Cervical polyps are common benign growths of the cervix and endocervix. Most cervical polyps are asymptomatic, but some cause vaginal bleeding. Diagnosis is with pelvic examination. Treatment is polypectomy, usually as a minor outpatient procedure.
Cervical polyps occur in approximately 2 to 5% of women (1). They usually originate in the endocervical canal. Endocervical polyps may be caused by chronic inflammation. They rarely become malignant.
Reference
1. Farrar HK Jr, Nedoss BR. Benign tumors of the uterine cervix. Am J Obstet Gynecol. 1961;81:124-137. doi:10.1016/s0002-9378(16)36314-1
Symptoms and Signs of Cervical Polyps
Most cervical polyps are asymptomatic, but they may bleed between menses or after intercourse or become infected, causing purulent vaginal discharge (leukorrhea).
Endocervical polyps are usually reddish pink, glistening, and < 1 cm in all dimensions; they may be friable.
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
Diagnosis of Cervical Polyps
Pelvic examination
Diagnosis of cervical polyps is by pelvic examination using a vaginal speculum.
Cervical polyps are usually benign and pathologic evaluation is performed there are examination findings that are atypical or concerning for cervical neoplasia (1). Cervical cytology should also be performed if there is concern for neoplasia or the patient is due for routine cervical cancer screening.
Diagnosis reference
1. Levy RA, Kumarapeli AR, Spencer HJ, Quick CM. Cervical polyps: Is histologic evaluation necessary?. Pathol Res Pract. 2016;212(9):800-803. doi:10.1016/j.prp.2016.06.010
Treatment of Cervical Polyps
Excision
Polyps that cause bleeding or discharge should be removed. Excision is usually a minor procedure and can be done in the office by grasping the base with forceps and twisting off the polyp (polypectomy). Typically polypectomy is not painful and does not require local anesthetics. Bleeding after excision is rare and can be controlled with chemical cautery.
If bleeding or discharge persists after treatment, endometrial biopsy is performed to exclude malignancy.
Key Points
Cervical polyps are common benign growths of the cervix and endocervix; they are usually benign.
Most are asymptomatic, but some cause bleeding or become infected, causing purulent vaginal discharge.
Diagnose by pelvic examination using a vaginal speculum.
If polyps cause symptoms, remove them; if bleeding or discharge persists after removal, biopsy is required to exclude cancer.
