Cervical polyp
ICD-10 N84.1 · ICD-11 GA15.0

Symptomatic Endocervical Polyp with Persistent Intermenstrual Bleeding After Polypectomy

Clinical Scenario

This protocol covers a symptomatic endocervical polyp causing abnormal vaginal bleeding — specifically intermenstrual bleeding — in a patient with a normal Papanicolaou (Pap) test result and no postcoital bleeding, where prior surgical management has not resolved symptoms.

Previous Treatment & Why It Was Insufficient

The initial step was cervical polypectomy using the ring-forceps technique. The intended outcome — relief of intermenstrual vaginal bleeding and full resolution of symptoms — was not achieved. This protocol defines the escalation pathway following that failure.

Next-Step Approach

When polypectomy has not resolved intermenstrual bleeding, or when the case falls outside straightforward primary-care management, specialist input is indicated. The complete protocol specifies the referral pathway, decision criteria, and what the gynecologic consultation addresses — details available in the full structured regimen.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.46747/cfp.710126

An example of an appropriate patient for consideration of cervical polypectomy by a PCP is a patient with normal Pap test results, a symptomatic cervical polyp, and minimal intermenstrual bleeding.

If a cervical polyp is abnormally large, broad-based (ie, does not have a stalk that is easily grasped), or if the polyp does not easily twist off and the procedure is unsuccessful, a gynecologist should be consulted.

If histologic examination returns with abnormal results following cervical polypectomy performed by a PCP, referral to gynecology for further management is required.

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