The FP diagnosed an endocervical polyp with atrophic changes to the mucosa of the vulva and cervix.
Endocervical polyps are the most common benign neoplasms of the uterine cervix in women in their 40s to 60s. They are found incidentally during pelvic exams and are usually asymptomatic, but may cause vaginal discharge or postcoital spotting.
Treatment for cervical polyps involves removing them by twisting them with ringed forceps. Smaller polyps may be removed with colposcopy biopsy forceps. Polyps with a thick stalk may require surgical or electrosurgical removal. If polyps are removed after a recently abnormal Pap smear, they should be sent for analysis as dysplasia may be found.
In this case, the patient’s endocervical polyp was removed with ring forceps. There were no complications and minimal bleeding. She declined the short course of topical estrogen cream for the atrophic changes but agreed to follow up if any additional vaginal bleeding occurred. Abstinence from sexual intercourse was recommended for 2 weeks so that the cervix could heal.
Photo courtesy of EJ Mayeaux, MD. Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Mayeaux EJ. Colposcopy–normal and noncancerous findings. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:525-529.
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