POLYP CERVIX

Definition
• Cervical polyps are small polyps, growing on the
surface of the cervical mucosa, or in the
endocervical canal and protruding on the cervical
mouth.
• Cervical polyp or uterine polyp is a mass or soft
tissue that grows in the inner lining of the uterus
and protrudes into the uterine cavity.
• The prevalence of cervical polyp cases ranges
from 2 to 5% of women.
Cervical polyps often have short legs, but some can have a wide base. The cause is not yet clear,
although its appearance illustrates the response of the cervical endo epithelial to the inflammatory
process. Cervical polyps can cause vaginal bleeding, contact bleeding, post coitus or after washing.
Classification
• 1; Ectocervical polyps.
Cervical polyps can grow from the outer surface layer of the
cervix.
Ectocervical polyps are often suffered by women who have
entered the post-menopausal period, although they can also be
suffered by women of childbearing age.
• 2; Endocervical polyps.
The growth of polyps comes from the inside of the cervix.
Usually in premenopausal women (over the age of 20 years) and
already have at least one child.
• Although the division of cervical polyps into ectocervical and
endocervical polyps is practical enough to determine the
location of the lesion based on age, it is not an absolute
measure to determine the exact location of polyps.
Differentiation
• Ectocervical polyps are slightly pale or flesh-red in color, soft,
and grow circularly or elongated from the pedicle.
• These polyps grow in the portion area and rarely cause
bleeding as endocervical polyps or malignant polypoid
degeneration.
• Microscopically, ectocervical polyp tissue contains more fibrous
fibers than endocervical polyps.
• Ectocervical polyps have or do not even contain mucous
glands.
• The outside of the ectocervical polyp is covered by squamous
stratified epithelium.
• Cell to malignant changes can occur, especially in ectocervical
polyps with chronic inflammation, which often causes necrosis
at the tip of the polyp.
Aetiology
Clinical Manifestation
• Abnormal vaginal bleeding that occurs between menstrual periods,
after menopause, after sexual intercourse, and after douching.
• The main symptom is the occurrence of bleeding outside
menstruation whose color is lighter than menstrual blood. Mainly
arises after intercourse.
• Cervical polyps can be inflamed but they rarely become severe
infections or menorrhagia
• discharge of white or yellow mucus; (vaginal discharge)
• Only a few symptoms are recognized and sometimes without
symptoms.
• A woman needs to have an annual checkup to evaluate women's
reproductive health.
Patofisiology
• Cervical polyps can attack the surface layers of the cervix
(ectocervical) and the inside of the cervix (endocerviic).
• Normally the cervical uterus in nullipara is in a normal condition
germ-free cervical canal, in multiparas with the external uterine
ostium more open, the upper limit of the germ-free internal uterine
ostium.
• Inflammation of the cervix uteri, can be found in the uterine portion
outside the external uterine ostium and / in the endocervix.
Gonorrhea, syphilis, molle ulcers and inguinale granulomas and
tuberculosis can be found chronic inflammation of the cervix.
• Due to chronic inflammation / virus triggers endocervical response
with the emergence of fibroma adenomas (hyperplasia of
endocervical epithelium).
• After the endocervical epithelium grows prominent and / is
stemmed and can be long to come out of the vulva, the ends
experience necrosis and bleed easily. (Prawirohardjo, Sarwono.
2009. Gynecology Science.Jakarta: YBPSP)
Risk Factor
• Risk factors for having cervical polyps are increased in
women with diabetes mellitus and recurrent vaginitis and
cervicitis.
• Cervical polyps never really occur before the onset of
menstruation, usually seen in women of reproductive age.
• The most vulnerable to this disease are women aged 40
to 50 years.
• Research also says that cervical polyps can be found in
incidents that trigger hormone production.
• Pregnant women have a higher risk because of changes
in hormone levels, possibly from an increase in circulating
hormone production as well.
Diagnosis and prevention
1. Based on the complaints raised.
2. Diagnosis due to chance checking.
3. On the inspection of the inspeculum found:
• Network increases
• Bleeding easily
• It's in the upper vagina.
There are several steps that can help prevent this infection:
• Clothing / pants made from cotton or cotton padded stockings
This helps prevent the accumulation of excess heat and moisture. The
heat and humidity make a woman vulnerable to vaginal and cervical
infections.
• Use of condoms
This is to reduce the risk of sexually transmitted infections.
Management
1. Conservative.
Namely if the size of the polyp is small,
does not interfere, and does not cause
complaints (eg frequent bleeding, often
vaginal discharge). the doctor will allow
and observe the polyp development
periodically.
2. Aggressive.
Ie, if the size of the polyp is large, the size
increases, interferes with activities, or
causes complaints. This aggressive action
is in the form of curettage or cutting polyps.
Complication and Prognose
• Complications
Cervical polyps can be infected, usually by the Staphylococcus,
Streptococcus, and other pathogen groups. Serious infections
usually occur after medical instrumentation is done to make the
diagnosis or after removing the polyp. Broad-spectrum antibiotics
need to be given if early signs of infection have been seen. The
initiation or exacerbation of acute salphingitis can occur as a
consequence of polypectomy.
• Prognosis
Prognosis of the disease is generally good. Simple extirpation by
removing polyps directly is a very curative action and is rarely
repeated. 99% of cervical polyps will remain benign and 1% will at
some point show neoplastic changes. cervical polyps will not grow
back.