Benign Cervical Polyp

Benign Cervical Polyp

Article
Sexual Health
Women's Health
+2
Contributed byKrish Tangella MD, MBAOct 28, 2019

What are the other Names for this Condition? (Also known as/Synonyms)

  • Benign Polyp of Cervix
  • Benign Polyp of Uterine Cervix

What is Benign Cervical Polyp? (Definition/Background Information)

  • The cervix of uterus has 2 parts namely the endocervix and ectocervix. The endocervix is the upper part of the cervix, lined by glandular epithelium. The ectocervix is the lower portion of the cervix, lined by squamous epithelium
  • Benign Cervical Polyps are common tumors of the uterine cervix, found mostly in middle-aged and older women. They may be of 2 types depending on the location of the polyp within the cervix:
    • Benign endocervical polyp: It is a tumor of the uterine endocervix and is lined by glandular epithelium
    • Benign ectocervical polyp: It is a tumor of the uterine ectocervix and is lined by squamous epithelium. It is less commonly observed than an endocervical polyp
  • There are no clearly established risk factors for a Benign Cervical Polyp and the cause of tumor formation is also unknown
  • The tumor appears as a single small polyp in the cervix. No significant signs and symptoms or complications are noted for small-sized tumors. However, some women may present with abnormal bleeding following sex and/or abnormal vaginal discharge
  • Treatment course includes close observation of the tumor in asymptomatic cases and surgical management, if necessary. In general, the prognosis of Benign Cervical Polyp is excellent with suitable treatment

Who gets Benign Cervical Polyp? (Age and Sex Distribution)

  • Benign Cervical Polyp is a common tumor that is observed in adult women over 40 years old. It may be seen at any age, though it is extremely rare before menarche
  • There is no known ethnic or racial preference

What are the Risk Factors for Benign Cervical Polyp? (Predisposing Factors)

  • No definitive risk factors have been identified for Benign Cervical Polyp
  • However, a vast majority of the tumors are only observed in women with a history of pregnancy

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Benign Cervical Polyp? (Etiology)

Currently, the exact cause and mechanism of formation of Benign Cervical Polyp is unknown.

What are the Signs and Symptoms of Benign Cervical Polyp?

A majority of the tumors are asymptomatic, presenting no significant signs and symptoms. In some cases, the following signs and symptoms of Benign Cervical Polyp may be noted:

  • Abnormal vaginal bleeding, particularly after having sex
  • There may be pain during sexual intercourse
  • Abnormal vaginal discharge
  • The polyp is usually less than 1 cm in size; it is usually solitary in nature
  • Benign Cervical Polyps may be lined by squamous or glandular epithelium. The polyp surface, when examined, may be eroded or inflamed
  • Large tumors may cause significant signs and symptoms such as abdominal/pelvic pain and discomfort, urination difficulties, and even lower back pain

How is Benign Cervical Polyp Diagnosed?

A diagnosis of Benign Cervical Polyp may involve the following steps:

  • Evaluation of the individual’s medical history and a thorough physical (pelvic) examination
  • Ultrasound scan of the abdomen
  • CT or CAT scan with contrast of the abdomen and pelvis may show a well-defined mass. This radiological procedure creates detailed 3-dimensional images of structures inside the body
  • MRI scans of the abdomen and pelvis: Magnetic resonance imaging (MRI) uses a magnetic field to create high-quality pictures of certain parts of the body, such as tissues, muscles, nerves, and bones. These high-quality pictures may reveal the presence of the tumor
  • A Pap smear may be ordered as a screening procedure. An abnormal Pap smear warrants further testing
  • Colposcopy: The cervix is examined with an instrument, called a colposcope. This helps the physician get a magnified view of the cervix

Cervical biopsy: It is the process of removing tissue for examination. In the case of Cervical Polyp, a complete excision and removal of the tumor can help in the process of a biopsy, as well as be a means for treating the condition.

A pathologist looks at the tissue sample under a microscope, to detect any evidence of cancer. Types of cervical biopsies include:

  • Colposcopic biopsy: The abnormal areas of the cervix are visualized with a colposcope. After numbing the cervix with a local anesthetic, an instrument, called a biopsy forceps, is used to get a tissue sample.  Mild cramps, pain, and some light bleeding, may occur following the procedure
  • Endocervical curettage (endocervical scraping): The curette is an instrument that can be used to scrape out tissue. Using a curette, cells are scraped out from the endocervix (the inner part of the cervix, close to the uterus/womb) and examined under a microscope. Mild pain and bleeding maybe present following the procedure.

Note:

  • On a colposcopic exam, an ectocervical polyp may be readily visualized, because it is placed in the lower part of the cervix. However, an endocervical polyp may not be readily visualized, because it may be placed higher up in the cervix
  • On a Pap smear, an ectocervical polyp may show the presence of atypical squamous cells; an endocervical polyp may show the presence of atypical glandular cells

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Benign Cervical Polyp?

Significant complications from Benign Cervical Polyp are generally not noted. However, the following may be observed in some cases:

  • Emotional distress due to a concern for cervical cancer
  • Polyps can ulcerate and bleed resulting in secondary infections
  • Fertility issues due to mechanical obstruction of the cervix: Blockage of the cervical canal opening can obstruct easy passage of the sperms
  • Polypoid tumors may undergo mechanical injury, such as torsion or twisting, which can result in excruciating pain
  • Damage to the muscles, vital nerves, and blood vessels, during surgery
  • Post-surgical infection at the wound site is a potential complication

How is Benign Cervical Polyp Treated?

Treatment measures for Benign Cervical Polyp may include the following:

  • If there are no symptoms, then the healthcare provider may advise a ‘wait and watch’ approach
  • Surgical intervention with complete excision can result in a complete cure
  • Post-operative care is important: Minimum activity level is to be ensured until the surgical wound heals
  • Follow-up care with regular screening and check-ups are important

How can Benign Cervical Polyp be Prevented?

  • Current medical research has not established a way of preventing Benign Cervical Polyp
  • Medical screening at regular intervals with scans and physical examinations are advised

What is the Prognosis of Benign Cervical Polyp? (Outcomes/Resolutions)

  • The prognosis of Benign Cervical Polyp is excellent with surgical intervention and complete removal, since it is a benign tumor
  • Large tumors may cause fertility issues and excessive bleeding, which can affect the prognosis

Additional and Relevant Useful Information for Benign Cervical Polyp:

Please visit our Women’s Health center for more physician-approved health information:

http://www.dovemed.com/healthy-living/womens-health/

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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