Flashcards in Cervical Polyps Deck (35)
1
What are cervical polyps?
Benign growths protruding from the inner surface of the cervix
2
Why are cervical polyps clinically significant?
A very small minority can undergo malignant change
3
What is the prevalence fo cervical polyps/
Estimated 2-5% of women
4
What do cervical polyps develop as a result of?
As a result of focal hyperplasia of the columnar epithelium of the endocervix
5
What causes cervical polyps?
The aetiology is unclear, but suggested causes are;
- Chronic inflammation
- Abnormal response to oestrogen
- Localised congestion of cervical vasculature
6
Who are cervical polyps more common in?
Multigravidae
7
At what age is the peak incidence of cervical polyps?
50-60 years of age
8
What is the most common presenting of cervical polyps?
Most often asymptomatic, identified only via routine cervical screening
9
If symptomatic, what is the most common clinical feature of cervical polyps?
Abnormal vaginal bleeding
10
What forms can the abnormal vaginal bleeding take in cervical polyps?
- Menorrhagia
- Intermenstrual, post-coital, or post-menopausal bleeding
11
What are the less common presentations of cervical polyps?
- Increased vaginal discharge
- Infertility
12
How can cervical polyps cause infertility?
If they grow large enough to block the cervical canal
13
What is found on speculum examination in cervical polyps?
Usually visible as polypoid growths projecting through the external os
14
What are the other causes of abnormal vaginal bleeding?
- Cervical ectropion
- Cancer
- STIs
- Fibroids
- Endometritis
- Pregnancy related bleeding
15
What is an important differential to exclude in cervical polyps in post-menopausal women?
Endometrial carcinoma
16
What is an alternative diagnosis if a polypoid lesion has be visualised within the cervix?
Endometrial polyp, which could be projecting through the cervical canal
17
How is the definitive diagnosis of cervical polyps made?
Histological examination after its removal
18
What is the main role of investigations in suspected cervical polyps?
To rule out differentials
19
What investigations may be done to rule out differentials in cervical polyps?
- Triple swabs
- Cervical smear
20
Why can cervical smear be difficult in cervical polyps?
Sometimes the polyp can prevent the smear being taken, in which case the smear should be repeated after the polyp has been removed
21
What % of women with cervical polyps have associated endometrial polyps?
27%
22
What should be done if symptoms of bleeding persist after the removal of the cervical polyp?
Ultrasound scan should be arranged to assess endometrial cavity
23
What is the risk of malignant transformation of cervical polyps?
Less than 0.5%
24
What is the result of the risk of malignant transformation of cervical polyps?
It is common practice to remove them when they are identified, even if asymptomatic
25
When can cervical polyps be removed in a primary care setting?
If small
26
How are small cervical polyps removed in a primary care setting?
The polyp is grasped with polypectomy forceps. and twisted several times. The polyp is avulsed as the pedicle becomes twisted
27
Should you pull the cervical polyp when removing it with polypectomy forceps?
No, as this will result in more bleeding
28
What should be done if there is any bleeding when removing small polyps in primary care?
Should be cauterised with silver nitrate
29
When will cervical polyps need to be removed in a colposcopy clinic?
Larger polyps, or those that are more difficult to access
30
How are cervical polyps removed in a colposcopy clinic?
Diathermy loop excision
31
When should cervical polyps be removed under general anaesthetic?
If the base of the polyp is broad
32
What should be done with all excised cervical polyps?
They should be sent for histological examination to exclude malignant
33
What is the recurrence rate of cervical polyps?
6-12%
34
What are the complications of polypectomy?
- Infection
- Haemorrhage
- Uterine perforation (very rare)
35