Cervical Erosion: Causes and Symptoms
Cervical erosion is a pathological condition of a viral or bacterial origin, in which there is a defect in the mucus, namely, the epithelial cover of the cervix.It is true only in 5-10% of women, in all other cases - it is pseudo-erosion or ectopia, but for convenience, doctors use the same term "erosion".
True erosion or pseudo-erosion( ectopia)?
True erosion is considered when it is an ulcer on the neck, which is found during a gynecological examination in a typical place - around its outer throat - and has a bright red color.The epithelium in this place is multilayered and when it is sloughing or rejection( more often as a result of mechanical damage) ulceration is formed and the mechanism of the inflammatory process is triggered.This condition lasts no longer than 2 weeks and is well treatable.
In the case of pseudo-erosion of the cervix, a more complex pathological process is triggered.The ulcer occurs at the junction of two types of epithelium - a flat multilayered and cylindrical.The first lining the vaginal part of the cervix, and the second is located in the cervical canal.Very often, namely - in 90% of cases, the zone where these two layers meet is shifted toward the neck.Microorganisms that create the microflora of the vagina, and the typical acidic environment, negatively affect the cylindrical cells, which provokes the development of local inflammation.At the same time this layer has no protective properties, therefore it is not an obstacle for pathogenic viruses and bacteria that penetrate the cervical canal, and then directly into the uterine cavity.
Cervical erosion: causes and mechanism of development
The most common cause of erosion of the cervix is the banal infection( intracellular parasites, bacteria, viruses) of the genital organs, and the trigger mechanism is the formation of microtraumas on the cervical mucosa( abortion, childbirth, inflammatoryprocess).Inflammation is always accompanied by excreta, if it is not treated, then the erosive surface does not heal for a long time, and its area increases.With mechanical action, it begins to bleed and easily re-inflames.The true erosion disappears on its own in 1-2 weeks, or goes into ectopia.
Today, there are a lot of causes and provoking factors that can cause erosion.
Among the most significant:
- insufficient intimate hygiene;
- problems with immunity;
- early first pregnancy;
- Colpitis;
- hormonal imbalance;
- endometritis;
- pathology of the genitourinary system;
- papillomavirus;
- Trichomoniasis;
- early sexual life;
- Chlamydia;
- gonorrhea;
- endocervicitis;
- early first delivery;
- genital herpes;
- candidiasis;
- chronic cervicitis;
- frequent sexual partners;
- Other sexually transmitted diseases.
The causes of true erosion are mechanical injuries, which lead to :
- heavy delivery;
- inaccurate introduction of hygienic tampons;
- traumatic abortion;
- wrong syringing;
- mechanical damage to the cervix;
- intrauterine manipulation;
- application of certain types of spermicides;
- neck ruptures after delivery;
- traumatic sexual intercourse;
- improper use of intravaginal contraceptives;
- congenital erosion as a result of heredity( the cylindrical epithelium in newborn girls is located outside the cervix, with age it is removed into the cervical canal, if this process slows down, a congenital defect of the mucosa can form).
Cervical erosion: symptoms of
Unfortunately, very often this disease has an asymptomatic course and generally does not make itself felt.That is why it is usually diagnosed during a regular medical examination.In other cases, the clinical picture is accompanied by typical symptoms of pathologies that are transmitted sexually.
In particular, erosion of the cervix can have the following symptoms:
- infertility;
- difficulty with urination;
- bloody or watery discharge from the vagina, which appear on their own or immediately after intercourse;
- violation of the monthly cycle;
- the presence of genital warts in the genital area;
- pain during intercourse.
During the gynecological examination, the specialist will notice the cervix, which has a red color, signs of inflammation and a granular surface.
The inflammatory process is connected because the cylindrical epithelium, which is not in a typical place, is quickly populated with bacteria and viruses.Thus, erosion of the cervix becomes the focus of chronic infection in the vagina, from where it spreads ascending( neck - body of the uterus - tubes - ovaries).
Important: When erosion for a long time exists on the mucosa, and the treatment does not yield results or is not performed at all, the cells of this site acquire the ability to atypical division, growth and irreversible change.This means that untreated erosion at times increases the risk of a woman getting cancer of the cervix.That is why it is very important to take regular preventive examinations every 6 months.
Cervical erosion is classified as a background process, on the basis of which complications occur more often and other pathologies develop.
The presence of a confirmed human papillomavirus virus is particularly distinguished.It is associated with an increased risk of malignant degeneration of erosion.
Cervical Erosion: Diagnosis
Given that there are often no symptoms at erosion of the cervix, it is important to visit a female doctor regularly.Already in the presence of complaints( bloody discharge, painful sexual intercourse), in addition to routine examination, a number of additional diagnostic tests are carried out.
Gynecological examination
It includes visual inspection of the vaginal walls and evaluation of the cervix.In this type of diagnosis, special gynecological mirrors are used.During the examination, the doctor will notice the modified site on the cervix.It is easy to distinguish by a brighter color and a typical granular surface.
Colposcopy
This is a procedure in which an on-site examination of the vagina and cervix is performed using an optical device.You do not need to prepare for it, and it is absolutely painless.This type of diagnosis is resorted to when erosion is small and it is required to consider it more carefully.Colposcopy also makes it possible to distinguish ectopia and true erosion.In parallel with this procedure, a biopsy can be performed, which will help to obtain a histological picture of the erosion itself( performed when there is a suspicion of a cancer process).
Analyzes
A number of specific studies help a gynecologist assess the stage of pathological changes in the cervix, identify the pathogen, choose an effective treatment.Some tests, or rather strokes, are taken from the patient during the examination, others assume the taking of blood for examination.
In this case, when diagnosing erosion of the cervix, the following are shown:
- smear from the vagina to assess the state of microflora;
- smear for purity - provides for the detection of sexual infections, if any, as well as the detection of the level of female hormones;
- smear on hidden infections - helps the doctor diagnose those infections that are not detected by a smear on the flora;
- analyzes for a number of urogenital infections( trichomoniasis, mycoplasmosis, chlamydia, herpes, papillomovirus, gardnerellez);
- blood test for syphilis, HIV, hepatitis;
- scraping from the cervix for a cytological study - makes it possible to determine the presence of changes at the cellular level - to clinical and visually noticeable changes.
Note: The study of the cervix on cytology must necessarily be performed by all women of childbearing age, as well as those who live an active sex life, regardless of age.
Cervical erosion in pregnancy: is there any danger?
Experts argue that erosion of the cervix during pregnancy does not carry a danger to the fetus developing in the womb.The main condition in this case is the absence of infections of the genital tract and pathological changes in the smears.
It should be borne in mind that cervical erosion is still a real reflection of the presence of a pathological process in the body( reduced immunity, hormonal imbalance, etc.).That is why it should be treated before pregnancy to save the future child from the possible risk of intrauterine infection.
In the case where erosion was first diagnosed already during pregnancy, it is important to conduct a full diagnosis.
Important: Treatment of erosion during pregnancy is not carried out, exceptions are only cases of its degeneration into a malignant form.In the presence of erosion, after giving birth in 2 months, it is absolutely necessary to visit a gynecologist in order to resolve the issue of treatment.
Cervical erosion: treatment of
To date, there are many methods that are used in the therapy of this pathology.The doctor chooses the treatment always individually, taking into account the peculiarities of the erosion in each individual patient.
The following treatment methods are applied :
- Cryodestruction is the freezing of erosive mucosa by exposing it to liquid nitrogen.
- Multiple wave surgery.With it, erosion is removed by radio waves, which act as a scalpel.
- Medication therapy.E is carried out in order to eliminate the inflammatory process.
- Laser coagulation.
- Chemical coagulants.With their help eliminate pseudo-erosion, applying the drug in the form of applications on the neck.
- Diathermocoagulation is an effective cauterization of the place of the pathological process on the neck with an electric current.
Video:
Viktorova Julia, obstetrician-gynecologist
