Do ultrasound polyps. What do polyps in the uterus and endometrium look like on ultrasound with blood flow

04.11.2019 -

Polyps in the uterus are benign areas of endometrial hyperplasia that can progress in growth and cause a number of unpleasant symptoms in a woman - bleeding, pain in the lower abdomen, iron deficiency anemia, infertility.

Predisposing factors for endometrial hyperplasia or its individual sections are:

hormonal changes;
obesity;
diabetes;
chronic inflammatory processes in the uterus and appendages;
abortions;
miscarriages in the early stages;
carried out diagnostic curettage of the contents of the uterus;
heredity.

Preparation and conduct of the procedure

It is recommended to do a pelvic ultrasound immediately after the end of menstruation, that is, approximately on the 7-8th day of the cycle. If a woman has any complaints, for example, heavy bleeding, prolonged menstruation, pain in the lower abdomen, then you can sign up for an examination on any day of the cycle.

Special preparation for the study is not required, but in order for the doctor to better examine the uterine cavity, it is recommended to fill before the procedure bladder. The study is carried out transvaginally to examine the cervix and cervical canal and transabdominally - examine the uterine cavity and appendages.

Signs of a polyp on ultrasound

On the monitor screen, the uterine polyp looks like a separate neoplasm with clear contours - with or without a stalk. Neoplasms of a very small size (no more than a couple of mm) can be seen as a thickening of the endometrium at the site of the polyp. In order for the study to be as informative as possible, it should be diagnosed no later than the 7-8th day of the cycle, when the endometrium is still thin.

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Zhumanova Ekaterina Nikolaevna

Head of the Center for Gynecology, Reproductive and Aesthetic Medicine, Candidate of Medical Sciences, doctor of the highest category, associate professor of the department restorative medicine and biomedical technologies MGMSU named after A.I. Evdokimova, Member of the Board of the ASEG Association of Specialists in Aesthetic Gynecology.

Graduated from the Moscow Medical Academy named after I.M. Sechenov, has a diploma with honors, passed clinical residency at the Clinic of Obstetrics and Gynecology named after. V.F. Snegirev MMA them. THEM. Sechenov.
Until 2009, she worked at the Clinic of Obstetrics and Gynecology as an assistant at the Department of Obstetrics and Gynecology No. 1 of the Moscow Medical Academy. THEM. Sechenov.
From 2009 to 2017 she worked at the Medical and Rehabilitation Center of the Ministry of Health of the Russian Federation
Since 2017, she has been working at the Center for Gynecology, Reproductive and Aesthetic Medicine, JSC Medsi Group of Companies
She defended her dissertation for the degree of Candidate of Medical Sciences on the topic: “Opportunistic bacterial infections and pregnancy"

Myshenkova Svetlana Alexandrovna

Obstetrician-gynecologist, candidate of medical sciences, doctor of the highest category

In 2001 she graduated from the Moscow State University of Medicine and Dentistry (MGMSU)
In 2003 she completed a course in obstetrics and gynecology at the Scientific Center for Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences
He has a certificate in endoscopic surgery, a certificate in ultrasound diagnostics of pathology of pregnancy, fetus, newborn, in ultrasound diagnostics in gynecology, a certificate in laser medicine. He successfully applies all the knowledge gained during theoretical classes in his daily practice.
She has published more than 40 works on the treatment of uterine fibroids, including in the journals Medical Bulletin, Problems of Reproduction. Is a co-author guidelines for students and doctors.

Kolgaeva Dagmara Isaevna

Head of Surgery pelvic floor. Member of the Scientific Committee of the Association for Aesthetic Gynecology.

Graduated from the First Moscow State medical University them. THEM. Sechenov, has a diploma with honors
Passed clinical residency in the specialty "obstetrics and gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov
She has certificates: an obstetrician-gynecologist, a specialist in laser medicine, a specialist in intimate contouring
The dissertation work is devoted to the surgical treatment of genital prolapse complicated by enterocele.
The sphere of practical interests of Kolgaeva Dagmara Isaevna includes:
conservative and surgical methods for the treatment of prolapse of the walls of the vagina, uterus, urinary incontinence, including the use of high-tech modern laser equipment

Maksimov Artem Igorevich

Obstetrician-gynecologist of the highest category

Graduated from the Ryazan State Medical University named after Academician I.P. Pavlova with a degree in General Medicine
Passed clinical residency in the specialty "obstetrics and gynecology" at the Department of Clinic of Obstetrics and Gynecology. V.F. Snegirev MMA them. THEM. Sechenov
He owns a full range of surgical interventions for gynecological diseases, including laparoscopic, open and vaginal access
The sphere of practical interests includes: laparoscopic minimally invasive surgical interventions, including single-puncture access; laparoscopic surgery for uterine myoma (myomectomy, hysterectomy), adenomyosis, widespread infiltrative endometriosis

Pritula Irina Alexandrovna

Obstetrician-gynecologist

Graduated from the First Moscow State Medical University. THEM. Sechenov.
Passed clinical residency in the specialty "obstetrics and gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
She is a certified obstetrician-gynecologist.
Skilled surgical treatment gynecological diseases on an outpatient basis.
He is a regular participant in scientific and practical conferences on obstetrics and gynecology.
The scope of practical skills includes minimally invasive surgery (hysteroscopy, laser polypectomy, hysteroresectoscopy) - Diagnosis and treatment of intrauterine pathology, pathology of the cervix

Muravlev Alexey Ivanovich

Obstetrician-gynecologist, oncogynecologist

In 2013 he graduated from the First Moscow State Medical University. THEM. Sechenov.
From 2013 to 2015, he underwent clinical residency in the specialty "Obstetrics and Gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
In 2016 passed professional retraining on the basis of GBUZ MO MONIKI them. M.F. Vladimirsky, majoring in Oncology.
From 2015 to 2017, he worked at the Medical and Rehabilitation Center of the Ministry of Health of the Russian Federation.
Since 2017, she has been working at the Center for Gynecology, Reproductive and Aesthetic Medicine, JSC Medsi Group of Companies

Mishukova Elena Igorevna

Obstetrician-gynecologist

Dr. Mishukova Elena Igorevna graduated with honors from the Chita State Medical Academy with a degree in general medicine. Passed clinical internship and residency in obstetrics and gynecology at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
Mishukova Elena Igorevna owns a full range of surgical interventions for gynecological diseases, including laparoscopic, open and vaginal access. He is a specialist in providing emergency gynecological care for such diseases as ectopic pregnancy, ovarian apoplexy, necrosis of myomatous nodes, acute salpingo-oophoritis, etc.
Mishukova Elena Igorevna is an annual participant of Russian and international congresses and scientific and practical conferences on obstetrics and gynecology.

Rumyantseva Yana Sergeevna

Obstetrician-gynecologist of the first qualification category.

Graduated from the Moscow Medical Academy. THEM. Sechenov with a degree in General Medicine. Passed clinical residency in the specialty "Obstetrics and Gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 First Moscow State Medical University them. THEM. Sechenov.
The dissertation work is devoted to the topic of organ-preserving treatment of adenomyosis by FUS-ablation. He has a certificate of an obstetrician-gynecologist, a certificate in ultrasound diagnostics. He owns a full range of surgical interventions in gynecology: laparoscopic, open and vaginal approaches. He is a specialist in providing emergency gynecological care for such diseases as ectopic pregnancy, ovarian apoplexy, necrosis of myomatous nodes, acute salpingo-oophoritis, etc.
Series author printed works, co-author of a methodological guide for physicians on organ-sparing treatment of adenomyosis by FUS ablation. Participant of scientific and practical conferences on obstetrics and gynecology.

Gushchina Marina Yurievna

Gynecologist-endocrinologist, head of outpatient care. Obstetrician-gynecologist, reproductive specialist. Doctor ultrasound diagnostics.

Gushchina Marina Yuryevna graduated from the Saratov State Medical University. V. I. Razumovsky, has a diploma with honors. Awarded with a diploma from the Saratov Regional Duma for excellent academic achievement and scientific activity, recognized as the best graduate of SSMU named after V. I. Razumovsky.
She completed a clinical internship in the specialty "obstetrics and gynecology" at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
He has a certificate of an obstetrician-gynecologist; doctor of ultrasound diagnostics, specialist in the field of laser medicine, colposcopy, endocrinological gynecology. Repeatedly attended refresher courses in Reproductive medicine and surgery”, “Ultrasound diagnostics in obstetrics and gynecology”.
The dissertation work is devoted to new approaches to differential diagnosis and tactics of managing patients with chronic cervicitis and early stages of HPV-associated diseases.
He owns a full range of minor surgical interventions in gynecology, carried out both on an outpatient basis (radiocoagulation and laser coagulation erosion, hysterosalpingography), and in a hospital (hysteroscopy, cervical biopsy, conization of the cervix, etc.)
Gushchina Marina Yurievna has more than 20 scientific publications, is a regular participant in scientific and practical conferences, congresses and congresses on obstetrics and gynecology.

Malysheva Yana Romanovna

Obstetrician-gynecologist, pediatric and adolescent gynecologist

Graduated from the Russian National Research Medical University. N.I. Pirogov, has a diploma with honors. Passed clinical residency in the specialty "obstetrics and gynecology" on the basis of the Department of Obstetrics and Gynecology No. 1 of the Medical Faculty of the First Moscow State Medical University. THEM. Sechenov.
He has a certificate of an obstetrician-gynecologist, an ultrasound diagnostician, a specialist in laser medicine, pediatric and adolescent gynecology.
He owns a full range of minor surgical interventions in gynecology, performed both on an outpatient basis (radiocoagulation and laser coagulation of erosions, cervical biopsy), and in a hospital setting (hysteroscopy, cervical biopsy, cervical conization, etc.)
Participant of congresses and scientific-practical conferences on obstetrics and gynecology.
Author of 6 scientific publications.

Ivanova Olga Dmitrievna

Ultrasound doctor

Graduated from the Moscow Medical Academy. THEM. Sechenov with a degree in General Medicine
Passed clinical internship in the specialty "Ultrasound diagnostics" on the basis of the Research Institute for Emergency Medicine named after A.I. N.V. Sklifosovsky
Has a Certificate of the FMF Fetal Medicine Foundation confirming compliance with international requirements for screening of the 1st trimester, 2018. (FMF)

Knows how to do it ultrasound:

Abdominal organs
Kidney, retroperitoneal space
Bladder
Thyroid gland
mammary glands
soft tissues and lymph nodes
Pelvic organs in women
Pelvic organs in men
upper vessels, lower extremities
Vessels of the brachiocephalic trunk
In the 1st, 2nd, 3rd trimester of pregnancy with dopplerometry, including 3D and 4D ultrasound

Kruglova Victoria Petrovna

Obstetrician-gynecologist, pediatric and adolescent gynecologist.

Kruglova Victoria Petrovna graduated from the Federal State Autonomous Educational Institution higher education"Peoples' Friendship University of Russia" (PFUR).
Passed clinical residency in the specialty "Obstetrics and Gynecology" on the basis of the Department of the Federal State Budgetary educational institution additional vocational education Institute for Advanced Studies of the Federal Medical and Biological Agency.
He has certificates: an obstetrician-gynecologist, a specialist in the field of colposcopy, non-operative and operative gynecology of children and adolescents.

Baranovskaya Yulia Petrovna

Doctor of ultrasound diagnostics, obstetrician-gynecologist, candidate of medical sciences

Graduated from the Ivanovo State Medical Academy with a degree in general medicine.
Passed an internship at the Ivanovo State Medical Academy, clinical residency at the Ivanovo Research Institute. V.N. Gorodkov.
In 2013, she defended her Ph.D. thesis on the topic “Clinical and immunological factors in the formation of placental insufficiency”, and was awarded the degree of Candidate of Medical Sciences.
Author of 8 articles
He has certificates: doctor of ultrasound diagnostics, doctor of obstetrician-gynecologist.

Nosaeva Inna Vladimirovna

Doctor obstetrician-gynecologist

Graduated from Saratov State Medical University named after V.I. Razumovsky
Passed an internship on the basis of the Tambov Regional clinical hospital majoring in obstetrics and gynecology
He has a certificate of an obstetrician-gynecologist; doctor of ultrasound diagnostics; a specialist in the field of colposcopy and treatment of cervical pathology, endocrinological gynecology.
Repeatedly took advanced training courses in the specialty "Obstetrics and Gynecology", "Ultrasound Diagnostics in Obstetrics and Gynecology", "Fundamentals of Endoscopy in Gynecology"
Owns the full surgical interventions on the pelvic organs performed by laparotomy, laparoscopic and vaginal accesses.

An endometrial polyp is a benign glandular formation of the epithelium of the uterus. Most often they are detected at the bottom of the uterus or near the junction of the fallopian tubes. Basically, these are single processes, but in some cases several of them develop at once.

Sometimes patients are concerned about discharge from the genital tract and cycle disorders - too heavy periods or "daub" in the intervals between menstruation. However, such symptoms may be characteristic of various gynecological diseases. Therefore, endometrial polyps on ultrasound are much easier to diagnose than guided by the above indirect signs.

Choice of research method

A polyp can be diagnosed in various ways:

This pathology is most often detected during a planned transvaginal ultrasound, because in most cases it does not manifest itself clinically.

Also, hydrosonography can be used to detect or confirm this pathology. This is a type of ultrasound diagnostics, which includes filling the uterus with a contrast agent. Any hyperplastic processes become clearly visible in the presence of contrast, which is used in this procedure.

If during the ultrasound a polyp is detected, then in the future the patient is recommended to undergo a hysteroscopy. The “office” version of the method can be applied on an outpatient basis in medical center. It allows you to clarify the presence of this hyperplastic process and get rid of it. The most accurate picture is given by standard hysteroscopy, but hospitalization is necessary for its implementation.

During hysteroscopy, you can not only assess the size of the formation and get rid of it, but also study the state of the epithelium in more detail, collect material for histological examination. Histology helps to clarify the type of education, possible atypia, as well as general state mucous membrane of the organ. If the patient has a glandular or, she is prescribed hormonal drugs for a course of up to six months. This is necessary to avoid recurrence of the disease.

It is believed that with a polyp you can not get pregnant

This is especially true for cases of near-mouth localization, as well as in the region of the fundus of the uterus. And although there is no direct connection between this disease and infertility, it has been noticed that after the removal of the process, the chances of conceiving a child increase.

Sonographic signs

Due to the peculiarities of the hormonal background, it is important to conduct an ultrasound of the endometrium in the second phase of the cycle. Immediately after completion menstruation, the endometrium is too thin, so it is difficult to detect pathological processes on it. Especially if the size of the polyp does not exceed 5 mm.

In the presence of this common pathology, the following signs are visible in the picture:

The presence of a homogeneous round or oval formation of reduced echogenicity.
Violation of the integrity of the line of closure of the mucosal sheets.
The vessel that feeds the formation, with a resistance index of 0.5-0.6, however, only about half of all polyps have venous and arterial blood flow.

What does a polyp look like on ultrasound?

The endometrial polyp on the ultrasound photo has clear boundaries and a leg on which it is attached. It has a rounded shape with a diameter of several millimeters, and with an increase in size - oval. The rest of the endometrium remains unchanged.

With sufficient qualifications and experience, it is easy to identify this pathology of the endometrium. The main thing is to come to the examination on the right day of the cycle. Some women planning a baby are wondering if it is possible. The diagnostician can accurately distinguish one from the other.

However, there are pathologies that may have similar symptoms with an endometrial polyp, these are primarily other hyperplastic formations in the uterine cavity. Therefore, it is important not only to remove it, but also to send the resulting material for laboratory research. The results will allow a more accurate understanding of the nature of the neoplasm.

Polyps in the uterus are far from a rare pathology among women of all ages. What danger do they pose? Is it possible to get pregnant if there is a polyp in the uterus? What are modern methods treatment?

What is it, what is the danger?

A polyp in the uterus is called a pathological outgrowth over the endometrium. The endometrium is the inner layer of the uterus. Polyps in the uterus are:

glandular;
fibrous;
Glandular fibrous.

The glandular polyp originates from the tissues of the glands, usually occurs in the reproductive age. Fibrous is based on connective tissue, it is detected in women of the postmenopausal period. Glandular-fibrous has a mixed structure.

Why polyps in the uterus should not be left without proper treatment?

the likelihood of its degeneration into a malignant neoplasm;
infertility;
miscarriage;
development of anemia.

Symptoms of polyps in the uterus

The clinical picture of polyps in the uterus directly depends on their number and size. A fairly small formation usually does not cause any discomfort to a woman, it is found during examination.

Larger polyps may present with:

Bleeding from the uterus between periods;
profuse menstruation;
anemia;
The appearance of bloody discharge after intercourse;
pain syndrome;
infertility;
The appearance of uterine bleeding in menopause.

Reasons for the appearance

Science cannot yet accurately answer the question: why do polyps appear in the uterus? However, scientists have put forward many theories in this regard. The most popular of these is the theory hormonal imbalance estrogen and progesterone.

Due to changes in the hormonal background, cyclic processes in the endometrium are disturbed, and a polyp is formed.

Also, the appearance of polyps in the uterus is associated with:

endometriosis;
infections that are sexually transmitted;
erosion;
injuries;
metabolic disorder;
reduced immunity;
abortions;
intrauterine spiral.

Diagnostic methods

The main diagnostic methods include:

Clinical;

If the polyp in the uterus is large, then the specialist with a special gynecological examination can detect it. Small formations are more often detected on ultrasound of the pelvic organs and hysteroscopy.

ultrasound is instrumental method diagnostics. It is carried out using two sensors - transabdominal and transvaginal.

The study of the uterus using a transabdominal probe should be carried out on a full bladder. In the case of transvaginal, on the contrary, to the emptied one. With the help of ultrasound, a polyp with a size of two and a half cm is detected.

Hysteroscopy is more reliable in diagnostic terms. With it, you can visualize even the smallest formations. Hysteroscopy belongs to the optical research methods. The procedure can be not only research, but also therapeutic.

Indirectly, a polyp can be judged by a blood test.

If there is a large blood loss during menstruation, there is a decrease in hemoglobin levels.

Treatment without surgery

Since in most cases polyps in the uterus are the result of a violation of the ratio of progesterone and estrogen, the conservative method of treatment is aimed at restoring it.

The specialist prescribes a course of treatment hormonal drugs most commonly progesterone. Periodically, the effectiveness is monitored by ultrasound.

Who needs conservative treatment?

Women with small polyps;
If there are contraindications to surgical intervention;
Refusal of patients from surgery.

It should be noted that surgical and conservative methods of treatment are usually combined to obtain the best result.

Treatment with folk remedies

Treatment with medicinal plants allowed at an early stage of the disease. Before starting herbal therapy, it is necessary to without fail consult a gynecologist.

On the good side, celandine has proven itself in the treatment of uterine polyps.

Since the plant has toxic properties, its dosage must be strictly observed.

To prepare a medicinal infusion, one glass of crushed celandine should be poured with two liters of boiling water. It is advisable to fill the grass in a thermos. If this is not possible, wrap the dishes in a towel. You need to insist ten hours, then strain and pour into a jar. Subsequently, the infusion is stored in the refrigerator.

How to take celandine infusion

During the first week, take the infusion in the amount of half a teaspoon in the morning. The second week - one teaspoon, the third week - one tablespoon, the fourth week - two tablespoons.

Then, in the same order, reduce the dose to one teaspoon. If you need to repeat the course of treatment, take a break of at least two weeks.

douching

Douching with infusion from the collection medicinal herbs is a local method of influencing pathology. To prepare the infusion you will need:

Before preparing the infusion, all herbs must be mixed. Prepare with the expectation of two tablespoons per half liter of water. Boil for three minutes, then strain. The resulting product is used for douching.

Attention! The temperature of the infusion should be warm before use.

Surgical removal

Removal of uterine polyps using hysteroscopy is the most modern and in a safe way surgical treatment. What are the advantages of this method?

minimally invasive intervention;
quick recovery after surgery;
high efficiency.

Removal of polyps is carried out after menstruation. It is worth considering if more than ten days have passed menstrual cycle, surgery is delayed. On the eve of hysteroscopy, food intake is prohibited (as a prevention of vomiting).

Removal of polyps in this way is carried out under anesthesia. A hysteroscope is inserted into the uterine cavity, which is a thin tube with a video camera at the end. The video camera transmits the image to the monitor.

The doctor examines the uterine cavity, determines the number, location and size of formations. A special tool is used to remove polyps with their histological examination.

The last point is mandatory, since it is necessary to exclude malignant degeneration of tissues.

The polyp on the leg is removed using the “unscrewing” method, its bed is processed using electrocoagulation (stopping the bleeding).

Such a criterion as the duration of the operation depends on the characteristics of the formations and the endometrium. Usually it is from ten to thirty minutes.

Removal of polyps by diagnostic curettage

This method is less preferred than the previous one. So it is carried out without visual control and is associated with greater trauma to the endometrium.

Separate diagnostic curettage (RDV) is performed in the presence of heavy uterine bleeding. This procedure prevents excessive blood loss.

The WFD is being carried out under general anesthesia. With different curettes, the doctor makes a scraping from the cervical canal and the uterine cavity. Then the tissues are also sent for histological examination.

After the curettage, relapses of polyps often occur. In this regard, experts subsequently recommend that a woman undergo a hysteroscopy.

Depending on the results laboratory research obtained tissue samples, the patient is prescribed treatment with hormonal drugs (glandular polyp), or dynamic observation by a gynecologist (fibrous polyp).

Possible Complications

The most common postoperative complications:

inflammatory;
perforation (puncture of the uterine wall);
accumulation of blood in the uterine cavity (hematometer);

An inflammatory process after removal of polyps in the uterus can occur if the intervention was performed against the background of an untreated infection (including latent), violations of asepsis rules, and non-compliance with genital hygiene after surgery.

In the event of endometritis (inflammation of the uterus), there is an increase in body temperature, a deterioration in the patient's well-being, pain in the lower abdomen, and changes in blood tests. Well-chosen antibiotic therapy is the basis for the treatment of endometritis.

A puncture of the uterine wall (perforation) is observed most often with loose walls of the organ, an insufficiently expanded cervical canal. Large holes need to be sutured, small perforations heal on their own.

The accumulation of blood in the uterine cavity occurs due to spasm of the cervix. The hematometer is manifested by a sharp cessation of discharge from the vagina in postoperative period and pain syndrome. This complication It is stopped by taking antispasmodics and anti-inflammatory drugs.

Polyps in the uterus and pregnancy

The possibility of getting pregnant in the presence of a polyp in the uterus is called into question. A fertilized egg cannot implant into the endometrium and pregnancy does not occur.

If, however, pregnancy has occurred, then treatment is postponed until the birth of the child. During gestation may appear bloody issues, however, they do not pose a danger. In order to differential diagnosis you should consult your doctor.

In the event that the formation is located in the cervical canal, it can be a source of an infectious process. When signs of infection appear, a pregnant woman is prescribed antibiotic therapy.

Due to changes in the hormonal background during pregnancy, a relapse (re-formation of polyps) may occur.

Prevention

Preventive measures are aimed at correcting the hormonal background, treating endocrine and inflammatory diseases. Every woman should undergo regular preventive examination by a gynecologist.

If a polyp is found in the uterus, do not panic. After surgical treatment, a course is prescribed hormone therapy. In case of revealing hidden foci of infection, it is also proposed to undergo treatment aimed at their sanitation.

Are the cause female infertility, acyclic uterine bleeding, pain and discomfort, and some types of formations represent an oncological danger, as they can degenerate into a cancerous tumor. Polyposis is a consequence of intensive cell proliferation, and any process of excessive division should be under the control of specialists. This pathology occurs among the younger generation and worries women in menopause. During the menopause, the greatest number of polyps, dangerous in the aspect of rebirth, are revealed.

Polyps are formations that occur due to the growth of glandular and stromal tissues of the endometrium. On ultrasound, a uterine polyp looks like a mushroom with a stem and a cap. It attaches directly to inner wall uterus with a leg, consisting of intertwined vessels, and its dimensions can be calculated both in millimeters and centimeters. Nodules are either multiple or single.

By structure, polyps are hyperplastic glands of the endometrium. Some elements are characterized by a predominance of glandular tissue, others are represented by fibrous or connective tissue, and others are mixed in structure. On ultrasound, fibrous elements look like hyperechoic areas, and the glandular variety may not be detected on ultrasound, which is dangerous and is considered the cause of underdiagnosis.

In every fourth case of detection of formations in the uterus they are polyps, 2 - 3% of which are transformed into a malignant tumor.

Why are polyps dangerous?

How can polyps in the uterus be dangerous to health? Initially, they do not pose a threat to life, but the risk of degeneration of their cells and the launch of a malignant process, unfortunately, exists, which poses a danger to the health of a woman. That is why it is important for patients who have been diagnosed with polyposis not to miss scheduled gynecological examinations and ultrasound to monitor the state of the pathological elements that have appeared. Not all glandular hyperplastic areas are visible on ultrasound, therefore, with such dangerous symptoms like acyclic bleeding, pain, brown discharge doctors prefer to carry out diagnostic curettage. Untimely diagnosis is dangerous by the transformation of elements into cancer.

In addition, the uncontrolled growth of polyps can provoke the following dangerous complications:

failure of the menstrual cycle due to hormonal surges. It can be expressed by the irregularity of menstruation or heavy bleeding during them. The latter is fraught with the development of anemia. Against the background of blood loss, physical weakness, fatigue and even loss of consciousness appear;
difficulties with conception and violation of the course of pregnancy. Such dangerous complications are due to the fact that a fertilized egg cannot gain a foothold in the deformed layer of the endometrium. During pregnancy, there is a high risk of dangerous bleeding causing placental abruption. In addition, the fetus is at risk of hypoxia, since the formations disrupt the uteroplacental blood supply;
uterine bleeding. Since the blood vessels in the pedicle of the polyp are characterized by increased permeability, the likelihood of opening uterine bleeding increases. Blood loss can be both significant and disturb in the form of a constant daub. Severe hemorrhages are dangerous for the development of anemia;
formation of a focus of infection. Any pathological process is accompanied by inflammation and impaired secretion of protective factors by the glands of the endometrium, which violates the integrity of the mucous membrane. The likelihood of infection and the development of such dangerous disease as chronic endometritis increases. In the presence of endocervicitis, the likelihood of infectious complications increases.

by the most dangerous complication disease is a malignant transformation, so doctors are highly wary of polyposis. Such a basic study as ultrasound, a woman should undergo 1 - 2 times a year. And when normal Ultrasound and the presence of a clinic, hysteroscopy and curettage should be performed. Elements look like mushroom-shaped outgrowths during hysteroscopy.

Varieties

Depending on how polyps look, where they grow and what structure they have, there are several types of polyps.

According to the composition of education in the uterus are:

glandular: consist only of the glandular component of the endometrium. As a rule, this type is found in young patients.
glandular-fibrous: consist of connective and glandular structures.
fibrous - are formations from connective tissue with few glands. Fibrous polyposis is rarely diagnosed.
adenomatous - the most dangerous. They consist of glandular tissue with signs of proliferation and restructuring of the glands. They are initially considered precancerous elements in the uterus, since the probability of their degeneration is extremely high: some of the cells that make up adenomatous polyps have characteristic features cancerous.
placental: a species found in women after an abortion or childbirth. It is a remnant of the placenta or chorion. Such a polyp is dangerous for bleeding and suppuration.

Polyposis neoplasms that appear in the uterine cavity are called endometrial polyps, and those that are located in the cervical canal are called cervical canal polyps. They are divided into 2 types:

ectocervical - growing in the outer part of the cervix. As a rule, this type appears in the postmenopausal period.
endocevical - protrude from the cervical canal. They form from the glands of the cervical canal and look like pedunculated nodules on ultrasound. Such elements are also visible during a gynecological examination in the mirrors. They usually occur in women of reproductive age.

Endocervical polyps of the uterus are the cause of spotting, daubing in the middle of the cycle, before and after menstruation. When they reach large sizes, they are dangerous for bleeding.

Causes of polyps

The most common cause of polyp growth is called hormonal disbalance due to disturbances in the functioning of the ovaries: the level of estrogen rises, and progesterone decreases.

Estrogen is responsible for the growth of the endometrium, so its excess is dangerous for the appearance of polyps in the uterus.

In addition, the following categories of women are at risk:

those aged 40 to 50 years;
with a genetic predisposition to the appearance of such dangerous types of polyps as adenomatous;
resorted to frequent abortions;
suffering from endocrine diseases and diabetes;
with significant excess weight;
having inflammatory processes in the uterus.

It should be noted that obese women are at high risk of developing polyposis. Excess weight dangerous not only by the appearance of this type of formation, but also by the formation of endometrial hyperplasia. The reason is that adipose tissue cells contain a lot of estrogen.

How to recognize pathology

Before going to the doctor, performing an ultrasound and confirming dangerous diagnosis, patients, as a rule, are concerned about the following symptoms:

vaginal bleeding between periods;
pain during intimacy and spotting after it;
failure in the menstrual cycle (irregular periods);
bleeding during menopause.

Unfortunately, the symptoms appear at the stage when the polyps in the uterus reach a fairly large size or their number is large. Small formations are always discovered by chance. Therefore, in order to prevent the development of polyposis, as well as the timely appointment of therapy in case of detection of polyps, a woman should regularly visit a gynecologist and undergo ultrasound of the pelvic organs.

Knowing what a uterine polyp looks like on an ultrasound scan, it is quite easy to detect it using this research method. But in addition to ultrasound, the following are successfully used in diagnostics:

metrography - an x-ray examination of the uterine cavity, which is pre-filled through the cervix with a contrast agent;
hysteroscopy - the study of the walls of the uterus using a special device that is inserted into the organ cavity through the vagina. Unlike ultrasound, hysteroscopy allows not only to see where they are located, but also how the polyps in the uterus look (their shape, size, condition). In addition, it makes it possible to control the course of the operation to remove neoplasms, that is, the hysteroscope is the "eyes" of the surgeon.

If a polyp is found in the uterus the doctor must take an aspirate (endometrial biopsy) from the organ cavity for cytological examination. This makes it possible early diagnosis dangerous precancerous conditions.

Treatment Options

If a small polyp is found in the uterus, which does not arouse suspicion, there are two options for the development of events: subsequent permanent observation by a doctor with regular ultrasound scans, or immediate removal of the neoplasm. The second option is considered preferable, since the option is never ruled out that a serious hormonal failure can occur in the body at any time, followed by a complication - the development of a dangerous oncological disease.

Therapy for endometrial polyposis is prescribed immediately. Depending on the specific case, this may include:

curettage - cleansing the walls of the uterus with a curette (special scraper);
hysteroscopy with scraping - getting rid of neoplasms under the control of a hysteroscope - the most preferred method;
taking medications to correct hormonal levels.

In the event of a risk of developing endometrial cancer, it is possible complete removal organ and its appendages.

Removal of polyps occurs under general anesthesia. With the help of special tools, the uterine cavity is expanded, and then a single neoplasm is excised or multiple ones are scraped. The base of the element must be cauterized with a spherical electrode, that is, hysteroscopy when removing hyperplastic areas is accompanied by the use of laser, radio wave, and electrical technologies. This measure is aimed at preventing the development of relapse.

The removed tissues are subjected to mandatory histological examination.

After cleansing the uterus, a woman is usually prescribed a six-month hormone therapy. Contraindications are:

diagnosed cancer;
diabetes;
obesity;
arterial hypertension of decompensated type;
severe liver and kidney disease.

After hormone therapy it is mandatory to monitor the cure in the framework of performing ultrasound, diagnostic hysteroscopy or vacuum aspiration of the endometrium. Many polyps in the uterus can recur, especially if there are aggravating factors, such as obesity.

Knowing how dangerous polyps in the uterus are, you should not neglect preventive examinations at the gynecologist and checking the hormonal background. After all, these neoplasms do not make themselves felt for a long time, and some of them are very dangerous, because they can degenerate into a malignant tumor and cause endometrial cancer.

Uterine polyp- This is a rounded outgrowth on a leg, resembling a mushroom. It is considered a benign formation, that is, it does not pose a danger to a woman's life. But this does not mean that you can refuse treatment, because over time a polyp can turn into a malignant tumor. But the probability of this is small, only 1-2%.

Polyps appear on the inner lining that lines the uterine cavity (endometrium) or inside the cervical canal. Polyps can form at any age, starting at 11 years of age. They are especially common in women before menopause at 40-50 years old.

Signs of the development of uterine polyps:

menstrual irregularities - menstruation becomes irregular;
severe bleeding during menstruation;
white mucous discharge from the vagina between periods (leucorrhoea);
spotting after intercourse due to trauma to the polyp;
discharge of blood from the vagina between periods;
pain in the lower abdomen with large polyps;

But more often than not, polyps cause no symptoms. They are discovered by chance, during a visit to the gynecologist or on ultrasound.

What are polyps? These are small nodules ranging in size from a few millimeters to 3 cm. In most cases, they are no more than 1 cm in diameter. Polyps can be single or multiple. They resemble burgundy-violet or yellowish small cylinders with a porous surface. Through them thin shell vessels are clearly visible.

Where do polyps come from? So far, scientists have not fully figured out this issue. However, many theories have been put forward. The main causes are considered hormonal disorders and inflammatory processes.

What procedures can detect polyps? The most accessible and painless method is ultrasound. The most accurate results are obtained by a study using a sensor that is inserted into the vagina. But if it is necessary to conduct a detailed study, the doctor may prescribe a hysteroscopy. In this procedure, a thin tube with a camera at the end is inserted into the uterine cavity. Using the same device, you can take tissue particles for research (biopsy). In some cases, special contrast agents, and after that is done X-ray.

Types of uterine polyps

All polyps consist of a body and a stalk. The body is wider and more massive, and with the help of a narrow stem, the outgrowth is attached to the wall of the uterus. If the stem is long, then the polyp may hang down into the vagina. Then it can be seen during a routine gynecological examination.

There are several types of polyps. They are divided by location and structure.

Depending on where the polyp is located:

Polyps of the cervix- a benign tumor on the leg, which is located on the surface of the cervical canal.
Polyps of the body of the uterus- a benign formation in the form of a nodule on the inner surface of the organ. Most often they appear in the upper part of the uterus.

Depending on what cells the polyp consists of, they distinguish:

glandular polyps- they are based on gland cells. More common in young age. They may look like fluid-filled cysts. Usually occur with endometrial hyperplasia.
Fibrous polyps are made up of connective tissue cells. They are denser. They appear after 40 years before menopause and during menopause, when hormonal changes occur.
Glandular fibrous polyps- consist of cells of the uterine glands and connective tissue.
Polyps-adenomas (adenomatous)- contain altered atypical cells. More often than others, they degenerate into cancerous tumors.
placental polyps- occur if after childbirth a piece of the placenta remains in the uterus. A polyp can grow from its cells.

Causes of uterine polyps

Doctors cannot give an unambiguous answer to the question of what causes the appearance of polyps. There are several versions.

Hormonal disorders . A high amount of estrogen hormones in a woman's blood causes the growth of the inner layer of the uterus. This may manifest as polyps or uniform proliferation of mucosal patches (endometrial hyperplasia). The lack of another female hormone - progesterone leads to the fact that polyps grow very actively.
Vascular overgrowth. If for some reason the vessel becomes clogged or grows, then epithelial cells begin to multiply around it.
Inflammatory processes in the genitals(endometriosis, cervicitis). When inflammation occurs in the uterus, a lot of immune cells- leukocytes. They destroy the infection, but at the same time cause the growth of endometrial cells.
Abortions or unsuccessful curettage. badly spent medical procedures can cause erosion and increased cell growth in certain areas of the uterine mucosa.
Diseases of the endocrine glands. The work of all glands in the body is interconnected. Therefore, violations in thyroid gland, liver or adrenal glands cause malfunction of the ovaries and excessive production of sex hormones.
Diabetes and high blood pressure . These diseases impair blood circulation in small capillaries. And where cells do not receive oxygen and nutrients, they begin to change and can begin to divide intensively.
Excess weight. It has been proven that adipose tissue is not just deposited under the skin and in organ cells. It can also produce estrogen hormones, which provoke the growth of polyps.
Heredity. The tendency to grow polyps in the uterus is inherited. Therefore, if the mother had polyps, then her daughters should be especially attentive to their health.
Sedentary lifestyle leads to stagnation of blood in the pelvic organs. Less oxygen is supplied to the uterus and ovaries, and this disrupts hormone production and cell reproduction.
Taking tamoxifen. This drug is used to treat tumors. It blocks the receptors that are responsible for sensitivity to sex hormones. In some women, this medicine may cause polyps to grow.

The mechanism of development of the uterine polyp

It all starts with the fact that the ovaries are disrupted, and they release too much estrogen into the blood. If normally this hormone controls female body only the first two weeks of the menstrual cycle, now it is produced without stopping. As a result, the endometrium grows. Its individual sections do not exfoliate during menstruation, but remain in the uterus. This continues for several cycles. A small outgrowth appears at this place. Gradually, vessels and connective tissue fibers grow into it - this is how a polyp is formed.

How can a polyp be removed?

Surgical methods treatments are the most reliable. They quickly relieve a woman of polyps. Modern techniques allow you to do without bloody operations, large incisions and scars. If there is only one polyp, then it is cut out. And if many small outgrowths have formed, then it is necessary to scrape the upper layer of the mucous membrane.

When should polyp surgery be done?

Surgery is indispensable in such cases:

if hormone treatment fails;
in the event that a woman is over 40 years old;
the size of the polyp is more than 1 cm;
when altered cells were discovered that could become the basis malignant tumor.

If the doctor has prescribed an operation to remove polyps - a polypectomy, you should not be afraid. Many women have gone through this process. modern medicine offers gentle techniques that allow you to make the intervention almost bloodless, avoid postoperative complications and quickly return to normal life.

Hysteroscopic method is the treatment of polyps with low-traumatic procedures. It is prescribed when you need to clarify the location of the polyps and remove them. This procedure is done under "light" anesthesia and lasts only 15-20 minutes. On the same day, the woman can return home.

The best period for this procedure is 2-3 days after the end of menstruation. On such days, the uterine mucosa is the thinnest and the polyp rises above it. This makes it possible to remove the outgrowth "under the root".

The operation is performed under regional or general anesthesia. The doctor opens the cervical canal with a special tool. A tubular apparatus, the hysteroscope, is inserted through the vagina into the uterus. At the first stage, the surgeon examines the uterine cavity using a small camera at the end of the tube. It determines the number of polyps and their size. After that, the polyp is cut off from the wall of the uterus with an electric surgical loop. The place where it was attached is cauterized with liquid nitrogen or 5% tincture of iodine.

A large single polyp can be removed with forceps. It is unscrewed by rotating around the axis. This method allows you to remove all the neoplasm cells as much as possible. After such a procedure, the vessels that fed the polyp are also twisted and do not bleed. Then the bed of the polyp (the place where it was attached) is scraped out with a curette and treated with an antiseptic. If this is not done, then the polyp may grow again from the remaining cells.

If the doctor finds many small polyps in the uterine cavity or in its cervix, then separate curettage is done under the control of a hysteroscope. An instrument is attached to the equipment, similar to a spoon with a pointed edge - a curette. With its help, the entire functional (upper) layer of the uterine mucosa is removed.

After the procedure, those tissues that are removed from the uterus are sent to the laboratory for examination.
The hysteroscopic method of treating uterine polyps allows you to effectively and safely get rid of any benign polyps and minimize the risk of their recurrence.

Advantages of the hysteroscopic method:

absolute security;
painlessness;
the camera allows you to control the quality of the operation and not miss even the smallest polyps;
There are no incisions to be made and there will be no postoperative sutures.

Laparoscopic method is the operation through small openings in the lower abdomen. The uterus is removed by the laparoscopic method if atypical cells are found in the polyp and the risk of developing uterine cancer is high.

Through a hole in the abdomen with a diameter of 0.5-1.5 cm abdomen fills up carbon dioxide. This is done in order to raise the abdominal wall, which interferes with the surgeon. Then a laparoscope with a camera at the end is inserted. The doctor examines the condition of the uterus and determines what needs to be done. Then, with the help of special equipment, he excises the diseased organ and takes it out. After that, sutures are applied. A few hours later, the woman is transferred from surgery to the gynecological ward. There she remains under observation for 5-7 days.

The method is very effective when the risk of a malignant tumor is high. It has many advantages:

woman does not feel postoperative pain;
there are practically no complications;
there are no scars on the body;
quick recovery (after 2 weeks, the woman can return to work).

Treatment of polyps with folk methods

Polyps of the cervix and body of the uterus can be treated folk methods. Neoplasms will disappear much faster if combined natural remedies with those hormonal drugs that the gynecologist will prescribe. Once every 2-3 months, you must definitely go to the doctor so that he can evaluate whether herbal medicine gives the desired results.

Pumpkin seeds

Take 6 tablespoons of dried but not roasted seeds and grind them in a coffee grinder. Add 7 yolks to this flour boiled eggs. Pour in 0.5 liters of refined sunflower oil. Heat this mixture in a water bath for 20 minutes. Take the remedy 1 teaspoon before meals 1 time per day. The mixture must be kept in the refrigerator. The scheme of taking the medicine is as follows: drink for five days, and rest for the next five days. Repeat courses until the medicine runs out.

This is unique remedy very rich in vitamins and minerals. These substances improve metabolic processes and hormone production. As a result, polyps gradually begin to decrease. But this is a long process that will take at least 3 months.

Microclysters with herbal tinctures

For treatment, you will need tinctures of calendula, rotokan and propolis. They can be purchased at a pharmacy. For microclysters, a solution is prepared daily: 1 tsp. tinctures are diluted in 100 ml of water. The solution is divided into two parts and used for microclysters in the morning and evening. The agent is injected with a rubber pear into the rectum. Tinctures must be alternated. The first 10 days - treatment with calendula. The next 10 days use rotokan, and the last 10 days finish the course with propolis tincture. After a month of treatment, take a break for 20 days, then repeat the course. In total, you need to complete 2-3 courses.

This remedy relieves inflammation in the genital organs and reduces the growth of the endometrium and polyps in the uterus. The amount of discharge from the vagina decreases and menstruation becomes more regular.

Golden mustache tincture

To prepare the tincture, you will need 20 joints from the processes of this houseplant. They are poured with 2 glasses of vodka or medical alcohol diluted by 1/3. Let it brew in a dark place for 10 days. Glassware with tincture is periodically shaken. Take 20 drops per 100 ml of water. Consume 2 times a day half an hour before meals. Course of treatment: 30 days of taking the tincture, then 10 days off. After rest, the course is repeated again. Treatment takes six months. During this time, immunity is strengthened, the work of the glands that produce hormones improves, inflammation in the pelvic organs disappears.

Tampons with onions

Wash the onion and bake in the oven. It should become almost translucent and soft. Cut the onion, remove the core and mash it with a fork. Put a teaspoon of this gruel on doubled gauze. Form a tampon and tie it with a strong thread so that it can be removed from the vagina. Such a tampon is administered at night. The procedure is carried out daily for a week. After 10 days, repeat the treatment and so on 3 times. To enhance the effect, it is recommended to add to the onion laundry soap 1 tsp It must be grated on a fine grater.

This tool perfectly fights all viruses and bacteria, relieves inflammation, cleanses the mucous membrane. The size of polyps also decreases, especially those located in the cervix.

How does a polyp inside the uterus affect pregnancy?

A woman can become pregnant if there is a small polyp in the uterus or her cervix. But in this case, complications often arise. The fact is that a polyp can cause placental abruption. This organ is responsible for ensuring that the child constantly receives oxygen and nutrition. Through the placenta and the umbilical cord, maternal blood brings everything the baby needs.

If the placenta does not adhere tightly to the wall of the uterus, then not enough blood enters it. As a result, the child is starving. This can cause developmental delay, fetal hypoxia, or threatened miscarriage.

In addition, if the polyp is injured, then bleeding, spotting bloody or sanious discharge occurs. In this case, the woman should see a doctor as soon as possible.

Treatment of polyps during pregnancy is usually not carried out. All the efforts of doctors are aimed at improving the condition of the baby. In addition, during pregnancy, many women polyps resolve on their own. This happens because estrogen levels have dropped and these hormones have stopped causing polyps to grow.

If a pregnant woman has a polyp, she can carry and give birth to a healthy baby. But she needs to take special care of her health.

Is it possible to cure a uterine polyp without surgery?

Today, medicine can cure a uterine polyp without surgery. But this is not possible in all cases. If a woman has found one small polyp, then with the help of special medicines you can make it decrease in size and completely disappear.

Doctors try to do without surgery if the patient is still very young. Sometimes polyps appear in girls in adolescence, and in women who have not given birth, surgery can cause problems with conception.

Hormonal drugs reduce the level of estrogen and increase the amount of progesterone. They eliminate the cause of the disease, and the polyps gradually dry out and come out of the uterus during menstruation.

Women under the age of 35 are prescribed estrogen-progestogen combined oral contraceptives : Jeanine, Regulon, Yarina. You need to take them for six months according to a special contraceptive scheme that the doctor will prescribe.
Women after 35 years of age are prescribed gestagens: Dufaston, Norkolut, Utrozhestan. They are taken 2 weeks after the first day of menstruation for six months.
Gonadotropin-releasing hormone agonists: Leuprorelin, Diphereline, Zoladex. They are prescribed to women after 40 and to those who are going through a period of menopause. These drugs protect against the action of luteinizing hormones and estrogens, which cause uterine dysfunction. The course of treatment is 3-6 months.
Antibiotics are prescribed to women of any age in the case when inflammation has caused polyps. In gynecology, Zitrolide, Gentamigin, Monomycin and other antibiotics are used.

Treatment of uterine polyps complement folk remedies. Such A complex approach helps to quickly cope with the disease.

After treatment of polyps, a woman needs to be observed by a gynecologist. The fact is that these growths sometimes appear again after treatment.

Prevention of polyps

The appearance of polyps is associated with disruption of the ovaries and excess estrogen. Prevention of this disease involves many factors.

Find out what to do to avoid polyps

Do not eat foods contaminated with dioxide and meat containing hormones.
Live in an area with a good environment.
Avoid hypothermia, dress for the weather and avoid sitting on cold surfaces.
Don't be messy sexual life.
To live an active lifestyle. Physical exercise do not allow blood to stagnate in the genitals.
When choosing hormonal birth control pills be sure to consult your doctor.
Visit your gynecologist regularly.

Women's health is an essential component of a happy life. Take care of yourself and be healthy!