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We describe how to treat a cervical canal polyp, in which cases surgical operation (polypectomy) is indicated, and in which cases other methods should be resorted to. You will also learn how neoplasm removal is performed at Expert Clinics, what our doctors recommend for preparation before the operation and during the rehabilitation period to speed up recovery and rule out complications.
What is a Cervical Canal Polyp
The cervical canal is the channel of the cervix that connects the uterine cavity and the vagina. It is lined with a mucous membrane. Benign neoplasms—polyps—can develop on the walls of the cervical canal, as well as on the mucous membrane of the uterus. They can be solitary or multiple. They appear as pink, purple, or dark red tubercles on thin stalks or wide bases.
Polyp symptoms are non-specific, which is why these growths can be confused with uterine fibroids (myomas), polycystic ovarian syndrome (polycystosis), or endometriosis. Most often, the pathology is asymptomatic, but in some cases, it is accompanied by vaginal bleeding. Other signs of polyps include: irregular menstruation, very painful and profuse menstruation, which is usually prolonged, intermenstrual spotting, post-coital bleeding, dyspareunia (pain during intercourse), infertility, early miscarriages (spontaneous abortions), cervical incompetence (isthmic-cervical insufficiency), and a feeling of heaviness in the abdominal or lumbar region.
The pathology is diagnosed during a gynecological examination. The physician uses a vaginal speculum for visual examination. If a polyp is observed, a detailed examination is then carried out using cervicoscopy or colposcopy, and biopsy. Hysteroscopy is performed to establish a definitive diagnosis. Urine and blood tests are prescribed (complete blood count, biochemical analysis, tests for hidden infections, extended coagulogram), as well as a vaginal flora smear. Additionally, an ultrasound (US) is performed, as cervical canal polyps may be associated with endometrial polyps, fibroids, and other growths.
Causes of Polyp Formation
The pathology is caused by the following factors:
•        Hormonal imbalance. This most often occurs during the period of perimenopause (end of reproductive age), after 40 years. Less frequently, polyps are found in adolescents during puberty. Pregnant and lactating women, whose hormonal background also changes, are in the risk group. Pregnant women may develop decidual polyps of small size, which usually do not pose a threat to carrying the baby to term.
•        Trauma, complicated deliveries, insertion of an intrauterine device (IUD), abortions, and other surgical interventions. Damaged epithelium proliferates actively, resulting in the formation of polyps.
•        Infectious diseases of the genital tract. Inflammatory processes in the uterus and adnexa (appendages) negatively affect the condition of the cervical canal mucous membrane, provoking epithelial thickening and the appearance of polyps.
Provoking factors also include ovarian dysfunction, vaginal microflora imbalance (vaginosis), stress, obesity, and diabetes mellitus. Heredity also influences the development of the pathology.
Indications for Removal of a Cervical Canal Polyp
Surgery is indicated for all patients in whom such growths are detected. Despite the fact that polyps are benign neoplasms, they can become malignant (undergo malignant transformation) and may completely close the cervical canal, leading to infertility. Therefore, upon detection of growths, they should be removed as soon as possible, provided there are no contraindications. The operative method of treatment is the primary approach, allowing the pathological process to be halted.
Before referral for a scheduled or urgent operation, the physician assesses the risks and explains the consequences of refusing treatment to the patient. When prescribing polypectomy, it is important to consider the size and number of the neoplasms, their location, and the patient's general condition.
The main indications for immediate procedure include:
•        Presence of large or medium polyps—from 1 to 1.5 cm.
•        Rapid growth and spread of neoplasms.
•        Prolonged vaginal bleeding that cannot be stopped with therapy.
•        Detection of cancer cells.
•        Detection of adenomatous polyps.
•        Inflammation or necrosis of tissues.
•        Formation of purulent foci (abscesses).
•        Threatened miscarriage.
•        Inability to conceive.
•        Profuse menses causing a decrease in hemoglobin levels in the blood.
Indications are established by the gynecologist based on examination, anamnesis (medical history) collection, and the results of laboratory tests. If the condition threatens the life of the woman or the fetus, polypectomy is performed on an emergency basis.
If the growths are small, do not cause discomfort or alarming symptoms, and do not interfere with carrying and giving birth to a child, a scheduled operation is prescribed. The best time for its performance is the first phase of the menstrual cycle—on the 2nd or 3rd day after menstruation ends. In this case, healing occurs faster, and the risk of developing endometriosis is minimal.
Refusal of treatment often leads to complications, including oncological diseases. Polyposis—multiple neoplasms in the area of the internal genital organs—develops. The consequences can be very adverse, up to spontaneous abortion, inability to conceive, and progressive oncological diseases.
Contraindications for Polyp Removal
The operation is not performed or is postponed in the presence of the following conditions and pathologies:
•        Inflammatory processes, including infections of the genital organs, exacerbation of bacterial vaginosis, candidiasis (yeast infection).
•        Oncological diseases of the vagina (the operation is performed after tumor removal).
•        Chronic diseases in the acute phase.
•        Coagulation system disorders (blood clotting disorders).
•        Use of anticoagulants.
•        Cardiovascular diseases.
•        Profuse uterine bleeding.
•        Menstruation.
Impaired vaginal patency, scars on the cervix, and stenosis are not absolute contraindications; surgical intervention may be possible in some cases.
The operation is postponed if the woman is breastfeeding or carrying a fetus (regardless of the gestational age). Surgery is indicated if there is a threat of miscarriage, rapid growth of polyps begins, or bleeding occurs. In this case, minimally invasive (low-trauma) methods are preferred.
Preparation for Polyp Removal
Treatment of cervical canal polyps (the operation for their removal) requires preliminary examination. To reduce the risk of complications during polypectomy and the recovery period, instrumental examinations and a series of tests must be completed.
Necessary examinations:
•        Blood tests—complete blood count, biochemical analysis, coagulation, hCG (for pregnant women), blood typing, tests for syphilis, hepatitis, HIV and other infections.
•        Vaginal flora smear.
•        Urine analysis.
•        Ultrasound (US) of the heart, pelvic organs.
•        Colposcopy or cervicoscopy.
•        Hysteroscopy of the uterus (if endometrial polyps are suspected).
•        Chest X-ray (radiography).
•        Electrocardiogram (ECG) (before general anesthesia).
The patient also consults with a therapist (general practitioner), and, based on indications, with a phlebologist and a cardiologist. The physician prescribes an individual preparation plan based on the woman's age, diagnosis, body characteristics, and collected anamnesis.
The procedure does not require complex preparation. The list of restrictions and recommendations before its performance is short:
•        Abstinence from alcohol consumption.
•        Cessation of smoking or reduction of tobacco consumption, if possible.
•        Sexual abstinence for one week before the operation.
•        Avoid consuming products that cause flatulence (gas formation) for several days.
•        Before surgical intervention, avoid using tampons, vaginal suppositories, ointments, and douching.
•        The intake of medications affecting blood coagulation is discontinued.
•        On the day of the operation or at least 8 hours beforehand, do not eat or drink if general anesthesia is planned.
Also, on the day of visiting the clinic, it is important to take care of intimate hygiene, and hair in the genital area must be shaved.
Methods for Removing a Cervical Canal Polyp
Various methods are used for the removal of cervical canal polyps:
•        Conization (Cone biopsy)—removal of a small amount of cervical canal tissue without damaging surrounding structures. Reproductive function is preserved. The obtained material is sent for histological examination to check for benign and malignant cells.
•        Polypectomy—excision of the polyp. The method is suitable for small neoplasms.
•        Laser coagulation. Relevant for medium and small growths. A laser beam is directed at them, which excises the pathological tissues, cauterizes the vessels, and stops bleeding.
•        Radiofrequency (Radio-wave) coagulation. Cells are heated using high-frequency electromagnetic waves. The cellular structure of the polyp is destroyed. Due to focused impact, healthy tissues are not damaged.
•        Diathermy coagulation (Diathermocoagulation). Electric current is used to destroy the neoplasm. A scab (eschar) forms in the area of impact, which takes a long time to heal and sometimes sloughs off, leading to bleeding. The technique is indicated for the presence of cervical deformation and dysplasia. It is not recommended for women of reproductive age due to the risk of complications—erosion, adhesion formation (synechiae). The method is outdated.
•        D&C (Dilation and Curettage) or Fractional Curettage (Separated Diagnostic Curettage of the cervix and uterine cavity). Used only if the patient also has endometrial polyps. The obtained material is sent to the laboratory for examination.
The treatment strategy and method of surgical intervention are determined by the gynecologist based on the size and location of the neoplasms, the patient's condition and age, and the presence of chronic diseases. The physician takes into account the data from laboratory tests and instrumental examinations.
How Polyp Removal in the Cervical Canal Occurs: Procedure Stages
Polypectomy—a surgical manipulation for removing polyps in the cervical canal of the cervix—is performed, whenever possible, using minimally invasive (low-trauma) methods. This allows the rehabilitation period to be minimized and the appearance of complications to be avoided. However, while solitary polyps can be removed by targeted impact on the affected tissues, curettage of the uterine walls with a curette is used for the elimination of multiple growths.
Due to the use of anesthesia, the manipulations do not cause pain or discomfort. Most often, local anesthesia (topical, infiltration) is used. In rare, particularly complex situations, general intravenous anesthesia is utilized.
Operation stages:
1.        The patient is placed on a special chair, adopting the position used for a gynecological examination.
2.        The physician administers general or local anesthesia.
3.        The external genitalia are treated with an antiseptic. This is necessary for protection against pathogens (infectious agents).
4.        A dilator and a hysteroscope are inserted into the cervical canal for visual control of the manipulations.
5.        Surgical intervention is performed using a laser, electrosurgical loop, electrocautery knife, or other selected instrument.
6.        The polyp is excised, and the mucous membrane and vessels are cauterized (coagulation).
7.        The removed polyp is placed in a solution and sent to the laboratory for analysis. Its type, and the presence/absence of cancer cells, must be determined.
8.        The physician examines the area of intervention, the surface of the cervical canal.
9.        The genital organs are treated again with an antiseptic.
During the operation for the removal of a cervical canal polyp, hysteroscopy is performed. This is a visual examination of the mucous membrane using a special device with a light tube and a miniature video camera—the hysteroscope. It transmits the image to a monitor. The instrument (forceps, scissors) used to remove the polyp is inserted through the operating channel of the device. After removal, a control hysteroscopy is performed.
The duration of the operation is about 20 minutes. The patient is then placed in a recovery room for several hours for rest and postoperative observation.
Rehabilitation
Complete recovery requires 2–3 weeks. Throughout this time, the woman must regularly visit the gynecologist for consultation and examination.
The rehabilitation process is often accompanied by cramping pain (pulling pains), discomfort, a feeling of weakness, nausea, and dizziness. These symptoms are observed in the first days after the operation. Bloody and mucous discharge is normal and usually ends after a few days. After curettage, bleeding may last longer. Menstruation resumes after 1–1.5 months.
Measures taken for faster recovery:
•        The physician may prescribe anti-inflammatory drugs, antibiotics, antispasmodics, and analgesics (painkillers) (usually taken during the first week). This helps speed up healing, avoid wound infection, and prevent other complications.
•        Vitamins and minerals are prescribed to strengthen the body's defenses (immune system).
•        All restrictions imposed by the doctor must be followed. Primarily, this is the prohibition of visiting a bathhouse or sauna, taking a bath, and also sexual abstinence, the use of tampons, and douching.
•        During the rehabilitation period, nutrition must be balanced. Foods rich in fiber must be included in the diet: vegetables, fruits, berries, and cereals.
•        It is essential to monitor intimate hygiene especially carefully to avoid infection.
After polypectomy, it is important to carefully monitor the body's condition. If lower abdominal pain persists for a long time, accompanied by fever (elevated body temperature), profuse dark discharge with an unpleasant odor, this indicates the presence of complications. Immediate medical attention should be sought.
Timely removal of the polyp reduces the risk of malignant tumor formation, increases the chances of conception, reduces the threat of miscarriage, and eliminates unpleasant symptoms. The success of the operation largely depends on the surgeon's experience and the clinic's equipment, the qualifications of the staff, and the availability of modern equipment.
At Expert Clinics, all conditions are created for the painless removal of cervical canal polyps and the performance of other gynecological operations. Highly qualified doctors with many years of practice work in the clinic. The examination rooms are equipped with modern equipment for the treatment and diagnosis of diseases. Operations are performed quickly and effectively, in comfortable and absolutely sterile conditions for the patient. The risk of complications and side effects is ruled out. We use unique, cutting-edge minimally invasive treatment methods. They yield outstanding results, and their effectiveness and safety are confirmed by global clinical practice. We apply an individual approach to each patient, acting with the utmost care and delicacy. You can book an appointment directly on the website or by calling the number indicated at the top of the page.
Q&A (Question/Answer)
1) What complications can occur after the removal of a cervical canal polyp?
The risk of complications during and after the operation is minimal. However, in some cases, there may be negative consequences:
•        Formation of coarse scars (cicatrices).
•        Narrowing of the cervical canal lumen (stenosis).
•        Damage to the uterine walls.
•        Onset of the adhesion process (synechiae).
•        Weakening of the body's defensive functions.
•        Development of infections.
•        Onset of tissue inflammation.
•        If pathological cells are not completely removed, they can proliferate and transform into cancer.
•        Blood accumulation in the uterine cavity because the cervix contracts (hematometra).
•        Hemorrhage (bleeding) may occur.
Even after a successful operation, the risk of recurrence is high. Much depends on the surgeon's experience and the chosen method. In 20% of cases, polyps reappear.
2) What should one not do after removing a cervical polyp?
Complete recovery takes 3–5 weeks. During this period, the patient must strictly follow all of the doctor's prescriptions.
It is prohibited to:
•        Sunbathe in a tanning bed or on the beach.
•        Visit a bathhouse or sauna.
•        Swim in a pool or open water bodies.
•        Take a bath—wash only by showering.
•        Exercise or lift heavy objects.
•        Use vaginal tampons—replace them with sanitary pads.
•        Have sexual intercourse (for 2 weeks, until the first menstruation, or until the doctor permits).
•        Consume products that can cause constipation—for example, refined sugar, baked goods (flour products), meat, or fats.
Conception is contraindicated for 3–6 months after polypectomy. Contraception should be used as prescribed by the doctor.
3) How long does one stay in the hospital after the removal of a cervical canal polyp?
Laser or radiofrequency removal is performed on an outpatient basis. After 2–4 hours of observation, the patient can go home. After hysteroscopy with curettage, one must stay in the hospital for 24 hours (one day). A follow-up examination is performed 7–10 days after the procedure and after the first menstruation.