| 词条 | Endometrial polyp |
| 释义 |
| name = Endometrial polyp | synonyms = Uterine polyp | image = Polyp.Uterus.jpg | caption = Endometrial polyp, viewed by sonography. | pronounce = | field = Gynecology | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} An endometrial polyp or uterine polyp is a mass in the inner lining of the uterus.[1] They may have a large flat base (sessile) or be attached to the uterus by an elongated pedicle (pedunculated).[1][2] Pedunculated polyps are more common than sessile ones.[3] They range in size from a few millimeters to several centimeters.[2] If pedunculated, they can protrude through the cervix into the vagina.[1][4] Small blood vessels may be present, particularly in large polyps.[1] Signs and symptomsThey often cause no symptoms.[3] Where they occur, symptoms include irregular menstrual bleeding, bleeding between menstrual periods, excessively heavy menstrual bleeding (menorrhagia), and vaginal bleeding after menopause.[2][5] Bleeding from the blood vessels of the polyp contributes to an increase of blood loss during menstruation and blood "spotting" between menstrual periods, or after menopause.[6] If the polyp protrudes through the cervix into the vagina, pain (dysmenorrhea) may result.[4] CauseNo definitive cause of endometrial polyps is known, but they appear to be affected by hormone levels and grow in response to circulating estrogen.[2] Risk factors include obesity, high blood pressure and a history of cervical polyps.[2] Taking tamoxifen or hormone replacement therapy can also increase the risk of uterine polyps.[2][7] The use of an intrauterine system containing levonorgestrel in women taking tamoxifen may reduce the incidence of polyps.[8] DiagnosisEndometrial polyps can be detected by vaginal ultrasound (sonohysterography), hysteroscopy and dilation and curettage.[2] Detection by ultrasonography can be difficult, particularly when there is endometrial hyperplasia (excessive thickening of the endometrium).[1] Larger polyps may be missed by curettage.[9] Endometrial polyps can be solitary or occur with others.[10] They are round or oval and measure between a few millimeters and several centimeters in diameter.[6][10] They are usually the same red/brown color of the surrounding endometrium although large ones can appear to be a darker red.[6] The polyps consist of dense, fibrous tissue (stroma), blood vessels and glandlike spaces lined with endometrial epithelium.[6] If they are pedunculated, they are attached by a thin stalk (pedicle). If they are sessile, they are connected by a flat base to the uterine wall.[10] Pedunculated polyps are more common than sessile ones.[3] TreatmentPolyps can be surgically removed using curettage with or without hysteroscopy.[11] When curettage is performed without hysteroscopy, polyps may be missed. To reduce this risk, the uterus can be first explored using grasping forceps at the beginning of the curettage procedure.[6] Hysteroscopy involves visualising the endometrium (inner lining of the uterus) and polyp with a camera inserted through the cervix. If it is a large polyp, it can be cut into sections before each section is removed.[6] If cancerous cells are discovered, a hysterectomy (surgical removal of the uterus) may be performed.[2] A hysterectomy would usually not be considered if cancer has been ruled out.[6] Whichever method is used, polyps are usually treated under general anesthetic.[9] It is unclear if removing polyps affects fertility as it has not been studied.[12] PrognosisEndometrial polyps are usually benign although some may be precancerous or cancerous.[2] About 0.5% of endometrial polyps contain adenocarcinoma cells.[13] Polyps can increase the risk of miscarriage in women undergoing IVF treatment.[2] If they develop near the fallopian tubes, they may lead to difficulty in becoming pregnant.[2] Although treatments such as hysteroscopy usually cure the polyp concerned, recurrence of endometrial polyps is frequent.[6] Untreated, small polyps may regress on their own.[14] EpidemiologyEndometrial polyps usually occur in women in their 40s and 50s.[2] Endometrial polyps occur in up to 10% of women.[1] It is estimated that they are present in 25% of women with abnormal vaginal bleeding.[7] See also
References1. ^1 2 3 4 5 {{cite book |author=Jane A. Bates |title=Practical Gynaecological Ultrasound |publisher=Cambridge University Press |location=Cambridge, UK |year=1997 |pages= |isbn=1-900151-51-0 |oclc= |doi= |accessdate=}} 2. ^1 2 3 4 5 6 7 8 9 10 11 {{cite web | title =Uterine polyps | publisher =MayoClinic.com | date =2006-04-27 | url =http://www.mayoclinic.com/health/uterine-polyps/DS00699/DSECTION=1}} 3. ^1 2 {{cite book | last =Sternberg | first =Stephen S. |author2=Stacey E. Mills |author3=Darryl Carter | title =Sternberg's Diagnostic Surgical Pathology | publisher =Lippincott Williams & Wilkins | year =2004 | url =https://www.google.com/books?id=ko3Hew4xaj4C&d | isbn =0-7817-4051-7 | page =2460 }} 4. ^1 {{MerckManual|18|244|d||Dysmenorrhea: Menstrual abnormalities}} 5. ^{{cite web | title =Endometrial Polyp | publisher =GPnotebook | url =http://www.gpnotebook.co.uk/simplepage.cfm?ID=1214971910 | accessdate =2007-10-20 }} 6. ^1 2 3 4 5 6 7 {{cite book | last =DeCherney | first =Alan H. |author2=Lauren Nathan | title =Current Obstetric & Gynecologic Diagnosis & Treatment | publisher =McGraw-Hill Professional | year =2003 | url =https://books.google.com/books?id=9xD0inFiEIAC&pg=PA703 | isbn =0-8385-1401-4 | page =703 }} 7. ^1 {{cite book | last =Edmonds | first =D. Keith |author2=Sir John Dewhurst | title =Dewhurst's Textbook of Obstetrics and Gynaecology | publisher =Blackwell Publishing | year =2006 | url =https://www.google.com/books?id=450c5k81lEgC&d | isbn =1-4051-5667-8 | page =637 }} 8. ^{{cite journal |vauthors=Chan SS, Tam WH, Yeo W, etal |title=A randomised controlled trial of prophylactic levonorgestrel intrauterine system in tamoxifen-treated women |journal=BJOG |volume=114 |issue=12 |pages=1510–5 |year=2007 |pmid=17995495 |doi=10.1111/j.1471-0528.2007.01545.x |url=}} 9. ^1 {{cite web | last =Macnair | first =Trisha | title =Ask the doctor – Uterine polyps | publisher =BBC Health | url =http://www.bbc.co.uk/health/ask_the_doctor/uterinepolyp.shtml | accessdate = 2007-10-21 }} 10. ^1 2 {{cite book | last =Bajo Arenas | first =José M. |author2=Asim Kurjak | title =Donald School Textbook Of Transvaginal Sonography | publisher =Taylor & Francis | year =2005 | url =https://books.google.com/books?id=N_QMGLWEgzgC&pg=PA503 | isbn =1-84214-331-X | page =502 }} 11. ^{{cite web |title = Uterine bleeding – Signs and Symptoms |publisher = UCSF Medical Center |date = 2007-05-08 |url = http://www.ucsfhealth.org/adult/medical_services/womens_health/gynecology/conditions/ubleed/signs.html |accessdate = 2007-10-20 |deadurl = yes |archiveurl = https://web.archive.org/web/20080411022146/http://www.ucsfhealth.org/adult/medical_services/womens_health/gynecology/conditions/ubleed/signs.html |archivedate = 2008-04-11 |df = }} 12. ^{{cite journal|last1=Jayaprakasan|first1=K|last2=Polanski|first2=L|last3=Sahu|first3=B|last4=Thornton|first4=JG|last5=Raine-Fenning|first5=N|title=Surgical intervention versus expectant management for endometrial polyps in subfertile women.|journal=The Cochrane Database of Systematic Reviews|date=Aug 30, 2014|volume=8|pages=CD009592|pmid=25172985|doi=10.1002/14651858.CD009592.pub2|url=http://eprints.nottingham.ac.uk/31823/1/Jayaprakasan_et_al-2014-The_Cochrane_library.pdf}} 13. ^{{cite book | last =Rubin | first =Raphael |author2=David S Strayer | title =Rubin's Pathology: Clinicopathologic Foundations of Medicine | year =2007 | location =Lippincott Williams & Wilkins | url = https://books.google.com/books?id=kD9VZ267wDEC&pg=RA3-PA805 | isbn = 0-7817-9516-8 | page =806}} 14. ^{{cite web | last = Kaunitz | first = Andrew M. | title = Asymptomatic Endometrial Polyps: What Is the Likelihood of Cancer? | work = Medscape Ob/Gyn & Women's Health | publisher = | date = 2002-08-26 | url = http://www.medscape.com/viewarticle/440353 | accessdate =2008-04-20 }} External links{{Medical resources| DiseasesDB = | ICD10 = {{ICD10|N|84|0|n|80}} | ICD9 = {{ICD9|621}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = | eMedicineTopic = | MeshID = }}{{Diseases of the pelvis, genitals and breasts}} 1 : Noninflammatory disorders of female genital tract |
| 随便看 |
|
开放百科全书收录14589846条英语、德语、日语等多语种百科知识，基本涵盖了大多数领域的百科知识，是一部内容自由、开放的电子版国际百科全书。