Polypectomy (removal of polyps) in Ternopil

Polypectomy in gynaecology is an effective minimally invasive surgery to remove polyps from the uterine cavity, cervix, and cervical canal. These are round, mostly benign neoplasms on a pedicle or with a wide base, which appear as a result of the growth of the inner layer of the uterus (endometrium). Such growths are potentially dangerous and can cause many serious problems, including uterine bleeding, reduced fertility, infertility, and malignancy. Therefore, experts recommend getting rid of polyps.

Polyps can only be effectively removed surgically. The choice of surgical technique depends on the size of the polyp, its shape, localization, as well as the number (single or multiple — polyposis).

Polypectomy is performed in a planned manner after examination.

Types of polyps

Polyps of the endometrium and endocervix, depending on the cellular structure, can be:

•     glandular, formed from stromal cells, occur more often in women of reproductive age;

•     adenomatous, formed from changed (atypical) cells of the glandular epithelium; have a very high risk of malignancy; are found more often in patients in the period of pre- and postmenopause;

•     fibrous; these small single connective tissue polyps appear more often after 40 years for non-hormonal reasons;

•     placental that arise from placental fragments left in the uterus as a result of poor-quality scraping or complicated childbirth;

•     mixed (glandular-fibrous): the body of the polyp is formed by glandular tissue while the pedicle (base) is fibrous.

Causes

The main reasons for the formation of endometrial polyps are the infectious and inflammatory process of the female reproductive organs and hormonal failure. Local hyperplasia of endometrium can be provoked by:

•     increased level of oestrogen;

•     hormone-dependent diseases (mastopathy, polycystosis);

•     abortions, diagnostic scrapings;

•     cervical injuries;

•     hypertension, excessive weight;

•     diseases of the thyroid gland;

•     diabetes;

•     adrenal gland dysfunction;

•     disorders of the ovaries;

•     genetic predisposition;

•     human papillomavirus infection (HPV infection);

•     chronic inflammatory processes of the pelvic organs.

Symptoms

Small single polyps may not make themselves known for a long time and are accidentally detected on ultrasound. That is why regular examination of female sexual health is important at any age. Clinical manifestations begin with the growth of neoplasms, an increase in their number, infection or transformation. Signs:

•     brown smearing discharge before and after menstruation;

•     abundant, long and painful menstruation;

•     the appearance of copious discharge from the genital tract, which may have an unpleasant odour and an unusual colour;

•     bleeding during postmenopause;

•     spasm-like pain in the lower abdomen;

•     bloody discharge after sexual intercourse;

•     difficulties with the onset of pregnancy.

How is it performed?

Polypectomy is performed by two methods:

1. Hysteroresectoscopy is performed under video control using an electrosurgical instrument (hysteroresectoscope). The duration of the procedure is 10 to 30 minutes.

It is carried out on the 6-10th day of the cycle after the disappearance of bloody discharge. Stages of the surgery:

•     expansion of the uterine cavity with a sterile solution to obtain high-quality visualization on the monitor;

•     introduction of a hysteroscope through the vagina and careful moving it into the uterine cavity;

•     introduction of a resectoscope (a precision cutting tool) through the hysteroscope canal;

•     cutting off the pedicle of the polyp at the base with a coagulation loop, cauterizing the bed of the polyp (under video control);

•     liquid removal; preparation of biological material for histological examination.

2. Targeted polypectomy is a mechanical removal of small polyps during hysteroscopy with simple surgical tools, such as: clamp, conchotome, forceps or curette.

Postoperative recommendations:

•     to limit physical activity;

•     to avoid general overheating and thermal procedures in the abdomen (sauna, solarium, hot baths);

•     to have sexual silence during the rehabilitation period;

•     to exclude douching and the use of tampons;

•     to undergo control examination and ultrasound one month after the surgery;

•     to receive medication treatment according to indications.

Full recovery after the surgery takes 2-3 weeks, and pregnancy can be planned already in the next menstrual cycle.

Advantages of Viasan

Polypectomy in gynaecological department. Viasan Medical Centre. Why to be treated at us?

•     Modern diagnostic and surgical equipment.

•     Full cycle of medical care, from consultation to surgery.

•     Own gynaecological hospital and laboratory.

•     Experienced specialists of high qualification and impeccable reputation.