The endometrial polyp is a benign neoplasm that can occur in women of any age. Due to the increased risk of neoplasm degeneration into cancer cells, special attention is paid to the timely treatment of this disease. Along with the main surgical intervention, there is a non-surgical treatment of a fibrous endometrial polyp.
Endometrial polyp - what is it
An endometrial polyp is an overgrowth of the cells of the inner lining of the uterus. It can be observed from one to several polyps ranging in size from 1 millimeter to 5 centimeters. They most often appear in women between the ages of 40 and 50. According to the structure, the polyp consists of a body and a vascular pedicle, with which it is attached to the wall of the uterus. It is distinguished by 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 is considered adenomatous (precancerous). Depending on the structure, 4 types of endometrial polyps are distinguished:
• Fibrous.
• Glandular.
• Glandular fibrous.
• Adenomatous.
There is also a functional endometrial polyp, consisting of epithelial cells and changing during the menstrual cycle, and the basal type of polyps, arising from the pathologically altered basal layer of the uterine body. It is possible to determine the exact structure of the formation using a 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 struggle if an endometrial polyp is detected. Treatment without surgery with medication is possible if the patient refuses the operation.
Reasons
There are different versions of the origin of the endometrial polyp. The main one is hormonal disorders caused by an excess of estrogen with a lack of progesterone. This conclusion was made on the basis of a study of the response of endometrial polyps to estrogen stimulation. Also, the possibility 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 is overgrown with connective tissue andturn into a polyp. Do not discount the likelihood of polyp growth due to 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 the disease. Mental disorders, depression, anxiety, stressful situations, as well as a decrease in immunity and a lack of vitamins in the body can provoke hormonal imbalances.
Endometrial polyp symptoms
In the event that the growths of the epithelium take small forms, then signs of an endometrial polyp are most often absent. Therefore, they are diagnosed, as a rule, with ultrasound of the small pelvis. Upon reaching a significant size, the following clinical picture is observed:
• the amount of pathological whitish discharge (leucorrhoea) increases;
• menstrual cycle disrupted;
• heavy menstrual flow;
• sharp pains in the form of contractions when the polyp reaches the cervical canal;
• bleeding occurs between periods;
• discomfort and pain during intercourse;
• infertility at a young reproductive age;
• IVF failures;
• The appearance of bleeding during menopause. Therefore, polyp removal is most often prescribed for such symptoms of endometrial pathology. Feedback from patients after surgery indicates thatthat surgical treatment contributes to the disappearance of symptoms completely and women feel significant relief.
Diagnosis
During the examination, the gynecologist can see a functional endometrial polyp extending into the cervix and vagina. Therefore, the main method of research is an ultrasound. 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 through a catheter. This technique allows you to explore the polyp in more detail, 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 also using this method, it is possible to accurately remove the polyp along with the leg. The technology of its implementation is a minimally invasive technique. An optical instrument of small cross-sectional diameter is introduced into the uterine cavity, which allows sampling of biooptic material, as well as curettage of the endometrium. After removal of the polyp, it is sent for a histological examination, which allows you to identify structural features, the presence of atypical cells and prescribe further treatment. If the presence of cancer cells is detected, an examination by a specialist in gynecological oncology is prescribed.
Treatment Methods
There are two main methods of treatment - surgery and non-surgical methods.
Surgical techniques
• Of the surgical methods, the most effective is hysteroscopy, which, thanks to an optical device (a hysteroscope containing micro-instruments in a tube), allows you to examine the location of the polyp in more detail and remove it accurately and is more preferable 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. Reviews of patients who underwent surgery say 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 with hormonal drugs.
• Antibacterial treatment for genital infections.
Hormonal treatment
In the event that an endometrial polyp is detected, treatment without surgery is prescribed with the following hormonal drugs:
• Gestagens, progesterone content (means "Utrozhestan", "Dufaston"). The drugs are prescribed for a period of 3-6 months in the 2nd phase of the menstrual cycle.
• Integrated oral contraceptives are prescribed for women under the age of 35 who have a uterine endometrial polyp. Treatment lasts for 21 days.
• Agonistsgonadotropin-releasing hormone
Non-surgical treatment with Chinese tampons
If it is impossible to carry out surgical intervention 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 tampons are Clean Point, Beauty Life. To complete the course of treatment, you will need 10-12 tampons, for prevention - 2 tampons per month. They consist of natural plant components of a wide spectrum of action, normalize hormonal levels and fight infectious diseases. Folk remedies, along with medical methods, there are also non-traditional ways to remove the endometrial polyp, folk remedies show low effectiveness of treatment. One way is to use garlic - it must be crushed, wrapped in a bandage, formed into a swab and tied with a thread. The tampon is inserted overnight into the vagina for one month. Many who have tried this method criticize the alternative treatment of a fibrous endometrial polyp, reviews indicate that it is very difficult to endure even four hours, not to mention the whole night. In this way, you can burn the mucous membrane of the vagina.
Prevention of endometrial polyp
As a prophylaxis of the endometrial polyp, the following recommendations should be followed:
• Be attentive to infectious and inflammatory diseasesfemale genital organs and carry out effective treatment.
• Get regular check-ups with a gynecologist.
• Seek medical attention at the first sign of symptoms.
• Normalize hormonal levels
Relapses of endometrial pathologies occur if it was not completely removed during the operation. Hormone therapy is used as a prevention of recurrent diseases, stressful situations, abortions should be avoided, proper nutrition and monitoring of he alth and immune system.
