Written by Dr.M.D.Mazumdar, MD
A cervical polyp is a small, benign, finger-like growth attached to the cervix. It is more common in women in the reproductive age group - especially between 20-40 years. It is rare in young girls who have not yet got their menstrual periods and somewhat uncommon in women in menopause.
Although the cervical polyp is invariably benign and harmless, about 1% may undergo neoplastic changes and may become cancerous.
The polyp is usually atached to the cervix by a stalk - called a peduncle. If no peduncle is present, it is called a sessile polyp. Pedunculated polyps are more common than sessile ones.
Causes of Cervical Polyps
The exact cause for the formation of a cervical polyp is not known. But there are certain theories:
- Chronic inflammation of the cervix can cause outgrowths in the mucus membrane to form polyps.
- High estrogen levels present in pregnancy or due to birth control pills can cause congestion of the mucus membrane of the cervix leading to a polypoidal outgrowth.
- During normal pregnancy, the blood vessels of the cervix become engorged and congested and this can stimulate the formation of polyps. A clogged blood vessel is more commonly associated with a polyp.
Symptoms of a Cervical Polyp
- Can be completely symptomless.
- Patient can complain of occasional blood stained vaginal discharge - pinkish, reddish or brownish.
- Intermenstrual bleeding or spotting and sometimes abnormally heavy menstrual bleeding (menorrhagia) can also occur.
- Vaginal bleeding in post-menopausal women can be caused by cervical polyps.
- Bleeding after sex due to pressure on the polyp by the penis.
- Bleeding in early pregnancy.
- There can be increased vaginal discharge.
- If accompanied by infection, the vaginal discharge may be mucopurulent and smell foul.
A small - usually no bigger than a pea, but sometimes much larger - growth is seen hanging from the os (mouth of the cervix). It is bright red in colour and soft and slippery to the touch. In some cases, it may be somewhat purplish due to venous engorgement. If there is associated infection, the surrounding area will look red and inflamed. Vaginal discharge may be seen over the polyp as well as the adjoining areas.
The polyp can be moved easily from side to side on its stalk. It may bleed on touch or presure.
Treatment of a Cervical Polyp
Cervical polyps should be surgically removed. They can be removed using a ring forceps or by tying surgical string around the polyp and cutting it off. Gentle twisting of a cervical polyp may also remove it, especially if it is a small polyp.
The base of the polyp usually heals spontaneously without much bleeding. In a large polyp, the base may need to be cauterised by a electrocautery or by using a laser.
A biopsy should always be done to examine whether the cells are normal or have undergone any malignant change. Most cervical polyps however are benign and do not recur after removal.
If a cervical polyp is diagnosed during pregnancy, it should be removed only if it is causing great discomfort.
If a decision to remove it is taken, its site of origin should be determined - if the origin is near the external os of the cervix, it can be easily removed. If it is estimated that the origin of the polyp is higher up in the cervix and removal can affect the pregnancy in any way, it is better to wait till after the delivery and childbirth to remove it, since symptoms caused by cervical polyps are usually not very troublesome.
Supplementary Vitamins to be taken in pregnancy:
- Iron tablets
- Folic Acid tablets
- High strength Multivitamin Capsules
- Calcium tablets.
- Psyllium Husk, a natural fibre, if there is constipation.
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