1.

Definition

The cervix is a tubelike channel that connects the uterus to the vagina. A

polyp is a mass of tissue projecting from a mucous membrane. Cervical polyps are

growths that usually appear on the cervix where it opens into the vagina. Polyps

are usually smooth, soft, cherry-red to reddish-purple or grayish-white. They are

considered fragile because it is common for polyps to bleed when touched. They

vary in size and often look like bulbs on thin stems. Cervical polyps are usually

not cancerous (benign) and can occur alone or in groups. Most polyps are small,

about 1 centimeter to 2 centimeters long. Because rare types of cancerous

conditions can look like polyps, all polyps should be removed and examined for

signs of cancer. (Harvard)

 There are two types of cervical polyps:

Ectocervical polyps can develop from the outer surface layer cells

of the cervix. They are more common in postmenopausal women.

Endocervical polyps develop from cervical glands inside the

cervical canal. Most cervical polyps are endocervical polyps, and

are more common in premenopausal women (reproductive ages).

Endocervical growths tend to have a longer stalk.

2. Epidemiology
Polyps are rare, occurring in about one in every 10,000 women. They are

more common in women who have been pregnant more than once. More

than 99% of polyps are benign. The incidence of malignant polyps of the

cervix is rare. Less than 1 in every 200 polyps is malignant. (hers)

According to Harvard University, theyre most common in women in their

40s and 50s whove had more than one child. Polyps almost never occur in

young women before the start of menstruation. Polyps are also common

during pregnancy. This may occur due to an increase in the hormone

estrogen. (healthline)

3. Etiology
The cause of cervical polyps is not well understood, but they are
 associated with inflammation of the cervix. They also may result from an

abnormal response to the female hormone estrogen. (harvard)

Suggested theories include:

Abnormal response to the female hormone estrogen. Estrogen may

over stimulate the growth of cervical tissue. Estrogen levels will be

highest during childbearing years, during any pregnancies, and in

the months leading up to menopause.

Chronic inflammatory disease that irritates the cervix.
Clogged blood vessels in the cervix.

4. Manifestation

Cervical polyps often cause no symptoms. If symptoms do occur, they may

include:

Heavier bleeding during periods

Bleeding after intercourse
Bleeding after menopause
Bleeding between periods
Vaginal discharge, with a foul smell caused by infection

5. Diagnosis
Diagnosing cervical polyps is relatively easy because they are usually

clearly visible during a pelvic examination. They appear red or purple

fingerlike growths with a smooth surface and protrude from the cervical

canal.(medline)
Ultrasound examination will show:
Sessile or pedunculated well-circumscribed masses within the

endocervical canal
may be hypoechoic or echogenic
identifying the stalk attaching to the cervical wall helps
 differentiate it from an endometrial polyp
A cervical biopsy will be performed. Most of the time, the biopsy will

show cells that are consistent with a benign polyp. Rarely, there may be

abnormal, precancerous, or cancer cells in a polyp. (medlineplus).

6. Treatment

The most effective and least invasive way to remove polyps is with a

polypectomy during a pelvic exam. This can be done by gently twisting the

polyp until it is freed. After the polyp is removed, the base is cauterized to

stop the bleeding.

Depending on the size of the polyp, other methods of removal include:

Tying the base of the polyp to minimize bleeding

Electrical current (LEEP) or laser therapy, for large polyps
Traditional surgery to cut off and stitch close the polyp site
Dilation and curettage, scraping the polyp off for heavy or irregular

bleeding, often without knowing the cause of the bleeding.

The removed polyp will be sent to the laboratory to evaluate for signs of

cancer.(bcm)

7. Differential Diagnosis

For a polypoid lesion within the cervical canal consider:

pedunculated uterine leiomyoma protruding through the cervical

canal
endometrial polyp protruding through the cervical canal
blood clot (mimic) (radiopedia)

8. Complication

A small percentage of polyps (between 2 and 15 in every 1,000) are

abnormal and may develop into cancer if left. (nhs)

9. Prognosis
The outlook is excellent. The vast majority of cervical polyps are not

cancerous. Once removed cervical polyps tend not to grow back on the

original site. However, they can occur in other parts of the cervix. For this

reason, a regular pelvic examination is recommended so that new growths

can be spotted and treated before they cause symptoms. (harvard)