Goubaa Mohamed MD Djerba Tunisia
multiparous woman is seen with pelvic pressure and painful intercourse.
Vaginal sonography detects an enlarged cervix with abnormal doppler
vascularisation and a 4-cm intravaginal mass.
de 45 ans, multipare, consulte pour une pesanteur pelvienne et des
rapports douloureux. L'échographie endovaginale montre un col un peu
élargie et une vascularisation anormale au Doppler et une masse intra-vaginale
de 4 centimètres.
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prolapses from the cervix.
sortant du col utérin
prolapse from the cervix
d'un polype à travers le col utérin
Endocervical polyps are the most common benign neoplasm of the cervix.
They are focal hyperplasic protrusions of the endocervical folds,
including the epithelium and substantia propria. They are most common
in the fourth to sixth decades of life and usually are asymptomatic
but may cause profuse leucorrhoea or post-coital spotting. Grossly,
they appear as typical polypoid structures protruding from the cervical
os. At times, endometrial polyps protrude through the cervical os
and are difficult to remove with endometrial curettage because they
tend to move away from the curette.
Polyps appear sonographically as hyperechoic endometrial foci. The
hyperechoic area can be a well-defined, or an ill-defined global
thickening of the endometrium. How-ever, endovaginal sonography
may miss focal endometrial polyps because the walls of the endometrial
cavity compress the polyps, making discrimination of a polyp from
a globally thickened endometrium difficult. For intrauterine contrast
to better visualize endometrial cavity lesions, clinicians began
using saline-infusion sonography, often called Sonohysterography.
Sonohysterography has become a valuable method for diagnosis of
endometrial polyps and other endometrial lesions.
Differential diagnosis of vaginal
Cystic vaginal masses :
* Gartner's duct Cysts (the most common cystic vaginal masses).
* Vaginal inclusion Cysts Mucinous cysts
* Urétral diverticule
Solid vaginal masses :
* Foreign body
* Leiomyoma of the
* Vaginal Neoplasms and Malignant vaginal masses (Carcinoma in situ.
, epidermoid carcinoma, Fibrosarcoma, Melanoma, Leiomyosarcoma,
Sarcoma botyroides, Metastatic carcinoma).
Treatment is removal, which can usually be accomplished by twisting
the polyp with a dressing forceps if the pedicle is slender. Smaller
polyps may be removed with punch biopsy forceps. Polyps with a
thick stalk may require surgical removal.