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  • On 26/04/2020

Definition of uterine polyp

The uterine polyp or endometrial polyp is a growth of the endometrium, a mucous membrane that lines the inside of the uterus. A benign tumor, its size, number, shape and composition are variable. A polyp can fill the entire uterine cavity, be single or multiple, be pedicled (attaching to the uterus by a foot) or sessile (with a broad implantation base). 

It can remain contained in the uterine cavity, be located in the cervix (endocervix polyp), or externalize through the cervix into the vagina. Located near the end of the fallopian tubes, it can interfere with fertility.

One should not confuse polyp with uterine fibroid, which develops at the expense of muscle cells in the uterus.

In addition, Dawabio experts offer you the opportunity to heal uterine polyps without curettage or hysteroscopy.

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When you have a uterine polyp, it means that you have a small growth of uterine lining (the tissue that normally lines the cavity of the uterus). The curettage will cut this polyp and evacuate it. It is therefore normal that there is some bleeding following this procedure, this bleeding may persist until the next period. The brownish discharge, that is to say brown, not really red, does not mean at all that it is "bad blood", in fact, the brownish tint is due to the coagulation of the blood, which is coagulation. allowed by the weak flow: if the bleeding was too profuse it could not stay more than a few seconds in the vagina and therefore do not coagulate (the vagina is at 37 °). Here they have time to stay several minutes or even more, and therefore take on this brownish color. Generally speaking, bleeding from the uterus is brown or black when there is little, and bright red when there is a lot.

What then of the hysteroscopy?

The hysteroscopy is an endoscopic examination of gynecology, which consists of exploring the uterine cavity. It is used both in the diagnosis of a certain number of pathologies and female disorders such as in the case of uterine polyps, but also in the treatment of certain gynecological problems.

The aftermath of hysteroscopy

After a  hysteroscopy, the patient can usually quickly resume a normal life. However, this intervention can cause some minor inconvenience:

Urinary disorders, with frequent urge to urinate for 1 or 2 days;

·          Irregular bleeding and low for a few days;

· Liquid losses mixed with mucous membrane debris for more than 6 weeks;

Pelvic pain similar to period pain;

· Tiredness ;

Nausea and vomiting in case of anesthesia.

In the event of pain, it is recommended to take analgesic drugs for a few days (drugs prescribed by the doctor according to the patient's state of health). In addition, some precautions must be observed in the days following a  hysteroscopy  :

- Do not use vaginal tampons for the next two cycles;

· Do not douche;

· Do not take a bath, nor bathe in the sea or in a swimming pool for ten days;

· Abstain from sexual relations for 15 days;

· Rest and slow down your activity for a few days.

A medical visit to the gynecologist or surgeon is generally scheduled between 8 and 30 days after the operation.

Complications of hysteroscopy

Hysteroscopy is a common procedure that rarely causes complications. The risks associated with hysteroscopy, whether diagnostic or operative, can be classified into two categories: Immediate complications and delayed complications.

The immediate complications are as follows:

· Sores in the cervix  when passing the hysteroscope;

Perforation of the uterus with the hysteroscope, most often without consequence, but which may require a second operation by laparoscopy to check that the intestines, bladder or blood vessels have not been affected;

Uterine bleeding;

Rare risks if the liquid injected into the uterus passes into the bloodstream: glycocoll can cause neurological signs (headaches, visual disturbances), an allergic reaction, or even exceptionally respiratory disorders (lung edema) and serious cardiovascular.

Beyond a few days, other complications can be attributed to the hysteroscopy  :

· An infection of the uterus, called endometritis, requiring the initiation of appropriate antibiotic treatment;

The formation of adhesions in the uterine cavity, rarely causing infertility or difficulty in evacuating periods.

If anesthesia has been performed, it carries its own risks, explained to the patient by the anesthetist during the preoperative anesthesia consultation.

In all cases, after a  hysteroscopy, certain warning signs should prompt you to consult a doctor quickly:

Severe pain;

· Vomitings ;

Heavy and persistent bleeding;

A fever above 38.5 ° C for several hours.

Uterine bleeding: a variety of management

Faced with functional disorders, the gynecologist usually first prescribes hormonal treatment (pill, progestins, etc.), aimed at correcting an imbalance between the two types of female hormones, estrogen and progesterone, produced by the ovaries. The goal is to limit hormonal disturbances which can cause excessive dilation of the vessels of the uterus, which is the source of bleeding. Placement of an IUD that regularly delivers progestin into the uterus or administration of anti-inflammatory drugs can also be tried. " Nevertheless, we now know that these drugs are, on average, only effective in less than half of the cases. Except for the progesterone IUD which remains effective in 60% of cases." specifies Pr. Fernandez.

In case of failure, it was common to resort to surgical treatments:

A hysterectomy: this radical solution consists of removing the uterus;

Curettage under general anesthesia of the uterine wall which requires 24 hours hospitalization.

According to Prof. Fernandez, these solutions are still too systematically adopted despite their very traumatic nature. “In 1999, more than 80% of treatments for uterine bleeding were based on curettage. However, we know that the maximum effectiveness of this technique is 50%. Moreover, it is estimated that out of 100 women who undergo a hysterectomy, 90 could have benefited from less aggressive treatments such as thermo-coagulation in particular, ”estimates Pr. Fernandez.

Uterine bleeding: new less traumatic alternatives

New treatments now make it possible to avoid removal of the uterus in many cases.

 Hysteroscopic endometrial resection involves removing part of the endometrium. While this does not guarantee the total cessation of bleeding, this technique is a response to the desire of patients to keep their uterus and keep their periods. But these very expensive techniques require real know-how on the part of the surgeon and the results may therefore depend on his experience. Not to mention that several interventions are sometimes necessary;

 Balloon thermo-coagulation has several advantages. A small flexible balloon attached to a catheter is inserted into the uterus. Inflated with sterile liquid, it follows the contours and dimensions of the uterus, then its contents are heated to 87 ° C for 8 minutes. This heat destroys the inner surface of the uterus, responsible for bleeding. Performed under local or general anesthesia, this operation rarely exceeds half an hour and requires only a short hospital stay. The consequences are limited to a few bloody losses and transient pain that can be prevented by taking pain medication or anti-inflammatory drugs. Be careful, like other surgical techniques, this method can only be considered in women who no longer want children.

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