Do uterine polyps require curettage?

We know that most polyps are caused by inflammation, but our attitudes towards uterine polyps vary greatly among women. Some people are very afraid that it will affect fertility or even turn into tumors or cancer in the future. After all, there are many such examples. Some women, however, believe that polyps are just minor problems caused by inflammation. As the inflammation subsides, the pain will also disappear. So whose opinion is correct? How much do we know about uterine polyps? Let's take a look at the relevant knowledge about uterine polyps. And today's question: Do uterine polyps require curettage?

1. Uterine polyp (metropolypus) is a common gynecological disease. In a broad sense, it refers to all tumors attached to the uterine wall by slender pedicles, including endometrial polyps, endometrial adenomyoma polyps, malignant polyps, etc. Most of them are benign and may have no obvious clinical symptoms, or they may cause increased menstruation, abnormal leucorrhea, vaginal bleeding, uterine enlargement, pain, etc. Hysteroscopic examination shows that polyps vary in size and pedicle length, which is a common intrauterine lesion in gynecology. Among them, endometrial polyps are the most common.

2. Tumor prolapse

If polyps occur in unmarried young women, such patients may show symptoms of prolapse of a swelling at the vaginal opening.

Abnormal vaginal discharge

Patients may experience increased leucorrhea and bloody leucorrhea. A small number of polyps with larger pedicles may protrude from the cervix, causing a small amount of vaginal bleeding, or bleeding after sexual intercourse and when squatting and straining to defecate. If the polyps become ulcerated, infected, or necrotic, bloody or purulent leucorrhea may occur.

Abnormal uterine bleeding

Patients may experience excessive menstruation, shortened or prolonged menstrual periods, or prolonged menstruation. Some patients will also bleed after sexual intercourse, the amount of bleeding in some patients is even similar to menstruation, and some patients may also experience postmenopausal vaginal bleeding.

Some patients with uterine polyps experience infertility or miscarriage, which is related to the location, size and number of the polyps. If polyps grow in the cervical canal, they may hinder sperm from entering the uterine cavity; if they grow in the uterine cavity, they will hinder the implantation of the fertilized egg or affect the development of the embryo, leading to infertility and miscarriage.

3. Ultrasound examination

As the most commonly used auxiliary diagnostic method, transvaginal ultrasound examination can determine the location, number, and size of polyps, and can also observe changes in the gross morphology of the uterus.

Gynecological examination

Gynecological bi- and tri- examinations were used. When uterine polyps are infected and acute inflammation occurs, the cervix may become congested, edematous, or eroded, with purulent secretions discharged from the cervical canal, and there may be pain when the cervix is ​​touched. If the pedicle of the uterine polyp is long, a lump can be seen or felt at the cervical opening. In patients with chronic cervicitis, the cervix may show varying degrees of hypertrophy, polyps, glandular cysts, and ectropion, or there may be purulent secretions at the cervical os and a hard cervix upon palpation. If it is cervical disease or polyps, there may be contact bleeding.

Hysteroscopy:

Hysteroscopy can directly observe the situation in the uterine cavity and perform biopsy on suspicious lesions under direct vision.

Pathological examination

Endometrial polyps are composed of the endometrium, covered with a layer of cuboidal epithelium or low columnar epithelium. The middle part of the polyp forms a fibrous longitudinal axis, which contains blood vessels. Due to the narrow pedicle and reduced blood supply, polyps are very prone to degeneration. Polyps are most prone to intravascular thrombosis, turning dark purple due to congestion, often beginning to necrotize at the top and eventually falling off.

The following aspects should be noted:

If there is accompanying inflammation, the infection must be controlled first.

If bleeding occurs, stop the bleeding first.

Surgery should be performed after inflammation is controlled.

After surgical resection, the polyp should be sent for pathological examination. If there are signs of malignancy, treatment measures should be taken as soon as possible.

This disease is prone to recurrence, and regular follow-up examinations should be conducted after surgery, once every 3 months.