Clinicopathological determinants of vaginal and premalignant-malignant cervico-vaginal polyps of the lower female genital tract.

OBJECTIVE

To establish pathology frequencies for polyps in the vagina and cervix and to identify determinants of vaginal polyps and premalignant-malignant cervico-vaginal polyps.

MATERIALS AND

METHODS

The pathology reports of all cervico-vaginal polyps examined for 6 years at a single institution were classified, and frequencies were calculated. In 2 separate case-control studies, clinical and pathological variables of vaginal cases were compared with cervical controls, and premalignant-malignant cases were compared with benign controls. Differences in variables that were abstracted from patients' chart and pathology reviews were tested for significance.

RESULTS

There were 4,402 polyps; 4,340 cervical (98.6%), 62 vaginal (1.4%), 4,268 benign (97.0%), 62 premalignant-malignant (1.4%) (CIN, endometrial hyperplasia, and carcinoma), and 72 unsatisfactory (1.6%). Age was a significant determinant of vaginal and premalignant-malignant polyps, and polyp size and number were significant determinants of vaginal polyps. Vaginal polyps were 3 times more frequent among women 40 years and younger and twice as frequent among those 60 years and older (p < .001). Premalignant-malignant polyps were twice as frequent among women 40 years and younger (p = .04), and malignant polyps were 6 times more frequent in those 60 years and older, which approached statistical significance (p = .09). Multiple polyps were 2 times more frequent (p = .04) and greater than 2 cm was 4 times (p = .01) more frequent among vaginal polyps.

CONCLUSIONS

Vaginal polyps and premalignant-malignant cervico-vaginal polyps are rare. Vaginal polyps are larger and multiple and cervico-vaginal polyps in younger and older women are at greater risk of premalignant-malignant changes.