Women with asymptomatic cervical polyps may not need to see a gynaecologist or have them removed: an observational retrospective study of 1126 cases (original) (raw)
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Cervical polyps: evaluation of routine removal and need for accompanying D&C
Archives of Gynecology and Obstetrics, 2011
Objective To estimate prevalence of malignancy and dysplasia in cervical polyps and to judge whether cervical polyps need to be removed routinely. Also to investigate if a cervical polyp is an indicator of endometrial pathology and to assess the necessity of performing dilatation and curettage (D&C). Materials and methods We retrospectively reviewed hospital records of 4,063 cervical polyp cases. Patients' age, menopausal status and pathological findings were recorded. Descriptive statistics, Pearson's v 2 , Fisher's exact test were used for statistical analysis. P value of B0.05 was accepted significant. Results Among 4,063 cervical polyps, only 3 (0.1%) cases of malignancy were encountered which were metastasis from endometrium. There were also dysplastic (0.4%), metaplastic (2.1%), inflamatory (1%) changes. Accompanying endometrial pathologies were: endometrial cancer (0.3%), hyperplasia without atypia (1.3%), endometrial polyp (6.6%). There was statistically significant relation between menopausal status and malignancy of cervical polyps (P = 0.055) malignancy of endometrial cavity (P = 0.0001). Conclusion Routine removal of cervical polyps, although not mandatory, seems clinically prudent because pathological evaluation is needed to confirm the diagnosis and to rule out other possibilities. 10.9% of postmenopausal patients and 7.8% of premenopausal patients were diagnosed with any endometrial pathology accompanying cervical polyp. Therefore, cervical polyps can be a sign of endometrial disease, especially in postmenopausal women with cervical polyp endometrium should be evaluated more carefully.
Clinicopathological Evaluations of Cervical Polyps
2015
Objective: Management of uterine cervical polyps is a common debate in clinical practice. Ethical concerns complicate decision making as well as designing randomized or prospective studies. Thus, clinical evidence can be gathered from retrospective studies. Possibility of malignant transformation is also a concern in assessment and management of preand post-menopausal patients. In this study we aimed to identify if a difference exist in between these groups, and discuss our results with the previously reported. Material and Method: We evaluated results of 245 patients retrospectively. Totally 270 polyps were detected. Pathological results of polyps were compared according to menopausal status and symptoms. Fisher’s Exact Test and Fisher-Freeman-Halton Test were used in statistical analysis. Statistical significance is considered where p<0.05 and p<0.01. Results: There was no invasive disease. Cervical intraepithelial neoplasia type 1 was seen in one postmenopausal patient. Pol...
Clinico-pathological study of cervical polyps
Archives of Gynecology and Obstetrics, 2010
Objective To determine the incidence of malignancy in cervical polyps and determine the effect of age and parity on clinical presentation. Methods A retrospective analysis of histological diagnosis and demographic information relating to 294 polyps was undertaken. Comparison was made between premenopausal and postmenopausal women as well as women with and without recurrent polyps. Results There was no case of malignancy. Majority of the women were parous (71.8%), asymptomatic (65.9%) and had their polyps removed in the outpatient setting (69.9%). The recurrence rate was 12.6%. The predominant symptom was IMB/PCB. Women with recurrent polyps were 10 times more likely to be parous (OR = 10.1, 95% CI 1.4–74.8), 7.9 times more likely to have symptoms (OR = 7.9, 95% CI 3.5–17.1) and 4.8 times more likely to have polyps removed under general anaesthesia (OR = 4.8, 95% CI 2.4–9.9). Postmenopausal women were 2.2 times more likely to have symptoms (OR = 2.2, 95% CI 1.6–4.7) and 1.7 times more likely to have general anaesthesia (OR = 1.7, 95% CI 1.0–3.1). Conclusion Cervical polyps are mainly benign, asymptomatic lesions and recur in about 12.6% of women. They are more likely to be symptomatic in postmenopausal women.
2015
Objective: Management of uterine cervical polyps is a common debate in clinical practice. Ethical concerns complicate decision making as well as designing randomized or prospective studies. Thus, clinical evidence can be gathered from retrospective studies. Possibility of malignant transformation is also a concern in assessment and management of pre- and post-menopausal patients. In this study we aimed to identify if a difference exist in between these groups, and discuss our results with the previously reported. Material and Method: We evaluated results of 245 patients retrospectively. Totally 270 polyps were detected. Pathological results of polyps were compared according to menopausal status and symptoms. Fisher’s Exact Test and Fisher-Freeman-Halton Test were used in statistical analysis. Statistical significance is considered where p<0.05 and p<0.01. Results: There was no invasive disease. Cervical intraepithelial neoplasia type 1 was seen in one postmenopausal patient. P...
Cervical cytology in patients with postmenopausal bleeding
Diagnostic Cytopathology, 2009
In this study, the role of cervical cytology in the diagnosis of post or perimenopausal (PM) bleeding was explored. A total of 135 patients with PM bleeding were selected. In all these cases both conventional cervical cytology and histopathology follow up were available. The commonest causes of postmenopausal (PM) bleeding with abnormal histopathology were squamous cell carcinoma of cervix , endocervical polyp , endometrial adenocarcinomas (13) and simple hyperplasia without atypia (13). There were a total 13 cases of endometrial adenocarcinoma and cervical smears of these cases were reported as high grade squamous intra epithelial lesion (1), presence of endometrial cells (4), unsatisfactory due to low cellularity (2), and within normal limit (6). In brief, endometrial carcinoma and hyperplasia are the predominant causes of PM bleeding due to endometrial pathology. The presence of benign looking endometrial cells with PM bleeding always indicates a careful work up to exclude endometrial pathology. Diagn. Cytopathol. 2010; 38:496-498. ' 2009 Wiley-Liss, Inc.
How often are endometrial polyps malignant in asymptomatic postmenopausal women? A multicenter study
American Journal of Obstetrics and Gynecology, 2009
The objective of the study was to evaluate the prevalence of cancer and premalignant lesions in polyps on atrophic endometrium in asymptomatic postmenopausal women to compare these findings with a similar cohort of patients with abnormal uterine bleeding. STUDY DESIGN: One thousand one hundred fifty-two asymptomatic and 770 consecutive postmenopausal women with abnormal uterine bleeding were included in a retrospective multicenter study. Recruited patients underwent hysteroscopic polypectomy based on a sonohysterographic or hysteroscopic diagnosis. The pathologic report was the main outcome measure.
The management of polyps in female reproductive organs
International Journal of Surgery, 2017
Definition of Polyp The word "polyp" arises from the ancient Greek word "polypus" meaning "many feet". The definition mainly describes its external characteristics rather than its histopathological features. Within this context any lesion or abnormal formation that looks like a polyp can be referred to as a polypoid structure. Polyps can arise from any mucus membrane in the body, and they are usually benign [1]. Gynaecological polyps are categorized based on their location, type, and presence/absence of a stalk [1]. According to Uglietti et al postmenopausal women are at higher risk of having malignant EPs compared to premenopausal women [2]. In addition, it was also found that the younger the woman's age, the less likely she is to develop a malignant polyp. Epidemiological factors, Frequency The exact epidemiology of gynaecological polyps remains unclear. The incidence of polypoid development is difficult to estimate. These structures may grow in the uterus, cervix, and rarely in the vagina. Additionally, the polyps may vary widely in exact localization within these tissues. In previous years the ability to locate and diagnose polyps was limited by technology, as well as the fact that they were asymptomatic in many cases. It is not uncommon for asymptomatic polyps to be first discovered in a routine physical examination or during investigations of infertility. The developments of high-resolution 2D and 4D ultrasound, contrast (HyCoSy / HyFoSy) sonography and hysteroscopy are aiding clinicians in diagnosing more cases of polyps [3].
Spectrum of Cervical Cytological Lesions in Premenopausal and Postmenopausal Women
Annals of Pathology and Laboratory Medicine, 2017
Cervix, the gatekeeper of the uterus, gets its name from the Latin word meaning "neck" due to its role as the narrow connection between the larger body of the uterus above & the vagina below. Various conditions can affect uterine cervix, including non neoplastic & neoplastic diseases. The incidence of these varies according to the different age groups. Cervical inflammatory lesions are very common in sexually active females all over the world; with non specific cervicitis, the most common of them, found commonly in third decade, also on histopathalogy. [1] Otherwise it can be said to occur rarely before menarche or after menopause. [2] The etiology is variable and is of importance because it may lead to considerable morbidity as endometritis, salphingitis, pelvic inflammatory disease, chorioamnionitis and also it may have a role in the initiation or promotion of cervical neoplasia. [3] Pap smears findings should thus vary in premenopausal & postmenopausal groups in terms of infections, premalignant & malignant lesions, as sought after in this study.
Proceedings in Obstetrics and Gynecology, 2013
Endometrial polyps are most commonly seen in the postmenopausal women with uterine bleeding, although the giant polyps which originate from the uterine cavity and protruding from the cervical os are rare. Several cases which have been described in the literature are usually developed secondary to tamoxifen use, and the polyps do not extend or protrude from the external cervical os. Most of the polyps protruded from the cervical os can mimic a cervical neoplasia or endocervical polyp. We report the case of a giant endometrial polyp (8x4x3 cm in size) which was protruding from the external cervical os and that developed spontaneously without tamoxifen use in a multiparous 73-year-old woman presenting with vaginal bleeding. Hysteroscopic polypectomy was performed and no recurrence was seen at 6 months after surgery. Diagnosis, management and outcome of this rare entity have been discussed according to the literature.