CERVICAL POLYP IN THE MENOPAUSE AND THE NEED FOR FRACTIONAL DILATATION AND CURETTAGE

Objective: To investigate the need for fractional dilatation and curet tage following excision of symptomatic versus asymptomatic cervical po lyps. Study Design: A prospective study was carried out on 467 women w ho were referred for treatment of symptomatic (accompanied by vaginal bleeding or discharge) or asymptomatic cervical polyps, from January 1 , 1990 to December 31, 1992. Of these, 204 were premenopausal and 263 postmenopausal, Every excision of a cervical polyp was followed by a d ilatation and curettage. The histological data were evaluated statisti cally using the chi(2)-test. Results: Postmenopausal women had more as ymptomatic than symptomatic cervical polyps (P = 0.004). Cervical poly ps were associated with more endometrial polyps in the postmenopausal than in the premenopausal women (P = 0.0009). Postmenopausal women wit h symptomatic cervical polyps had more endometrial abnormalities on hi stological examination than those with asymptomatic ones (P < 0.0001); this difference was not significant in the premenopausal group (P = 0 .49). Conclusions. While neither symptomatic nor asymptomatic cervical polyps are an indication for dilatation and curettage (following exci sion) in women in their reproductive years, and do not affect their ma nagement or prognosis, this is not the case in postmenopausal women. S ymptomatic cervical polyps after the menopause must be excised and fol lowed by mandatory fractional dilatation and curettage, because there is a marked incidence of associated severe pathological conditions in this age group.