Cervical polyp

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Synonyms and keywords: Polypoid cervical lesion; Cervical polypoid lesion; Polypoid cervical growth

Overview

Cervical polyps are defined as polypoid benign overgrowths of endocervical tissue. Usually, cervical polyps are growths projecting into the cervical canal. Cervical polyps are the most common cause of intermenstrual vaginal bleeding.

Historical Perspective

• Cervical polyp was first described by Peterson and Novak in 1956 following the description of endometrial polyps.

Classification

• Cervical polyps may be classified according to morphological features into 3 subtypes:
• Distribution

• Single
• Multiple

• Shape

• Tear shaped
• Lobular

• Size

• Less than 3 cm
• More than 3 cm

• Pedicle

• Broad-based
• Sessile

Pathophysiology

• The pathogenesis of cervical polyp is characterized by chronic inflammation of the endocervical canal.
• Cervical polyps arise from the endocervical canal and tend to protrude in the external cervix.
• There are no genes associated with the development of cervical polyp.
• On gross pathology, flesh-colored, single finger-like growth, 1 cm size, are characteristic findings of cervical polyp.
• On microscopic histopathological analysis, inflamed and dilated endocervical (mucus) glands and myxoid stroma are characteristic findings of cervical polyp.

Causes

• There are no established causes for cervical polyp.

Differentiating cervical polyp from other Diseases

• Cervical polyp must be differentiated from other diseases that cause abnormal vaginal bleeding, dyspareunia, and abnormal vaginal discharge

• Cervical intraepithelial neoplasia
• Cervical cancer
• Cervicitis

Epidemiology and Demographics

• The estimated prevalence of cervical polyp is approximately 1.5–10% in general population.

Age

• Cervical polyp is more commonly observed among patients aged 40 to 55 years old.
• Cervical polyp is more commonly observed among perimenopausal and postmenopausal women.

Race

• There is no racial predilection for cervical polyp.

Risk Factors

• Common risk factors in the development of cervical polyp, include:

• Chronic inflammation
• Hormonal factors
• Presence of endometrial hyperplasia
• Previous history of pregnancy

Natural History, Complications and Prognosis

• The majority of patients with cervical polyp remain asymptomatic for years.
• Early clinical features include abnormal vaginal bleeding, postcoital vaginal bleeding, and abnormal vaginal discharge.
• If left untreated, only 0.2–1.7% of patients with cervical polyp may progress to develop malignant transformation.
• Common complications of cervical polyp include malignant transformation, bleeding, and recurrence.
• Prognosis is generally excellent, and the 5-survival rate of patients with cervical polyp is approximately 100%.

Diagnosis

Diagnostic Criteria

• The diagnosis of cervical polyp is made when at least [number] of the following [number] diagnostic criteria are met:

• [criterion 1]
• [criterion 2]
• [criterion 3]
• [criterion 4]

Symptoms

• Cervical polyp is usually asymptomatic.
• Symptoms of cervical polyp may include the following:

• Vaginal discharge
• Dyspareunia
• Dysmenorrhea
• Leukorrhea

Physical Examination

• Patients with cervical polyp usually appear [general appearance].
• Physical examination may be remarkable for:

• [finding 1]
• [finding 2]
• [finding 3]
• [finding 4]
• [finding 5]
• [finding 6]

Laboratory Findings

• There are no specific laboratory findings associated with cervical polyp.

• A [positive/negative] [test name] is diagnostic of cervical polyp.
• An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of cervical polyp.
• Other laboratory findings consistent with the diagnosis of cervical polyp include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Imaging Findings

• There are no [imaging study] findings associated with cervical polyp.

• [Imaging study 1] is the imaging modality of choice for cervical polyp.
• On [imaging study 1], cervical polyp is characterized by [finding 1], [finding 2], and [finding 3].
• [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

• Cervical polyp may also be diagnosed using [diagnostic study name].
• Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

• There is no treatment for cervical polyp; the mainstay of therapy is supportive care.

• The mainstay of therapy for cervical polyp is [medical therapy 1] and [medical therapy 2].
• [Medical therapy 1] acts by [mechanism of action1].
• Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

• Surgery is the mainstay of therapy for cervical polyp.
• [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of cervical polyp.
• [Surgical procedure] can only be performed for patients with [disease stage] cervical polyp.

Prevention

• There are no primary preventive measures available for cervical polyp.

• Effective measures for the primary prevention of cervical polyp include [measure1], [measure2], and [measure3].

• Once diagnosed and successfully treated, patients with cervical polyp are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].