Treatment Of Cervical Polyps
Polypectomy And Dilation and Curettage

Treatment

Contents

• Why Are Cervical Polyps Treated?
• How Are They Treated?
• When Is General Anesthesia Recommended?
• Cryocautery
• Is Treatment Really Necessary?

Topic Overview

Polyps Guide

Why Are Cervical Polyps Treated?

Although cervical polyps do not cause symptoms in most cases, some women can experience light bleeding or spotting, particularly after sexual intercourse, douching or using a tampon. Polyps are generally removed to stop bothersome symptoms and to prevent future bleeding and irritation (see symptoms of cervical polyps). Although the vast majority of polyps are noncancerous (benign), they should be removed and biopsied for signs of cancer. Some rare cervical cancers first appear as polyp tumors. If you are diagnosed with polyps, try not to panic if your doctor mentions ruling out 'cancer' - it is an extremely rare occurrence. You are probably just as likely to knocked down by a number 9 bus!

How Are They Treated?

Occasionally a cervical polyp will drop off on its own during menstruation - it may burst and disintegrate if knocked during sexual intercourse. In most cases however they need to be surgically removed because they tend to imbed and grow indefinitely. Fortunately the surgical procedure (called a polypectomy) is simple to perform and is relatively painless. It can be carried out in a gynecologist's office or as an outpatient in a hospital.

Polypectomy
Surgery to remove a polyp is called a polypectomy. The doctor will insert a speculum to widen the vagina and may insert a colposcopy (a special magnifying device) to improve his vision. Next, he inserts a looped forceps to grasp the base of the polyp. He will then gently twist until the lesion falls off. You may experience a slight tugging sensation but otherwise it should not be painful. The doctor will then examine the area for signs of any remnant polyp tissue. He may use a curette (kevorkian) to scrap the base to ensure all tissue is removed. Finally, using a silver nitrate stick (a short stick containing medication) he will cauterize (burn) the wound to seal it. The polyp is placed in a sterile container and sent to a pathology laboratory to check for precancerous or cancerous cells. If the polyp turns out to be cancerous, the treatment will depend on the type and extent of cancer identified. Read also, about cervical polyps in pregnancy, management and treatment options.

Post-Operative Care

• Wear a sanitary pad as you will have some bleeding. This will continue for up to 14 days.
• Avoid sexual intercourse, douching or using tampons until bleeding stops.
• You may experience some cramping for a few hours. Mild pain killers Tylenol or ibuprofen (Advil and Motrin) can help relieve discomfort.
• You can bath and shower as normal straight away.
• You will need to return to the doctor 6 to 8 weeks later for a follow-up.

When Is General Anesthesia Recommended?

Polyp removal as an outpatient procedure (as described above) is recommended for women who are asymptomatic. Hospitalization and removal of the polyp under general anesthesia - accompanied by dilation and curettage (D&C procedure) - is usually only reserved for women with a large lesion that is causing symptoms. Most women are treated under local anesthesia, although a study published in Gynecology and Obstetrics (2010) found than patients who had given birth a least once were 5 times more likely to require general anesthesia. Additionally, they reported, postmenopausal women were 1.7 times more likely than younger women to have polyps removed under general sedation.

Cryocautery

Your doctor may offer this additional treatment after your polypectomy. Cryocautery involves freezing the neck of the womb (cervix) by inserting a metal probe for 2 minutes. It is usually done to treat cervical infections and may be recommended if an infection is a possible underlying cause of your polyp. About half an hour after the procedure you will experience a gush of fluid as the ice in the cervix melts. You may also have a vaginal discharge which can be brown or clear and lasts for 2 or 3 weeks as the cervix heals. You will need to wear a panty liner and avoid intercourse and tampons for 4 weeks.

Recurrence

Cervical polyps tend not to grow back in the same site. However new ones can form and for this reason, an annual pelvic examination is recommended. Researchers in the Gynecology and Obstetrics (2010) study reported a 13 percent rate of recurrence.

Is Treatment Really Necessary?

One interesting study (2011, Maccabi Health Service clinics, Israel) questioned:
Is the removal of asymptomatic cervical polyps really necessary?

The primary reason doctors tend to remove asymptomatic polyps is to check for cancerous cells. Researchers who carried out this trial wanted to assess the actual risk of cancer. 228 asymptomatic patients who had undergone a polypectomy were investigated. The average age of the patient was 40-49 years old. The results showed that 9 abnormal colposcopy patterns were reported and 6 had carcinoma in situ (CIS or CIN) - that is the precancer stage of cervical cancer. CIN 3 (the most advanced stage of CIN) was only found in one polyp. Out of 228 patients, no actual cases of malignancy were found. Scientists concluded that there is no ground for recommending polypectomy in asymptomatic patients who have normal Pap smear results (where cell sample is taken from the polyp).

Personal Stories

I had a large polyp on the outside of my cervix for years. Finally I went to see my Gyno because it had gotten so big and it was getting irritated. She removed it there and then. She basically just twisted it off. It felt like a slight pinch but it was over in minutes. I had minor spotting for a few days but that was all.
Kelly, Boston

I had a small cervical polyp removed 2 weeks ago. My doctor found it during a routine smear test and told me to go to a gynecologist to have it removed. Although they polyps nearly always benign, and mine was causing no problems, he said it is just a precautionary measure. When I asked what caused it, he said they don't really know and that I'm just one of the statistics that get them. I had the polyp removed and it was relatively painless. The doc just clipped it at the root and twisted it off. She applied a solution to stop the bleeding but that wasn't painful either. The polyp itself looked like a squiggly bit of fatty tissue. It was sent to a lab for biopsy, and I should have the result this week. I'm not worried.
Miranda, Albuquerque

Mine was removed under general anesthetic a few years ago. The doctor said the base of it was too wide to snip with forceps and that it would have bled a lot. They performed a D&C instead.
Vanessa, Arlington

I've had three procedures to remove polyps, and they kept coming back. A few weeks ago I had cervical ablation which will hopefully stop them coming back once and for all.
Shelly, London

I was diagnosed with a polyp 2 years ago, it was picked up during a smear test. It was quite large according to the doctor, so I really started panicking. As you do, I imagined the worst, but it all turned out fine. I was scheduled for a D&C but I went to my local doctor first for an internal examination because I was worried about the bleeding. During the examination the polyp burst and was completely gone by the time I went to hospital. The surgery wasn't necessary.
Katherine, Newport

Related Articles on Polyps

For more information, see the following:

• Causes of cervical polyps: Effects of estrogen.
• Treatment of uterine polyps and symptoms of uterine polyps.

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