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Endometrial Polyp

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ENDOMETRIAL POLYP

Endometrial polyp or uterine polyps are the same syndromes, is a mass in the inner lining of the uterus. They may have a large flat base attached to the uterus by a stalk pedunculated Their size varies from a few millimeters to several centimeters. Endometrial polyps are localized hyperplastic growth of endometrial glands and stroma that are sessile or pedunculated projection from the surface of the endometrium. They rarely include foci of neoplastic growth. These soft endometrial tumors are red and fleshy (uterus or endometrium). Endometrial tissue changes in the size of 1 cm - 5 cm. Large polyps are not usually deep in the wall of uterine endometrial cells, but also includes the muscles and fibrous tissue. In a large series of 509 consecutive women with endometrial polyps removed by hysteroscopy, histology was benign in 70 percent, and showed hyperplasia externally atypia in 26 percent, hyperplasia with atypia by 3 percent, and cancer of 0. 8 percent. The average age of women was 56 years and just over half had abnormal uterine bleeding. Endometrial polyps are rare in women under 20 years of age.

A uterine polyp is an abnormal growth of tissue that arises from the endometrium lining the uterus. This tissue is shredded during the menstrual cycle. Although polyps are found normally in the womb, from time to time may arise on the surface of the cervical canal. Uterine polyps are small protrusions, benign tissue that grow in the lining of the uterus (endometrium). They are an overgrowth of the same kind of cells that the coating itself and may appear as finger-like projections or mushrooms recently. As they grow, they become fragile and bleed, and as such are a common cause of abnormal uterine bleeding. Occasionally a polyp can grow on or through the cervix and cause irritation and irregular bleeding. One or more polyps can occur, ranging from a few millimeters to several centimeters.

CAUSES:

No definitive cause of endometrial polyps is unknown, but seem to be affected by hormone changes and grow in response to estrogen circulation. Where they occur, signs include irregular menstrual bleeding, bleeding between menstrual periods, Excessively heavy menstrual bleeding (menorrhagia) and vaginal bleeding after menopause. Bleeding from blood vessels in the polyp contributes to increased blood loss during menstruation and blood "spotting" between periods or after menopause. If polyp protrudes through the cervix into the vagina, pain can result. Because they are common after menopause, and is believed to be caused by hormonal imbalances that occur in these people. She was also associated with chronic infectious processes of congestion of the uterus and blood vessels. Polyps in the uterus are sensitive to estrogen, which means they respond to the hormone estrogen in the same way as the lining of the uterus - in response to increasing circulating estrogen.

SYMPTOMS:

Polyps are prone to bleeding. In many cases, the first evidence of its existence is bleeding between periods. Pedunculated polyps sometimes hang through the cervix, which can be trapped and cut off the blood supply (known as strangulation). In this case, can bleed profusely and be painful.

Irregular menstrual bleeding that changes in duration and heaviness

  • Infertility

  • Very heavy and prolonged menstrual periods

  • Enlarged abdomen which can be mistaken for pregnancy, or weight gain

  • Pressure on the bladder causing a standard need to urinate or the inability to empty the bladder

  • Pressure on the bowel which can lead to constipation and/or bloating

  • Pain during intercourse

  • Pain in the back of the legs

  • Uterine polyps symptoms include:

  • Irregular menstrual bleeding - for example, extremely heavy vaginal

  • bleeding after menopause, infertility, menstrual periods, vaginal length and weight of bleeding between menstrual periods, often unpredictable periods

DIAGNOSIS:

Endometrial polyps might be detected by vaginal ultrasound (sonohysterography), hysteroscopy and dilation and curettage. Detection by ultrasound can be difficult, especially when there is endometrial hyperplasia (excessive thickening endomeritum). Large polyps may be missed by scraping. A special ultrasound, called sonohysterogram or water ultrta sound, when a few drops of sterile water infused into the uterus through the vegina to view the uterine cavity to determine if there are polyps. Hysterosalpingography using a dye under pressure to open the uterine cavity, followed by rapid X-ray to check for polyps.

Transvaginal ultrasound:

The thin, stick-like explosive device placed in the vagina and sends the sound waves create an image of the uterus, including its interior. A relationship, known as hysterosonography, involves the existence of salt water (saline) was injected into the uterus through a small tube through the interdependence of the vagina and cervix. Saline expands the uterine cavity, which gives the doctor a clearer view inside the uterus.

Hysteroscopy:

The doctor can perform an action called the uterus to diagnose and treat uterine polyps. In the womb, the doctor inserts a thin, flexible, lighted telescope (hysteroscope) through the vagina and cervix. Hysteroscopy allows the physician to examine the inside of the uterus and remove any polyps that are found. This eliminates the need for observing

Curettage:

During the curettage, the doctor uses a long metal instrument with a loop at the end to clean the inner walls of the uterus. This can be done to collect samples for laboratory tests or to remove a polyp. Your doctor can perform curettage, with the assistance of the hysteroscope, which allows the doctor to look inside the uterus before and after the procedure. When used alone without using a hysteroscope, a procedure known as a blind curettage. Most uterine polyps are benign (benign). However, some precancerous changes in the uterus (endometrial hyperplasia) or cancer of the uterus (endometrium) appear as uterine polyps. Your doctor may send a tissue sample for laboratory analysis to ensure that they have cervical cancer.

TREATMENT:

The polyps can be removed surgically with curettage with or without hysteroscopy. When the curettage is performed without hysteroscopy, polyps can be lost. To reduce this risk, the uterus may be the first to explore with tweezers at the start of the procedure of curettage. Hysteroscopy is the visualization of the endometrium (lining of the uterus) and polyp with a camera inserted through the cervix. If it is a polyp, it can be cut into sections before each section was deleted. If cancer cells are discovered, a hysterectomy (surgical removal of the uterus) can be performed. A hysterectomy is often not taken into account if the cancer has been ruled out. Whichever method is used, the polyps are usually treated with general anesthesia. Treatment usually includes endometrial polyps to remove a polyp cauterization, laser therapy to remove a polyp, or surgical excision. Small polyps can be removed in the doctor's office for the guidance of a hysteroscope through the vagina and cervical opening to grab the polyp and cut with small scissors. Larger polyps are removed in the operating room under general anesthesia to control bleeding as possible. If polyps are numerous, a hysterectomy may be recommended.

Other ways to treat symptoms include polyps or polyps reduced thyrotropin-releasing hormone (GnRH). Oral contraceptives or cyclic progestin treatment can help control irregular menstrual flow. Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce cramping and pain control in the pelvis.

  • Watchful waiting:

    • Small endometrial polyps can go away on their own

    • Small, asymptomatic polyps can resolve on their own. Treatment is not required if you are at risk of uterine cancer.

  • Curettage: The doctor uses a long metal instrument with a loop on the end to clean the inner walls of the uterus. This can be done to collect samples for laboratory tests or to remove a polyp. Your doctor may perform curettage with the assistance of the hysteroscope, which allows the doctor to look inside the uterus before and after the procedure. When used on its own without using the hysteroscope, a procedure known as a blind curettage.

  • Surgical removal: If you go through hysteroscopy, instruments inserted through the hysteroscope - the device the doctor uses to see inside the uterus - can remove polyps once they are identified. Remove the polyp may be sent to a laboratory for microscopic examination.

  • Hysterectomy:If upon closer examination shows that the uterine polyp contains cancerous cells, an operation to remove your uterus (hysterectomy) becomes necessary. Polyps of the uterus, after removal, may be repeated. It is possible that you will have to undergo treatment more than once if you experience recurring uterine polyps.

  • To develop a diagnosis: This is usually done by scrapping and test the tissue in the laboratory. May have the larger polyps, other diagnostics are a special x-ray of the womb or uterus(where a thin telescopic device enables the surgeon checks inside the uterus).

  • To exclude a malignant cancer: The most polyps are benign (they just get larger, where they are in the womb and not distribute it and do not invade other tissue), but it is important that some of the tissue removed (biopsy) to make sure that it is not accidentally, as malignant endometrial cancer can be formed as a polyp.

  • For the treatment of irregular bleeding, by removing the tumor. In an attempt to improve fertility. Polyps may interfere with the implantation of a fertilized egg in the lining of the uterus, so often removed in an attempt to increase the chances of pregnancy.

COMPLICATIONS:

The major complications are frequent and heavy bleeding that may produce anemia.
If a woman is pregnant may cause abortion.
Some patients are likely to occur sterility (inability to have children).
In very few cases tend to malignancy, specially in older women.

PROGNOSIS:

Rarely, once the growths are eliminated, they can return -- this generally causes years later, if at all. Many polyps grow too slowly. Rarely is main surgery required for polyps, unless they are discovered to be precancerous or cancerous.

PREVENTION:

Because the underlying reasons are not known, it is feasible to develop preventive measures. Only Promptly treat vaginal infections and intrauterine devices only when require. The risk of malignancy of polyps, although low, raises with patient's age and the size of them, so special care must be taken in people above 60 with bleeding.

 

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