loader

UTERINE POLYPS TREATMENT

UTERINE POLYPS

DIFFERENT TYPES OF POLYPS: -

Benign polyps: -

  • Mucus
  • Fibroid
  • Placental

MALIGNANT: -

De novo Secondary changes of benign polyp.

Benign: - polyp is a clinical entity referring a tumor attached by a pedicle.

Mucous: -The commonest type of benign Uterine polyp is the mucus one. It may arise from the body of the uterus of from the cervix.

Risk factors: Hormone replacement therapy, tamoxifen therapy, diabetes, hypertension, obesity and increased patient age are the important risk factors.

Pathogenesis Body: A part of the thick endometrium projects into the cavity and ultimately attains a pedicle.

Naked eye appearance shows a small polyp size of about 1–2 cm, looks reddish and feels soft. The pedicle may at times be long enough to make the polyp protruded from the cervix.

Microscopically — The core contains stromal cells, glands and large thick-walled vascular channels. The

surface is lined by endometrium. The tip may undergo squamous metaplasia. Malignant change is rare but may coexist with endometrial carcinoma. The pedicle contains thin fibrous tissue with thin blood vessels.

Rarely, smooth muscles invade the polyp and is then called adenomyomatous polyp.

Predictors of malignancy are:

(a) Size >10 mm

(b) Postmenopausal status

(c) Abnormal uterine bleeding.

Cervical: The polyp mainly arises from the endocervix and rarely from the ectocervix. The stimulus of epithelial overgrowth is probably due to hyperestrinism, chronic irritation by infection or localized vascular congestion.

Naked eye appearance shows the polyp of usually small size rarely exceeding 1–2 cm, single and red in color. The pedicle may at times be long enough to reach the vaginal introitus.

Microscopically—The stroma consists of fibrous connective tissues with numerous small blood vessels and occasional cervical glands. The lining epithelium is tall columnar like that of endocervix. The tip may undergo squamous metaplasia. Malignant change is rare and usually of squamous cell carcinoma.

SYMPTOMS: There may not be any symptom. The entity is accidentally discovered during speculum examination, following hysterosalpingography (filling defect) or hysteroscopy.

However, the following symptoms are related:

  • Irregular uterine bleeding, either pre or postmenopausal
  • Contact bleeding, if the polyp is situated at or outside the cervix
  • Excessive vaginal discharge which may be offensive.
  • Multiple endometrial polyps may cause infertility or miscarriage in young women.

SIGNS: Unless the polyp is at or outside the external os, no positive finding is present. However, if it protrudes out of the cervix, it feels soft, slippery and is small in size. Per speculum, it looks reddish in color, usually attached with a slender pedicle.

HOMOEOPATHIC MEDICINES FOR UTERINE POLYPS: -

From a huge lists of medicines for managing Uterine polyps, the major ones are:

  • Calcarea carb
  • Medorrhinum
  • Belladonna
  • Phosphorus
  • Sepia
  • Thuja
  • Teucrium marum varum