Endocervicosis of the cervix

Endocervicosis of the cervix is a violation of the normal location of the epithelium of the cervical canal, in which it partially shifts beyond the boundaries of its normal location. Uncomplicated endocervicosis of the cervix does not belong to gynecological diseases, it can be considered a physiological condition, not associated with pathological causes. It is formed both in perfectly healthy women( 39%) and in patients with gynecological pathology( 50%).The largest number of endocervical cervical uteri diagnosed in nulliparous patients who did not overcome the 25-year-old barrier, including in girls of the early reproductive period.

Congenital endocervical cervical cancer is associated with imperfections in the hormonal function of the ovaries, and the acquired forms of endocervicosis have many causes of external or internal nature. Conditionally they can be divided into posttraumatic and dyshormonal.

The cervix, contrary to the erroneous opinion of some patients, is not an independent organ. It represents the lower, considerably narrowed segment of the uterus, and resembles a hollow tube. Inside the neck there is a narrow spindle-shaped lumen - the cervical canal, or the cervical canal, which connects the vaginal and uterine cavities. Before each of them the cervical canal forms physiological constrictions( throats), which act as a barrier. The external sill is located in a place where the cervical canal opens into the vaginal cavity, and the inner cervical canal opens into the neck and the uterus.

Part of the cervix, located in the vagina, like the vagina itself, is covered with an identical mucous layer. It is formed by several layers of cells of flat epithelium( multilayered flat epithelium).The cavity of the cervical canal lays one layer of epithelial cells of cylindrical shape( cylindrical epithelium).The site of the fusion of the two kinds of epithelium is located outside the( above) outer throat and is called the "transformation zone".Normally, it can not be seen when viewed.

In endocervical cases, the epithelium of the cervical canal is displaced to the vaginal part of the cervix, around the outer throat. When the cylindrical epithelium from the cervical canal begins to "crawl" to the surface of the cervix, it carries along and the transformation zone, which becomes visible during examination.

Uncomplicated, formed on the unchanged surface of the cervix, endocervicoses do not bother a woman. Symptoms of complicated endocervical cervix, in fact, coincide with the signs of the disease that accompanies it.

Diagnosis of endocervical cervix, as a rule, does not cause difficulties. It is clearly visualized during the initial examination "in the mirrors" in the form of an unusual, different from the surrounding mucosa, a site more often located around the external throat. To clarify the diagnosis, colposcopy and cytological examination of the cellular composition of the "suspicious" site help.

Small-size endocervicosis without complications does not require special medical measures, it is enough to observe annually. Sometimes endocervicosis disappears on its own together with the cause that caused it. For example, when endocervical cervical cancer is provoked by hormonal dysfunction, it is often self-exterminated after the normal functioning of the ovaries.

Complicated endocervical cervical cancer never fails without proper treatment.

There are a lot of methods for treating endocervicosis, the choice of the necessary therapeutic scheme depends on the type of endocervicosis, its cause and the presence of complications. Correctly selected treatment eliminates this disease completely.

Causes of endocervicosis of the cervix

Mechanisms that trigger the formation of endocervicosis have not been studied conclusively, so it is customary to talk about factors that provoke unusual structural relationships in the epithelium lining the cervical canal and the cervical surface.

Endocervicosis of the cervix of an innate origin, apparently, is associated with an incorrect differentiation of the epithelium into a flat and cylindrical one. From the moment of birth, until the onset of the period of puberty, the displacement of the cylindrical epithelium beyond the outer throat is attributed to the physiological period of "growing" of the cervix. When the amount of estrogen in a girl begins to match that of a woman of reproductive age, the boundary of the cylindrical and flat epithelium "rises" to the proper place. Therefore, congenital endocervical cervical cancer refers to a temporary physiological phenomenon, does not require additional medical measures, and is also fairly considered a safe phenomenon.

Congenital endocervicosis is not always eradicated on time and may be present on the surface of the cervix in adolescents and adult women with hormonal dysfunction due to the relative deficiency of estrogens.

The appearance of endocervical cervical uteri on the background of pregnancy is also a physiological condition associated with a normal restructuring of the ovaries and a change in the ratio of hormones in the body.

Acquired endocervicosis is formed on the unchanged mucous cervix of the uterus under the influence of a large number of provocative causes. They can be divided into external( or exogenous) and internal( endogenous).

Exogenous causes of acquired cervical endocervicosis:

- Infectious-inflammatory( including viral) causes. They are provoked by early sexual intercourse, a large number of partners, the presence of inflammation in the genitals.

- Traumatic causes. These include mechanical damage to the normal mucous cervix in the process of abortion, childbirth, instrumental manipulation in the neck and its canal.

Regardless of the nature of the causes of the acquired endocervical cervix, it often has a single mechanism of development. Initially, under the influence of a provoking factor on the mucosa surrounding the outer yawn, a defect of multilayer epithelium arises - true erosion. In fact, it is a small wound surface that exists no longer than two weeks, and then begins to heal. The process of restoring the integrity of the epithelial cover in the erosion zone can occur in two ways. In the case of physiological healing, the eroded surface is closed from the reserve of reserve cells of multilayer epithelium, and the cervix becomes normal. Sometimes this process occurs with the participation of the cylindrical epithelium of the cervical canal, it "crawls" into the damaged area of ​​the mucosa and closes it, then a site of an atypically located cylindrical epithelium, endocervical cervix, appears on the site of the former erosion.

Symptoms of endocervical cervix

The diagnosis of endocervical cervical cancer can not be performed without direct examination of the neck surface due to the frequent absence of active complaints in patients.

Even if endocervical infection is present simultaneously with inflammation, the pathological symptoms will correspond only to the existing form of this inflammation. Therefore, the greatest number of cases of cervical endocervical disease is diagnosed on preventive examinations or is detected by accident.

During the examination, endocervical cervix looks like located near the external throat( around or nearby) a section of mucous red with a velvety surface of different shapes and sizes. In the presence of inflammation in the cervical canal and / or in the vagina is a cloudy yellowish cervical mucus, which serves as a source of leucorrhoea in endocervicosis.

On examination, inflamed, friable, the surface of the endocervical cervix may be slightly bleeding, which explains the presence of complaints of minor contact bleeding.

A valuable diagnostic method for studying changes in the cervix is ​​colposcopy. Under a large increase, the surface of the cervix and the area of ​​the external throat are examined.

The picture of endocervicosis, which the colposcopist sees, is not always the same. Therefore it is accepted to allocate:

- Ferrotic endocervicosis. It is characterized by the presence of well-developed glands.

- Papillary endocervicosis. The stroma of the epithelium grows in the form of towering papillae.

- Epidermisable endocervicosis. Formed in the case when on its surface among the cylindrical cells there are sections of multilayered epithelium.

Ironous endocervicosis often accompanies whitecaps, and epidermisable endocervicosis sometimes indicates the onset of mucosal healing.

There are also simple and proliferating endocervicosis( progressive endocervicosis) of the cervix. Proliferating endocervicosis characterizes newly formed glands and cell proliferation.

This isolation of forms of endocervicosis does not matter for the patient. In the conclusions of the colposcopists, a variety of terms may be indicated, which in terms of content mean the same, but incomprehensible to patients. So, for example, proliferating and progressing endocervicosis means one process.

The diagnosis of endocervical cervix is ​​considered final only after the conclusion of a cytological examination of the cellular composition of a modified area of ​​the cervical surface.

Diagnosis of endocervicosis against inflammation is complemented by laboratory tests to identify the cause of infection.

Chronic endocervicosis of the cervix

Complicated endocervicosis in the absence of timely adequate treatment can be on the mucous membrane of the cervix for many months or even years.

Complaints of patients with chronic endocervicosis coincide with those in infectious inflammation of the external genitalia, namely:

- Pathologic discharge( whites) of serous or serous-purulent form, sometimes accompanied by a non-pleasant odor.

- Appearance of blood after intimacy, syringing, or contact with instruments during examination( contact bleeding).

- Feeling of burning, itching in the external genital area.

During the examination in the vagina, inflammatory changes are visualized: edema, hyperemia( reddening) of the mucosa, leucorrhoea. On the cervix of the uterus are also visible signs of inflammation, and the endocervical zone is covered with serous or serous-purulent coating. If infectious inflammation in the vagina exists for a long time, and the cervical canal is involved in the pathological process, signs of endocervicitis are revealed during examination.

Chronic endocervicosis implies additional diagnostic measures. The conducted laboratory research( smears "on the flora", bakposev, PCR method) is designed to identify the cause of inflammation.

Before starting the treatment of chronic endocervicosis, preliminary adequate anti-inflammatory therapy is performed.

Treatment of endocervical cervix

80% of all endocervical infections are complicated, they all require treatment. The success of therapy is largely determined by the correctness of the treatment of concomitant disease. Before the elimination of the focus of endocervicosis of the cervix, it is necessary to eliminate the infection, restore the correct hormonal and immune background, lead to normal vaginal microbiocenosis.

Often, especially in young girls without a serious gynecological pathology, after a preliminary anti-inflammatory treatment, the zone of endocervicosis decreases.

There are many ways to eliminate endocervicosis. The choice is made by the doctor, having studied all the survey data and taking into account the possibilities of the hospital.

Most commonly used:

- Diathermocoagulation. The most "old" traditional method, based on "moxibustion" of the mucosa in the field of endocervicosis with the help of electrodes.

- Cryodestruction of the cervix. With the use of nitrous oxide, the neck "freezes."

- Laser destruction. A costly method that allows you to "evaporate" undesirable cells of the mucosa with the participation of a laser.

This list does not contain all treatment methods. Many modern clinics use advanced alternative medical methods, which are not yet used universally.

All existing methods have one goal - to eliminate the "improperly" the expanded cells of the cylindrical epithelium so that a normal mucosal layer, typical for the cervix, appears on the released site.