Cervical Polyps

 

This guideline applies to adults aged 18 years and over.

 

Introduction

• Almost all cervical polyps are benign, but removal of symptomatic polyps is recommended.  Asymptomatic polyps may be left, but large (>1cm) are usually removed
   
• This can be done in the GP surgery (see method below) or women can be referred to the General Gynaecology Clinic.

 

In scope   

• Cervical polyps

 

Not in scope    

• Heavy Menstrual Bleeding
  
  
• Irregular Bleeding and Intermenstrual Bleeding
  
  
• PMB
  
  
• USB on HRT
  
  
• PCB

 

  Red Flag Features

• Abnormal or suspicious looking cervix

 

Investigations required prior to referral

If an endometrial polyp is suspected, an ultrasound pelvis is needed.

 

Management optimisation

For asymptomatic polyps: offer the woman a choice of removal.  If the polyp is symptomatic or large (>1cm) removal is recommended.

 

Method for removal of cervical polyps:

• Speculum examination of cervix with good light
• Visualise polyp and grasp the base with polyp forceps
• Close the forceps and twist through 360 degrees many times whilst gently retracting hand until the polyp is twisted off its base
• Cauterize the base with silver nitrate sticks (may need to use 2-3 if vascular)
• Send polyp for histological evaluation – if endometrial in origin, will need a transvaginal scan and referral for further investigation of endometrium to ensure complete removal.

 

Advise the patient that she may experience light bleeding and mild period cramps for up to 24hrs after removal. She may also get some grey/brown coloured discharge for a couple of days.

 

Advice and Guidance

Please send advice and guidance via eRS

 

Referral instructions

Red flags: 

If appearance of cervix is suspicious for cervical cancer, send a fast track suspected gynaecological cancer referral

 

Routine referral criteria

• The polyp is greater than 1cm wide or symptomatic polyp and unable to remove in GP
• Confirmed endometrial polyp (on TVUSS)
• Base of the polyp is not visible (suspected prolapsed endometrial polyp).

 

Information to consider for referral

• TV USS if suspected endometrial polyp
• Any current hormonal treatment
• Smear history (including last smear result)
• Relevant past medical/surgical history
• Current regular medication and allergies.

 

Supporting Information

For professionals

• Cervical Polyps - StatPearls - NCBI Bookshelf

 

For patients

• Cervical Polyps — Chelsea and Westminster Hospital NHS Foundation Trust

 

Page Review Information

Review date	05 December 2025
Next review date	05 December 2027
Clinical editor	Dr Melanie Schick
Contributors	Ms Lisa Verity Consultant Obstetrics and Gynaecology, Royal Cornwall Hospitals NHS Trust