Polyposis is a disease during which polyps develop on endometrium or the cervix and are benign tumors, have “body” and “leg” to hold on the uterine wall. Theoretically, endometrial polyposis may occur at any age, but they mostly develop at adult (35-50yrs.) or old age. During his interview with the NEWS.am Medicine reporter, Arman Nazinyan, the head of the Department of Obstetrics and Gynecology in “Astghik” MC spoke about the types of polyps, the question of how much they are dangerous and whether they should be removed or not.
What Types of Polyps Are There?
According to their structure, endometrial and cervical polyps are divided into several types:
. glandular polyps: consist of glands and stroma,
. gland-fibrous polyps: mainly consist of connective tissues and partly – glandular tissues,
. fibrous polyps: consist of only connective tissues,
. adenomatous polyps: they are called “precancerous” polyps which mostly consist of glandular epithelium but also have atypical cells. Women at reproductive age often have polyps of glandular structure and those in older age have fibrous and adenomatous polyps. Glandular and fibrous polyps are specific to groups of all ages. The polyp sizes are usually between 0,2 – 0,3mm to 2 – 2,5cm. The largest polyps that have ever met the “Astghik” MC specialists, were about 3cm.
What Problems May Arise From Polyps?
Polyps are benign tumors but they are not absolutely safe. As noted by the specialist, in some cases polyps may lead to the menstrual cycle disruption and infertility. Sometimes they can “physically” prevent a woman from getting pregnant, especially when they are large, occupy a large area of the uterine cavity and close the cervix. Certain patients of the medical center have succeeded to get pregnant after the removal of polyps. Besides, there is a danger that some polyps (often adenomatous) may overgrow into an endometrial cancer. Therefore, it is not recommended to consider them as a minor problem and neglect them.
Symptoms of Polyposis
Very often the clinical symptoms of polyposis are obvious, especially when the polyp or the polyps are small in size. In that case they are discovered by an ultrasound examination. Polyps may be felt in case of the following symptoms:
. menstrual cycle disruption,
. mid menstrual less viscous bleeding which has no connection with menstruation,
. very abundant menstruation in young women: menorrhagia,
. bleeding in women at the menopausal stage,
. spasmodic pains in lower abdomen which usually becomes severe during the sexual act,
. “contact” bleeding from sexual routes after sex or gynecological examination,
. infertility in women of reproductive age.
How Are the Polyps Diagnosed?
Endometrial and cervical polyps are mostly detected by an ultrasound examination. As polyps are not felt, all women are recommended to visit a gynecologist once a year and have an ultrasound examination.
If a polyp is noticed during the examination, the specialist will decide the further steps.
Should the Polyps Be Removed?
Dr. Arman Nazinyan thinks that polyps should definitely be removed and sent to the histological study which will show the benign or malignant nature of the polyp, or whether there is a danger for endometrial cancer or recurrence risk. According to the results of histological study, the specialist can define whether the patient needs a further treatment or the removal is enough.
As by Dr. Nazinyan, basically polyps are removed in “Astghik” MC by means of histeroresectoscopy which enables to see the whole process and remove the polyp itself without damaging the endometrium. Usually, the histeroresectoscope does not have any negative influence on a woman’s reproductive function. After the intervention, the menstruation cycle recovers quickly and the woman can get pregnant. Moreover, if the woman failed to get pregnant because of the polyp, then, after the intervention the chance of getting pregnant increases.