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Atlas of visual inspection of the cervix with acetic acid for screening, triage, and assessment for treatment

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VIA procedure Ė Examination before application of acetic acid Ė Abnormal findings on speculum examination Ė Cervical polyp


Cervical mucous polyps are overgrowths of the endocervical columnar epithelium and appear as single or multiple smooth reddish or pinkish soft masses protruding through the external os.

The presence of multiple polyps or large polyps at the external os often interferes with proper visualization of the SCJ and the TZ. Because most polyps are mobile, they can be gently pushed in different directions with the help of a small cotton swab in an attempt to visualize the SCJ in its entirety.

If the polyps are very large, it may not be possible to visualize the SCJ completely even after adequate manipulation.

Most mucous polyps remain small, do not cause any symptoms, and regress after menopause. Some larger polyps may cause symptoms, such as vaginal discharge or postcoital bleeding. Such polyps that are pedunculated can be easily removed by holding the polyp with a sponge-holding forceps and twisting the polyp at the base repeatedly until the polyp comes out. No anaesthesia is required, and the small amount of bleeding from the attachment of the polyp can be easily stopped with gentle pressure.

Sometimes a polyp may not be mobile, because of the presence of a thick and short stalk, and is firm in consistency. Such a polyp, which is usually due to a benign tumour originating from the muscle and fibres of the cervix or even the body of the uterus, is known as a fibroid polyp. A fibroid polyp may be located inside the endocervical canal and bulge through the external os. In such a situation, it may become difficult to see the SCJ or even the cervix. Such polyps require surgical excision.

A polyp with necrosis may sometimes be misdiagnosed as a cancer.

The next section describes a condition called leukoplakia.


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