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The role of hysteroscopy in the current management of the cervical polyps

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Abstract

The current management of patients with cervical polyps may include different approaches and protocols, such as a simply removal of the polyp in most cases at an office setting, surgical dilatation and curettage, electrosurgical excision or hysteroscopic polypectomy. Exploration of the cervical canal and uterine cavity by hysteroscopy determines the exact origin of the polyp pedicle (cervical or endometrial) and if there is any concurrent endometrial pathology. The majority of cervical polyps are asymptomatic, and their incidence is increasing with age. Symptomatic cervical polyps may cause intermenstrual bleeding, postcoital bleeding, heavy menses, postmenopausal bleeding and vaginal discharge. Cervical polyps may be detected by routine gynaecological examination, colposcopy, filling defects on hysterosalpingogram, gynaecological ultrasound (abdominal, transvaginal or sonohysterography) or endometrial biopsy. The location, number, and size of cervical polyps are best determined with diagnostic hysteroscopy. In the past, simple twisting or avulsion of the polyp or blind curettage was the standard surgical treatment of choice. However, this treatment often leaves residual polyp fragments in the cervical canal. Difficulty may also occur in differentiating endocervical from endometrial lesions. In addition, up to 25% of patients who have cervical polyp, have also a coexisting endometrial polyp, so there is a need for evaluation of the endometrial cavity. It is important to note the usefulness of hysteroscopy to manage a patient with a cervical polyp, especially when she presents abnormal uterine bleeding, in order to make an accurate diagnosis and offer appropriate treatment.

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References

  1. Aaro LA, Jacobsen LJ, Soule EH (1963) Endocervical polyps. Obstet Gynecol 21:659–665

    PubMed  CAS  Google Scholar 

  2. Hill EC (1982) Disorders of the uterine cervix. In: Benson RC (ed) Current obstetric, gynaecologic diagnosis and treatment, 4th edn. Lange Medical Publications, Los Altos pp 225–226

    Google Scholar 

  3. Novak ER, Woodruff JD (1967) (eds) Gynaecologic and obstetric pathology. WB Saunders, Philadelphia, Chap 4, p 72

  4. Golan A, Ber A, Wolman I, David MP (1994) Cervical polyps: evaluation of current treatment. Gynacol Obstet Invest 37:56–58

    CAS  Google Scholar 

  5. Keryer H, Lochtig C (1993) Mullerian adenosarcoma presenting as cervical polyp: a report of seven cases and review of the literature. Obstet Gynaecol 81:655–659

    Google Scholar 

  6. Mainguene C, Hugol D, Canlet S, Ayel S, Poitout P, Diebold J (1993) Botryoid rhabdomyosarcoma of the cervix. Clinicopathologic study of a case. Ann Pathol 13(1):40–44

    PubMed  CAS  Google Scholar 

  7. Brockmays FS, Swartjes JM, Vay der Valk P, Schutter EM (1993) Primary malignant lymphoma of the uterus: localisation in a cervical polyp. Eur J Obstet Gynecol Reprod Biol 48(3):215–219

    Article  Google Scholar 

  8. Jimenez-Ayala M, Martnez-Cabruja R, Esteban-Casado ML, Chinchilla Redondo C (1996) Serous surface papillary carcinoma of the ovary metastatic to a cervical polyp: a case report. Acta Cytol 40(4):765–769

    PubMed  CAS  Google Scholar 

  9. Duckman S, Suarez JR, Sese LQ (1988) Giant cervical polyp. Am J Obstet Gynecol 159:852–854

    PubMed  CAS  Google Scholar 

  10. Nanda S, Sangwan K, Gulati N (1998) Giant cervical polyp. Trop Doct 28:112–113

    PubMed  CAS  Google Scholar 

  11. Newmay HF, Northup JD (1962) Mucosal cervical polyps. Am J Obstet Gynecol 84:1816–1819

    Google Scholar 

  12. Pradham S, Chenon R, O’Brien PMS (1995) Dilatation and curettage in patients with cervical polyps: a retrospective analysis. Br J Obstet Gynaecol 102:415–417

    Google Scholar 

  13. Khalil AM, Azar GB, Kaspar HG, Abu Musa AA, Chaavarah IR (1996) Second MA giant cervical polyp, a case report. J Reprod Med 41(8):619–621

    PubMed  CAS  Google Scholar 

  14. Winter GF (1957) Histological examination of epidermization and the carcinoma of cervical polyps. Arch Gynakol 189:404–406 (in German)

    Article  PubMed  CAS  Google Scholar 

  15. Caroll S, Woolfson J (1996) The significance of cervical polyps. Diplomate 3:1179–1182

    Google Scholar 

  16. Lutge PC (1957) Clinical significance of cervix polyps. Z Arztl Fortbild (Jena) 51(3):91–94

    CAS  Google Scholar 

  17. Israel SL (1940) A study of cervical polyps. Am J Obstet Gynecol 39:45–50

    Google Scholar 

  18. Cornier E (1984) The Pipelle: a disposable device for endometrial biopsy. Am J Obstet Gynecol 148:109–110

    PubMed  CAS  Google Scholar 

  19. Rodriguez CG, Nizar, Yaqub, King ME (1993) A comparison of the Pipelle device and the Vabra aspirator as measured by endometrial denudation in hysterectomy specimens: the Pipelle device samples significantly less of the endometrial surface than the Vabra aspirator. Am J Obstet Gynecol 168:55–59

    PubMed  CAS  Google Scholar 

  20. Word B, Gravlee LC, Widemay GL (1958) The fallacy of simple uterine curettage. Obstet Gynecol 12:642–648

    PubMed  CAS  Google Scholar 

  21. Loffer FD (1989) Hysteroscopy with selective endometrial sampling compared with D&C for abnormal uterine bleeding: the value of a negative hysteroscopic view. Obstet Gynecol 73(1):16–20

    PubMed  CAS  Google Scholar 

  22. Stock RJ, Kanbour A (1975) Prehysterectomy curettage. Obstet Gynecol 45(5):537–541

    PubMed  CAS  Google Scholar 

  23. Gimpelson RJ, Rappold HO (1988) A comparative study between panoramic hysteroscopy with directed biopsies and dilatation and curettage: a review of 276 cases. Am J Obstet Gynecol 158(3 Pt 1):489–492

    PubMed  CAS  Google Scholar 

  24. Goldrath MH, Sherman AI (1985) Office hysteroscopy and suction curettage: can we eliminate the hospital diagnostic dilatation and curettage? Am J Obstet Gynecol 152:220–229

    PubMed  CAS  Google Scholar 

  25. Emmanuel MH, Wamsteker K, Lammes FB (1997) Is dilatation and curettage obsolete for diagnostic intrauterine disorders in premenopausal patients with persistent abnormal uterine bleeding? Acta Obstet Gynecol Scand 76(1):65–68

    Google Scholar 

  26. Hill EC (1987) Benign disorders of the uterine Cervix. In: Pernoll ML, Benson CR Current obstetric and gynecologic diagnosis and treatment, 6th edn. Appleton and Lange, Los Altos, Chap 35, pp 651–653

  27. Aridogan N, Cetin T, Kadayifci O, Atay Y, Bisac U (1988) Giant cervical polyp due to foreign body in a virgin. Aust N Z J Obstet Gynecol 28:146–147

    CAS  Google Scholar 

  28. Tang H, Jones I (2004) An intrapartum giant cervical polyp. N Z Med J 117:1206

    Google Scholar 

  29. Coeman D, Van Belle Y, Vanderick G, Xavier de Muylder, Edgar de Muylder, Campo R (1993) Hysteroscopic findings in patients with a cervical polyp. Am J Obstet Gynecol 169(6):1563–1565

    PubMed  CAS  Google Scholar 

  30. Stamatellos I, Stamatopoulos P, Rousso D, Assimakopoulos E, Bontis I ((2005)) Investigation of abnormal uterine bleeding by hysteroscopy and endometrial biopsy. Gynecol Surg 2(1):51–55

    Article  Google Scholar 

  31. Spiewankiewicz B, Stelmachow J, Sawicki W, Cendrowski K, Kuzlik R (2003) Hysteroscopy in cases of cervical polyps. Eur J Gynaecol Oncol 24(1):67–69

    PubMed  CAS  Google Scholar 

  32. Vilodre LC, Bertat R, Petters R, Reis FM (1997) Cervical polyp as a risk factor for hysteroscopically diagnosed endometrial polyps. Gynecol Obstet Invest 44(3):191–195

    Article  PubMed  CAS  Google Scholar 

  33. Goudas VT, Session DR (1999) Hysteroscopic polypectomy with a polyp snare. J Am Assoc Gynecol Laparosc 6(2):201–203

    Article  Google Scholar 

  34. Gupta JK, Clark TJ, More S, Pattison H (2004) Patient anxiety and experiences associated with an outpatient “one-stop” “see and treat” hysteroscopy clinic. Surg Endosc 18(7):1099–1104

    Article  PubMed  CAS  Google Scholar 

  35. Farrugia M, McMillan DL (2000) Versapoint in the treatment of focal intra-uterine pathology in an outpatient setting. References en Gynecologie Obstetrique (2):7

  36. Bettochi S, Ceci O, Di Venere R, Pansini MV, Pellegrino A, Marello F, Nappi L (2002) Advanced operative office hysteroscopy without anaesthesia: analysis of 501 cases treated with a 5 Fr bipolar electrode. Hum Reprod 17:2435–2438

    Article  Google Scholar 

  37. Bettocchi S, Ceci O, Nappi L, Di Venere R, Masciopinto V, Pansini V, Pinto L, Santoro A, Cormio G (2004) Operative office hysteroscopy without anesthesia: analysis of 4863 cases performed with mechanical instruments. J Am Assoc Gynecol Laparosc 11(1):59–61

    Article  PubMed  CAS  Google Scholar 

  38. Campo R, Molinas CR, Rombauts L, Mestdagh G, Lauwers M, Braekmans P, Brosens I, Van Belle Y, Gordts S (2005) Prospective multicentre randomized controlled trial to evaluate factors influencing the success rate of office diagnostic hysteroscopy. Hum Reprod 20(1):258–263

    Article  PubMed  Google Scholar 

  39. Kent ASH, Haines P, Manners BTB, Coats PM (1998) Blind endometrial biopsies: insufficient for diagnosis in women with intrauterine pathology. Gynecol Endosc 7:273–278

    Article  Google Scholar 

  40. Neri A, Kaplan B, Rabinerson D, Ovadia J, Braslavsky D (1995) Cervical polyp in the menopause and the need for fractional dilatation and curettage. Eur J Obstet Gynecol Reprod Biol 62:53–55

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Ioannis Stamatellos.

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Stamatellos, I., Stamatopoulos, P. & Bontis, J. The role of hysteroscopy in the current management of the cervical polyps. Arch Gynecol Obstet 276, 299–303 (2007). https://doi.org/10.1007/s00404-007-0417-2

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  • DOI: https://doi.org/10.1007/s00404-007-0417-2

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