Cervical Polypectomy

Cervical polypectomy is a procedure to remove small tumors (polyps), often growing on a stalk, from the opening of the cervix or inside the cervical canal (endocervix). The polyps are generally noncancerous (benign).

Cervical polyps are caused by an overgrowth of normal tissue. They are relatively common and most do not cause symptoms. Cervical polyps are frequently the result of infection, and may be linked to chronic inflammation, an abnormal response to higher levels of estrogen, or local congestion of cervical blood vessels.

Cervical polyps do not usually cause symptoms. Some individuals may experience light bleeding or spotting caused by irritation from a tampon or sexual intercourse (postcoital bleeding). Polyps are generally removed because of this bleeding, or to prevent additional future irritation and bleeding. Although most polyps are benign, all should be removed and examined because cancerous (malignant) changes may develop; some cervical cancers first appear as polyps.

Polypectomy is usually an outpatient procedure performed in the physician's office. It is generally painless, so no anesthesia is required. The woman lies on the exam table with her legs in the stirrups (lithotomy position); a speculum is then inserted into the vagina to hold it open to visualize the cervix. The cervix is cleansed using a vaginal swab soaked in an antiseptic solution. The polyp is grasped with a surgical clamp (hemostat), twisted several times, and pulled until it is freed. The polyp is sent for microscopic examination (pathology) to rule out cancer. The base of the polyp is then removed by scraping it off with a sharp surgical instrument (curettage), or by using heat, cold, or chemicals to destroy the tissue (cauterization).

If the polyp is large, or if it is attached by a broad base rather than a stalk, it may need to be cut off and the wound stitched (sutured) closed. This procedure may be done under local anesthesia in the hospital because of the possible risk of excessive bleeding (hemorrhage).

If the cervix is soft, distended, or partially opened, and the polyp is large or not clearly visible, dilation and curettage (D&C) will be done. The cervical opening will be widened (dilated) so that the cervical canal and uterus may be examined for other polyps. All removed polyps will be biopsied for evidence of cancer.

Regardless of the method used, cervical polypectomy is a routine procedure that has an excellent outcome.

Other than time off for the procedure, work restrictions or accommodations are not usually required.

Complications following cervical polypectomy are rare; however, hemorrhage and infection can occur.

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