Stamatellos Ioannis, Stamatopoulos P, Bontis J
First Academic Department of Obstetrics and Gynaecology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54606, Thessaloniki, Greece.
Arch Gynecol Obstet. 2007 Oct;276(4):299-303. doi: 10.1007/s00404-007-0417-2. Epub 2007 Jul 25.
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.
目前宫颈息肉患者的管理可能包括不同的方法和方案，例如在大多数情况下在门诊简单切除息肉、手术扩张刮宫、电外科切除或宫腔镜下息肉切除术。通过宫腔镜检查宫颈管和子宫腔可确定息肉蒂的准确起源（宫颈或子宫内膜）以及是否存在任何并发的子宫内膜病变。大多数宫颈息肉无症状，其发病率随年龄增长而增加。有症状的宫颈息肉可能导致经间期出血、性交后出血、月经过多、绝经后出血和阴道分泌物异常。宫颈息肉可通过常规妇科检查、阴道镜检查、子宫输卵管造影的充盈缺损、妇科超声（腹部、经阴道或宫腔超声造影）或子宫内膜活检检测到。宫颈息肉的位置、数量和大小最好通过诊断性宫腔镜检查来确定。过去，简单扭转或撕脱息肉或盲目刮宫是标准的手术治疗选择。然而，这种治疗常常会在宫颈管内留下残留的息肉碎片。区分宫颈管病变和子宫内膜病变也可能存在困难。此外，高达25%的宫颈息肉患者同时存在子宫内膜息肉，因此需要对子宫腔进行评估。需要注意的是，宫腔镜检查对于管理宫颈息肉患者非常有用，尤其是当患者出现异常子宫出血时，以便做出准确诊断并提供适当治疗。
