Uterine polyps

　　The causes of uterine polyps may be related to inflammation, endocrine disorders, especially high estrogen levels. Polyps come from immature endometrium, especially the basal endometrium.

　　This disease can occur at any age after puberty, but it is more common in women over 35 years old. Small, solitary endometrial polyps often have no clinical symptoms and are often discovered during macroscopic examination after hysterectomy for other diseases, or diagnosed after curettage. Multifocal disseminated polyps are often associated with menorrhagia and prolonged menstrual periods, which are related to the increase in endometrial area and excessive endometrial hyperplasia. Large polyps or polyps that protrude into the cervical canal are prone to secondary infection and necrosis, causing irregular bleeding and malodorous bloody discharge. Endometrial polyps are localized endometrial lesions that can occur at any age due to excessive endometrial hyperplasia and are very common types of lesions. They protrude into the uterine cavity with smooth, meaty hardness, and the pedicle can vary in length, some of which can protrude outside the cervical os. Smaller polyps generally have no clinical symptoms, and some polyps that protrude outside the cervical os may cause bleeding after sexual intercourse and be discovered when seeking medical attention.

　　In addition to its clinical manifestations, corpus uteri polyps can also cause other diseases. Large polyps or polyps that protrude into the cervical canal are prone to secondary infection and necrosis, leading to irregular bleeding and malodorous bloody secretions.

　　1. Acute inflammation may show cervical congestion and edema, or erosion, with purulent secretions discharged from the cervical canal. There may be pain upon touching the cervix. Chronic cervicitis may show cervical erosion, hypertrophy, polyps, glandular cysts, inversion, etc., or there may be purulent secretions at the cervical os, with a harder cervix upon palpation. Contact bleeding may occur if there is cervical erosion or polyps.

　　2. Endometrial polyps are composed of endometrium, with the surface covered by a layer of cuboidal epithelium or low columnar epithelium. The middle part of the polyp forms a fibrous longitudinal axis, containing blood vessels within it.

　　Due to the narrow base, blood supply is reduced, polyps are prone to change. The most common occurrence is thrombosis within the polyp blood vessels, which turns deep purple due to stasis, often starting from the top and leading to necrosis, and finally possibly rotting and falling off.

　　3. Cervical scraping shows Bethesda II grade.

　　Patients with polyps, especially those with uterine polyps, should eat less spicy and刺激性 food, fried, meat and eggs, cold, greasy, high-fat, and high-energy food. Increase the intake of fruits and vegetables, maintain smooth defecation, and prevent the accumulation of fat and energy, dampness, and stasis, which may lead to cancer.

　　Actively prevent colds and flu, and adjust clothing according to the change of seasons. Abstain from smoking and drinking, and defend against toxic gases and pollution, as well as the long-term stimulation of dust on the nose and throat. Avoid long-term use of vasoconstrictors such as nasal and eye drops to prevent drug-induced rhinitis. Do not develop the bad habit of picking the nose. Do not force blowing nose when it is severely blocked, as this may lead to sinusitis, otitis media, and other conditions. Timely treatment of diseases in the nose, throat, and surrounding organs should be sought to prevent infection spread and recurrence.

　　To prevent corpus uteri polyps, attention should be paid to the hygiene of the external genitalia, preventing vaginal inflammation and cervical erosion, and maintaining sexual hygiene. It is advisable to often expose bedding to sunlight and wear cotton underwear, changing them frequently. Good health care should be practiced during the menstrual period, postpartum, or after abortion. Additionally, the key to preventing corpus uteri polyps is for women to pay attention to strengthening physical exercise and improving their body's ability to resist diseases.

　　Examination items needed for corpus uteri polyps

　　Gynecological examination

　　1. Gynecological examination: Acute inflammation may show cervical congestion and edema, or erosion, with purulent secretions discharged from the cervical canal. There may be pain upon touching the cervix. Chronic cervicitis may show cervical erosion, hypertrophy, polyps, glandular cysts, inversion, etc., or there may be purulent secretions at the cervical os, with a harder cervix upon palpation. Contact bleeding may occur if there is cervical erosion or polyps.

　　2. Microscopic examination: Endometrial polyps are composed of endometrium, with the surface covered by a layer of cuboidal epithelium or low columnar epithelium. The middle part of the polyp forms a fibrous longitudinal axis, containing blood vessels within it.

　　Due to the narrow base, blood supply is reduced, polyps are prone to change, and the most common occurrence is thrombosis within the polyp blood vessels, which turns deep purple due to stasis, often starting from the top and leading to necrosis, and finally possibly rotting and falling off.

　　3. Cervical scraping shows B cervical grade II.

　　4. For patients with severe conditions, cervical biopsy can be performed to clarify the diagnosis. The pathological diagnostic criteria for malignant transformation of polyps are: ①The entire morphology of the polyp must be seen; ②Malignant transformation is limited to the polyp; ③The endometrium around the polyp has no cancer, and it should be distinguished from endometrial adenocarcinoma that grows in polyp-like form.

　　1. Diet should be light, and avoid foods that can cause heat, such as mutton, shrimp, crab, eel, salted fish, and black fish.

　　2. Avoid spicy foods and drinks such as chili, Sichuan pepper, scallion, garlic, and white wine.

　　3. Avoid eating foods with hot properties, blood coagulation, and hormone components such as longan, jujube, glue, royal jelly, etc.

　　4. Eat more lean meat, chicken, eggs, quail eggs, crucian carp, turtle, white fish, cabbage, asparagus, celery, spinach, cucumber, winter melon, mushrooms, tofu, kelp, seaweed, and fruits, etc.

　　Tips:Most scholars believe that polyps come from immature endometrium, especially the basal endometrium. Most are due to inflammatory endocrine disorders. Therefore, women with gynecological inflammation must actively check and treat to avoid causing other inflammations.

　　①Dilate the cervix, remove the polyps, and then scrape the entire uterine cavity, which can remove diffuse small polyps and send them for pathological examination.

　　②Hysteroscopic resection: For multiple, especially large polyps that are difficult to remove by curettage, hysteroscopic resection can be performed, with good results. It should be noted that after the operation does not mean that everything is fine, and hormone drugs should be taken for 3-6 months after the operation to prevent recurrence. Regular follow-up should be carried out after the operation, paying attention to recurrence and malignant transformation, and timely treatment should be provided. For patients over 40 years old, if the bleeding symptoms are obvious and the above treatment cannot be eradicated or often recurs, consideration can be given to total hysterectomy.

　　Large pedunculated polyps can be seen or felt in the lower segment of the uterus. At this time, the polyps can be removed by dilating the cervix, and then cervical and uterine cavity curettage can be performed to scrape out the remaining polyps and send them for pathological examination. Small focal or diffuse polyps should be scraped thoroughly, especially at the fundus and cornu of the uterus. After uterine cavity surgery, anti-infection treatment should be carried out. Clinically, oral or intravenous antibiotics can be given.