Cervical Erosion Causes

Cervical erosion of the cause of is a list of mechanisms that provoke the formation of local wound damage on the cervix. In fact, true erosion is an open wound( shallow ulcer), a site without a superficial epithelium with a naked underlying layer, glands and vessels. The reasons for its development are diverse and are still being studied.

The cervix has the appearance of a hollow tube, and the inside of the cervical canal communicates the vaginal and uterine cavities. Two physiological narrowing of the cervical canal, called "yawns," are at the base of the uterine and vaginal end. Outer sores are visible at the base of the cervix during normal examination.

Inside the cervical canal is lined with epithelial cells of cylindrical shape. The surface of the cervix, like the vagina, is covered with a flat epithelium, arranged in several rows. The upper row of flat cells is constantly updated, thus protecting the sexual path from unwanted infections and inflammation. Inside the external pharynx, the "transformation zone" is located on the border separating the epithelium of the cervix from the mucous membrane of the cervical canal. Due to the deep arrangement, it is impossible to see it without proper equipment.

Under the influence of traumatic factors, sometimes a wound( ulcer) is formed on the neck surface - true erosion of the cervix. The reasons for the formation of cervical erosion are ambiguous, sometimes they depend even on the way of life. However, the external characteristics and cellular structure of all erosions are identical: they are formed only with the participation of normal cells present on the neck or in its channel.

Damage of any origin on the surface of the mucous neck, like the wounds of another localization, is epithelized by the growth of surrounding elements, that is, from the reserve cells of multilayered planar epithelium. The healing process of the damaged mucosa occurs irrespective of the cause of erosion of the cervix, epithelization usually does not take more than two weeks, and in the absence of complications passes asymptomatically. True erosion due to a brief existence and asymptomatic course is observed by doctors infrequently( 2%).

Sometimes the eroded surface on the neck heals incorrectly: the cylindrical epithelium, lining the cervical canal from inside, creeps into the damaged surface and closes it. An open wound is eliminated, but on the surface of the neck there is a visible defect - a mucosa, formed by "irregular" cells, called false erosion( ectopia).Virtually all diagnosed erosions are ectopic cylindrical epithelium. They are formed in children and nulliparous girls, accompany every fifth gynecological disease, and are diagnosed in half of the patients who have experienced childbirth.

Thus, there are two consecutive stages of a single process: damage to the cervical epithelium( true erosion) and incorrect restoration of its integrity( ectopia).Therefore, the oral use of the term "erosion" in all cases is fully justified.

An exception is congenital erosion of the cervix. The causes of erosion on the neck in utero are nontraumatic, it is always a false erosion, and not an open ulcer.

Perhaps, it is hardly possible to find an adult woman who does not know about the gynecological pathology, called erosion of the cervix. However, patients should remember that a primary conclusion with the phrase "erosion of the cervix" may well be true, false( ectopia) or congenital erosion. Details of the pathological process on the cervical mucosa are carried out during additional diagnostic measures.

Causes of erosion of the cervix

According to the reasons for the appearance of cervical erosion is classified:

- Traumatic erosion of the cervix. The causes of wound surface formation on the neck: abortion, severe traumatic birth, instrumental surgical manipulation. In elderly patients with genital dislocation, an ulcer on the cervix causes mechanical damage to the mucous membrane when using a pessary placenta( ring).

Infection on the cervix can occur if there is inflammation in the vagina( colpitis, vaginitis) and the cervical canal( endocervicitis, cervicitis).

- Specific erosion of the cervix, the causes of which can be far from the genitals. Diagnosed very rarely in patients with tuberculosis or syphilis.

Sex infections can also cause damage to the cervix. As a rule, they are identified and eliminated quickly enough, and the cervix does not have time to damage. Erosion on the background of sexual infections can appear only if they have a long negative effect on the epithelium of the cervix.

- Inflammatory erosion of the cervix, the causes of which are always infectious. Some infections are so aggressive that they can cause the development of local inflammation on the neck, followed by necrosis and rejection of the pathological infected area. Inflammatory erosions are always accompanied by signs of an infectious lesion: edema, hyperemia, purulent plaque and insignificant bloody discharge from damaged vessels.

- Burning erosion. Diagnosed as a result of therapeutic measures. To eliminate false erosion of the cervix, several methods are used that have the same goal - the destruction of the altered focus and the subsequent restoration of the proper mucous layer over the surface of the former erosion. More often they resort to electrocoagulation( "cauterization"), cryodestruction( "freezing"), chemical treatment or laser treatment. Regardless of the technique of exposure, further events have a single scenario: the surface layer of the "wrong" cells dies, forming a scab( crust) that covers the underlying mucus layer. Restoration processes begin under the scab, and, as the mucosa grows, the crust is gradually discarded. If epithelization does not occur correctly, the scab falls off prematurely, leaving behind an uncovered ulcer( true erosion).

- Trophic erosion of the cervix, the causes of which lie in the disturbances in the process of normal nutrition and blood circulation of tissues. It is often diagnosed during menopause in hypoestrogenic conditions and atrophic processes in the mucous membranes of the genitals.

- Physiological erosion. For obscure reasons, it appears in healthy women before the age of 25, and then completely disappears without external intervention.

The state of the mechanisms of immune defense significantly affect the course and outcome of erosion therapy.

Causes of cervical erosion in nulliparous

Existing among the patients opinion that erosions appear on the cervix only in adult women after childbirth is absolutely wrong. In young girls, adolescents and nulliparous young women, erosion of the cervix also occurs. The causes of the formation of erosion on the "nulliparous" neck can be conditionally divided into:

- Congenital. Congenital erosion of the cervix is ​​essentially a physiological ectopy of the cylindrical epithelium. During the intrauterine period, the formation of the integumentary epithelium of the cervix and the cervical canal takes place, and the presence of a zone of cylindrical cells outside the outer throat is considered the norm. Gradually, as the "inclusion" in the process of development of estrogens, the transition zone between the cylindrical and flat epithelium rises up beyond the outer throat, so it becomes invisible during visual inspection. As a rule, when the time of puberty ends, the congenital false erosion of the cervix disappears. The reasons why it continues to exist on the neck, often have a hormonal nature.

Congenital ectopy is diagnosed during the first visit to a gynecologist after the onset of sexual activity. More often, its presence is accompanied by signs of hormonal dysfunction. Congenital pseudo-erosion is not considered a disease. They are considered a temporary physiological condition of the mucous membrane of the cervix and are not treated.

- Purchased. A large group of causes of erosion, including internal and external provoking factors. Among the internal causes are chronic infectious( including non-gynecological) diseases, decreased immune defenses, hormonal dysfunctions.

Early sexual debut( under 18), sexual infections, promiscuous intimate life, mechanical damage to the cervix during abortion are external causes of cervical erosion.

- Physiological. Sometimes in healthy, not overcoming the 25-year-old line of girls on the cervix, false erosion of the cervix is ​​visualized, the causes of which can not be established. If such ectopia passes independently without interference from outside, it is correlated with the physiological process.

Regardless of the origin, complicated true and false erosions are treated. Unpleasant ability of erosions is their recurrence. Causes of repeated erosion of the cervix are associated with an incorrectly performed procedure for its elimination, when the neck remains a portion of the cylindrical epithelium. Also, a relapse of erosion can occur because of the incompletely cured background infection process.

Some patients believe that there are psychological causes of cervical erosion. True erosion is a short-term ulcer on the cervix, and false erosion refers to its effects. Their causes are of an organic or hormonal nature, and the authentic participation of psychoemotional disorders in their formation is not established, therefore the opinion that there are psychological causes of erosion of the cervix is ​​incorrect.

Causes of cervical erosion after childbirth

Postpartum true erosions of the cervix are always of traumatic origin. In the process of progressive fetal movement through the birth canal, the cervix of the uterus, due to the presence of elastic and muscle fibers, significantly stretches. If the birth process is incorrect, small injuries or even tears appear on the neck.

Despite the fact that all the birth injuries of the cervix are carefully sutured, they are more often the source of post-natal erosion. Three or four days after birth, a wounded surface with signs of acute inflammation forms on the cervix in the area of ​​damage. With a visual examination, postpartum erosion is a small rounded ulcer of bright red color with marked edema at the edges, covered with a dense purulent coating. At the bottom of the ulcer, the damaged blood vessels are located, so when touching, the erosion bleeds a little.

In conditions of well-functioning mechanisms of local immune defense, on the fifth day after the appearance of the bottom of erosion, it begins to self-clean from necrotic elements, and when the entire damaged surface becomes "clean"( that is, turns into a normal wound), the healing processes are started.

Postnatal true erosion is diagnosed in the postpartum department. To prevent the possibility of secondary infection of the wound surface and to "help" the cervix to cope with the trauma, the erosion area is cleaned of necrotic elements, using wipes impregnated with disinfectant solutions. When the wound is completely cleansed, proceed to ointment antibacterial applications. Completely epithelization of the eroded surface ends on the 12th day.

When patients who know that they have post-partum erosion come to the first routine examination and hear that there is "erosion" on the neck, they are very surprised and ask what causes the repeated erosion of the cervix. In fact, in this situation, the epithelization of true postpartum erosion occurred incorrectly: instead of the proper multilayer epithelium, it "closed" the cylindrical epithelium of the cervical canal, and an ectopia was formed.

Principles of treatment of pseudo-erosion formed after delivery are similar to those of all other patients.