Cervical Polyps Flashcards Preview

B - Gynaecology > Cervical Polyps > Flashcards

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

How is the risk of uterine perforation caused by polypectomy reduced?

Only polyps that are visible easily should be removed in the outpatient setting