Clinicopathological evaluation of cervical polyps

Abstract

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. Polyps were asymptomatic in 39.6% (n=97) of the cases and coincide with abnormal uterine bleeding (AUB) in 53.9% (n=132), and missed abortus in 6.5% (n=16). Patients with polyps significantly tend to have complaint of abnormal uterine bleeding compared to other symptoms.

Conclusion: Routine cervical polypectomy is not necessary. Cytology and utilization of colposcopy should be considered prior to polypectomy, as well as assessment of clinical and menopausal status.

Keywords

• Menopause
• Uterine Cervi
• Polyp

Serviks poliplerinin klinikopatolojik değerlendirmesi

Öz

Amaç: Klinik pratikte servikal poliplerin nasıl yönetileceği yaygın bir tartışma konusudur. Randomize kontrollü prospektif çalışmalar etik olarak doğru bulunmadığından bu konudaki çalışmalar retrospektif olmaktadır. Malin transformasyon potansiyeli pre ve postmenapozal hastalarda endişe oluşturmaktadır. Bu çalışmada, servikal polip görülen hastalarda, semptom ve menopoz durumuna göre polipektomi piyeslerinin patoloji sonuçlarının karşılaştırılması amaçlanmıştır.

Gereç ve Yöntem: Servikal polip tanısı konulan 245 hasta retrospektif olarak incelendi. Total olarak 270 polip incelendi. Patoloji sonuçları menopoz durumu ve semptomlara göre Fisher’s Exact Test ve Fisher-Freeman-Halton Test ile karşılaştırıldı. İstatistiksel anlamlılık p<0.05 ve p<0.01 olarak kabul edildi.

Bulgular: Olgularda invazif hastalık görülmedi. Sadece postmenapozal bir hastada servikal intraepitelyal neoplazi (CIN 1) görüldü. Poliplerin %39,6’sı (n=97) asemptomatik hastalarda, %53,9’u (n=132) anormal uterin kanaması olan hastalarda ve % 6,5’i (n=16) missed abortus ile başvuran hastalarda görüldü. Anormal uterin kanaması olan olgularda servikal polip belirgin olarak fazla idi.

Sonuç: Rutin servikal polipektomi gereksizdir. Kolposkopi kullanımı ve sitoloji klinik ve menopozal durumun değerlendirilmesiyle beraber polipektomiden önce dikkate alınmalıdır.

Anahtar Kelimeler

• Uterin serviks
• Menopoz
• Po- lip

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