polyps in the uterus are the causes
When studying this pathology it was found out that the polyps in the uterus, the causes of which in each individual case are different, arise on the background:
• hormonal disorders;
• reduced immunity;
• stress and prolonged nervous overstrain;
• changes caused by the woman's age.
In addition, there is still a mass risk factors provoking the development of polyps in the uterus:
1. Diseases of the genital organs in women (ovarian cysts, fibroids, endometriosis).
2. Mechanical damage to the cervix arising from instrumental gynecological examinations, as a result of inflammatory diseases (endocervicitis), during labor or abortion.
3. Sexually transmitted infections (STIs), as well as against the background of a violation of the vaginal microflora. The most dangerous of them are: ureaplasmosis, herpes, toxoplasmosis, mycoplasmosis, candidiasis.
4. Genetic predisposition.
5. Physical inactivity.
6. Long-term treatment with Temoxifen - a drug used in the presence of tumors in order to block hormone-sensitive receptors. As a result, in some patients, endothelial cells begin to grow vigorously and polyps form.
Vascular proliferation: when the vasculature is formed around it, active multiplication of epithelial cells begins.
The risk group includes women who have:
• obesity;
• hypertonic disease;
• endocrine pathology.
The mechanism of polyps in the uterus
Because of hormonal failure, normal functioning of the ovaries can be disturbed, and therefore a large number of estrogens enter the blood.
Normally, its production takes place within two weeks of the menstrual cycle. With hormonal disorders, he enters the blood continuously. Under its influence, there is an increased expansion of the endometrium.
During the period of the monthly endometrium does not completely exfoliate, some part of it remains in the uterus. This process takes place during several cycles and leads to the formation of the formation of the endometrial cluster at the site of the congestion.
In the future, there is a germination of blood vessels and fibers of connective tissue - a polyp is formed.
Types of polyps in the uterus
Polyps, depending on the cells from which they are formed and their structures, distinguish:
1. Glandular polyps - formed at a young age, similar to fluid cysts.
2. Fibrous polyps - dense, because they are based on connective tissue, develop after the age of 40, before menopause and in menopause.
3. Glandular - fibrous, formed, respectively, from the cells of the glands and connective tissue.
4. Polyps - adenomas: atypical cells are found in their structure, therefore, the development of cancer is possible.
5. Placental polyps are formed from the particles of the placenta preserved after childbirth.
Dimensions of polyps in the uterus vary from a few millimeters to 3,0 cm. In general, polyps occur up to 1,0 cm.
Polyps in the uterus are the first symptoms
Polyps in the uterus can be asymptomatic. In such cases, they are a finding in the examination for another pathology, or when clarifying the causes of infertility.
When certain polyps are reached in the uterus, the first symptoms are manifested:
• various violations of the menstrual cycle;
• uterine bleeding between periods;
• bleeding during menopause;
• pain and discomfort during sex, and after it - spotting.
Also, the polyp can be detected if inflammation develops or trauma occurs. This leads, in addition to the above, to the manifestation of following clinical symptoms:
• pulling pains that occur not only during sexual intercourse, but also shortly before the onset of menstruation;
• the presence of blood in the discharge, not associated with menstruation.
Polyps in the uterus are signs
As the polyps grow in the uterus, their signs become more pronounced:
• anemia develops;
• persistent violation of the menstrual cycle;
• miscarriage;
• fetal hypoxia;
• infertility;
• cancer of the uterus, which is the main danger of polyps.
Diagnosis of polyps in the uterus
Ultrasound of the uterus is the most accessible, informative and painless method of diagnosis. When the procedure is performed by an intravaginal sensor, the most accurate results are obtained.
For a detailed study, hysteroscopy is performed: the apparatus (a thin tube with a chamber) is inserted into the uterine cavity. Hysteroscopic if necessary, taking material for biopsy. Also through the apparatus in the uterine cavity, you can enter a contrast agent and make an X-ray.
Treatment of polyps in the uterus
Treatment of polyps in the uterus is exclusively surgical. When a single polyp is found, it is cut out. In polyposis, the upper layer of the uterine mucosa is scraped out.
Indications for surgical treatment are:
• lack of effect from hormonal treatment;
• age over 40 years;
• the size of the formation is more than 1,0 cm;
• if atypical cells are found during histological examination.
Currently, the treatment of polyps in the uterus is performed by hysteroscopic and laparoscopic methods.
Hysteroscopic method is considered a low-traumatic procedure, it is carried out under a slight anesthesia and lasts about 20 minutes.
The most suitable time for manipulation is 2 - 3 day after the month: the uterus of the uterus at this time is thin, the polyp is easily determined, because it rises above it, you can remove it quickly. The method has several advantages:
• safety;
• painlessness;
• absence of incisions and, accordingly, operational seams;
• the hysteroscope camera allows you to detect even small polyps and remove them.
Laparoscopy is performed under the control of the laparoscope through the hole (0,5 - 1,5 cm) in the lower abdomen. The method is very effective in the presence of malignant formation. In case of detection of abnormal cells in the polyp, which indicates a high risk of the tumor, the uterus is removed using this method.
The advantage of laparoscopy is:
• postoperative pain is rare;
• there are practically no complications;
• absence of scars;
• fast recovery of the body.
Treatment of polyps in the uterus
Treatment of polyps in the uterus in certain cases is done without surgery. This is possible in some cases:
• in women who have not given birth, since surgery leads to problems with conception;
• in young patients (cases are described when polyps were found in adolescent girls)
• if there is one small polyp, taking certain medications can reduce it and achieve complete disappearance.
Given that the polyp is formed in the uterine cavity under the influence of a high level of estrogen, hormonal drugs are prescribed that reduce the amount of estrogens and contribute to an increase in the level of progesterone. They eliminate the etiological factor (estrogens), resulting in a significant decrease in the polyp, it dries up and leaves the uterus during menstruation.
Preparations for the treatment of polyps are appointed taking into account the age:
• up to 35 years old - estrogen - gestagenic contraceptives (Regulon, Zhanin, Yarina);
• after 35 years - gestagens (Dyufaston, Utrozhestan, Norkolut);
• after 40 years and with the onset of menopause - gonadotropin releasing hormone antagonists (Zoladex, Dipherelin) - they protect against the effects of estrogens that cause changes in the uterus;
• antibacterial drugs are prescribed at any age - they are necessary in cases where the formation of polyps has occurred in connection with the inflammatory process in the uterus (Zitrolide, Monomycin, etc.).
All drugs are prescribed by a gynecologist in a certain phase of the cycle and according to a special scheme.
Prevention of polyps in the uterus
Prevention of polyps in the uterus is associated with dysfunction of the ovaries that produce a large number of estrogens. Therefore, preventive measures include:
• regular visits to the gynecologist to exclude pathology and the correct selection of contraceptives;
• active physical activity, the fight against hypodynamia, exclude blood stagnation in the small pelvis;
• exclude promiscuous sex;
• do not eat meat products containing hormones;
• avoid sudden hypothermia.
It is always necessary to carefully treat your body and at the slightest failure to consult on time with a specialist in order to avoid unpleasant complications.