Endometrial Polyps

Endometrial Polyps
[Summary]



Where, by the slender pedicle attached to the uterine cavity wall mass clinic can be called uterine polyps. Therefore, in the uterine cavity of polypoid mass may be pedunculated submucosal fibroids, endometrial polyps, uterine Adenomyoma like polyps and malignant polyps (cancer or sarcoma).



[Diagnosis]




The main symptoms are increased or irregular menstrual bleeding volume; cervical I see or touch the polyps, uterine body slightly increased for the sub-hysteroscopy or scraping up, the organization will remove the polyps removed or send pathological examination it is clear diagnosis, and dysfunctional uterine bleeding and submucosal uterine fibroids and endometrial cancer, and other identification.


[Treatment]




Dilated cervix, removed polyps, followed Saogua whole uterine cavity can be diffuse small polyps curettage, and sent to pathological examination. Postoperative follow-up should be regularly, and pay attention to the recurrence of malignant transformation, timely treatment. In recent years it was used Hysteroscopic laser treatment or surgical resection of small polyps, a success.

On the patients over 40 years of age, if the bleeding obvious, would not eradicate the treatment of recurrent or recurrence, may consider hysterectomy.


[Etiology:




The reasons for the formation of polyps, and may be inflammatory, endocrine disorders, in particular the high levels of estrogen. Most scholars believe that polyps of the endometrium from the immature, particularly at the bottom of endometriosis.


[Pathological changes:




General observation, the most common type is the limitations of endometrial tumors in the uterine cavity outstanding, or a single hair, gray red, glossy, generally smaller, with an average diameter of 0.5 to 2 cm in between. Only a small 1 to 2 mm in diameter, large and can be filled with multiple intrauterine. Beattie thickness and vary in length and can be prominent in the elderly extraoral cervix. Some shorter Beattie, a diffuse growth (Figure 1). Surface polyps often hemorrhage and necrosis can be co-infection, such as torsion, a hemorrhagic infarction.



Figure 1 endometrial polyps

Microscope: endometrial polyps from endometrial composition of the surface layer of cubic epithelial lining or low columnar epithelium. The middle part of polyp formation of the longitudinal fibers, which contain blood vessels.

The pedicle narrow, reducing blood supply, polyps vulnerable degeneration. Most prone polyps intravascular thrombosis, as a result of bleeding dark purple, and often start in the top of necrosis, and may eventually rot collapsing loss.

Pathologic diagnosis malignant polyps standards: ① must see the whole polyps form; ② to malignant polyps; ③ around the endometrial polyps without cancer. It should be noted with endometrial adenocarcinoma was polypoid growth phase identification.


[Clinical]




The disease can occur at any age after puberty, but is common in women over the age of 35. Single smaller endometrial polyps often without symptoms, often due to other diseases after resection of uterine general inspection before they were found, or in the diagnosis after curettage that diagnosis. Multiple diffuse common menorrhagia, and menstrual extension of this area and increase of endometrial hyperplasia and endometrial relevant. Large polyps or into the neck of the polyps and easy to secondary infection, necrosis, and cause irregular bleeding and the stench of blood secretions.