Erosion of the cervix uteri - Defective, damaged cervical epithelium flat on her vaginal parts around the external os. Most often it occurs as a result of endocervicitis and other inflammatory diseases of the sexual sphere, hormonal imbalance in the female body. The course may be asymptomatic or manifest abnormal secretions mucopurulent, sometimes bloody nature, drawing pains in the sacrum. It is a risk factor of cervical tumors (polyps, cancer). The main methods of diagnosis of cervical erosion are the inspection of the cervix in the mirrors and colposcopy. The treatment can be applied diathermocoagulation methods lazerovaporizatsii and cryoablation, and radio-wave method
Erosion of the cervix uteri
Causes of cervical erosion may be different. Changes in cervical mucus can develop after birth, abortions, due to inflammatory diseases of the cervix, hormonal disorders. Often, the cause of cervical erosion are sexual infections - chlamydia, bacterial vaginosis, ureaplasmosis, trichomoniasis, etc., agents which, penetrating into the damaged mucosa, causing inflammation in it Cervical erosion may occur in adolescence and in nulliparous women.
Endocervicitis. True erosion is usually bright red in color, irregularly rounded, easy bleeding on contact. When colposcopy examination and microscopy eroded surface of dilated blood vessels visible, swelling, infiltration, traces of fibrin, blood, mucous-purulent discharge. After 1-2 weeks a true erosion becomes the healing stage - pseudo.
During the healing process are replaced by squamous epithelium defect cylindrical, extending to erosive surface of the cervical canal. columnar epithelial cells have a more vivid color in comparison with the cells of stratified squamous epithelium, and erosive surface is bright red in color.
Stage replacement of flat epithelial cylindrical cells - is the first stage of true healing of cervical erosion. Usually at this stage of cervical erosion is diagnosed by a gynecologist.
Growth of columnar epithelium occurs not only on the surface erosion, but also the depth to form ferrous branching moves. The erosion gland secretes and accumulates secret with difficulty outflow which cysts form - from the smallest - to the apparent by visual inspection and colposcopy. Sometimes large cysts located near the external os, resemble cervical polyp. Multiple cysts lead to thickening - hypertrophy of the cervix.
There are pseudo:
Pseudo without treatment may persist for several months or years until the elimination of the causes of its development and existence. Pseudo itself is a source of inflammation in the cervix due to infection in the presence of erosion glands.
When calming inflammation independently or as a result of the treatment there is a reverse replacement process columnar epithelium flat, ie the restoration of normal cervical epithelium cover - The second stage of erosion healing. In place of the healed erosion often remain small cysts (Nabothian cyst), resulting from blockage of ducts erosion glands.
Long duration and pseudo concomitant inflammatory process may lead to pathological changes of skin cells - atypia and dysplasia. Cervical erosion with the presence of epithelial dysplasia considered as a precancerous condition.
Pseudo may be small in size (from 3do 5 mm) or capture a significant portion of the vaginal cervical segment. The preferential localization - around external os or trailing edge (lip) of the cervix. Pseudo represent a modified portion of the mucous membrane of irregular shape, with a bright red color, velvety or rough surface, covered with mucus or pus-like discharge. Along the edges of pseudo-healing squamous epithelium seen lots of pale pink and Nabothian cyst.
Pseudo, particularly papillary, bleed easily during sexual intercourse and instrumental studies. Also, increased bleeding seen with dysplasia and pseudo-pregnancy. Healing pseudo considered complete if there is rejection of erosion glands and columnar epithelium and restoration of squamous epithelium across the surface of the defect.
Congenital cervical erosionuterus.
congenital cervical erosion formation occurs as a result of displacement of the boundaries of the columnar epithelium lining the cervical canal beyond. Offset (ectopia) epithelium occurs in utero development of the fetus, so these are considered congenital erosion.
Congenital cervical erosion usually takes a small portion along the line the external os, has a bright red color, smooth surface. An objective study (in the mirrors or colposcopy) abnormal secretion of the cervical canal, and no symptoms of inflammation.
Congenital cervical erosion detected in childhood and adolescence is often cured on their own. When saving to the inherent erosion of mature period, it is possible to infection, inflammation, and subsequent amendments. Occasionally on the background of congenital cervical erosion develop flat warts, malignancy congenital erosions were observed.
ectropion (eversion) of the mucous membrane of the cervical canal during birth injuries. Cervical Erosion (pseudo - follicular, papillary, mixed), characterized by a long, persistent, recurrent, not amenable to conservative therapy with microscopic signs of dysplasia, prone to bleeding contact, regarded as premalignant zabolevnaiya.
colposcopy, which allows to consider the pathological center by multiple increase in detail.
The method uses an extended colposcopy for suspected malignancy of cervical erosion. erosion zone is treated with 5% alcoholic solution of iodine and viewed under a colposcope. True erosion (pseudo) has a light pink color, dysplasia zone - yellow, atypical foci - white. Upon detection of erosion sites, questionable in terms of dysplasia is carried out aiming cervical biopsy with histological analysis of tissue obtained.
gynecology adheres to the following rules:
Current approaches to the treatment of cervical erosion are based on the use of the mechanism of destruction of columnar epithelial cells, their rejection and the subsequent restoration of squamous epithelium in the pseudo-surface. For this purpose, the methods used diathermocoagulation, lazerovaporizatsii, cryoablation, radio-wave method.
Diathermocoagulation is changed whereas the method of cauterizing tissue exposure to alternating electric current of high frequency, causing significant tissue heating. Coagulation does not apply in nulliparous patients because of the risk of scarring, preventing the disclosure of the cervix during labor. traumatic method, rejection of coagulated necrosis of the surface may be accompanied by bleeding. Complete healing after diathermocoagulation occurs after 1.5-3 months. After diathermocoagulation often develop endometriosis, so it is advisable to conduct the procedure planned for the second phase of the menstrual cycle.
Lazerovaporizatsiya or "burning" of cervical erosion is carried out by a laser beam on day 5-7 of the menstrual cycle. Before lazerovaporizatsiey patient undergoing a thorough reorganization of the vagina and cervix. painless procedure leaves no scar on the cervix, and thus does not complicate for subsequent delivery. Laser destruction of altered tissue causes a rapid rejection necrosis, early epithelialization and complete regeneration of the wound surface for a month later.
Cryosurgery (cryocautery) based on frozen out, cold destruction of the tissues of cervical erosion by liquid nitrogen or nitrous oxide. In comparison with diathermocoagulation, cryocautery painless, bloodless, does not entail consequences cicatricial narrowing of the cervical canal, it is characterized by a relatively rapid epithelialization of the wound surface after the rejection of necrosis. The first day after cryoablation marked heavy liquid separation, cervical edema. The complete epithelialization of the defect occurs in 1-1.5 months.
Radiowave treatment of cervical erosion machine "Surgitron" is the impact on the pathological focus electromagnetic waves of ultrahigh frequency - radio waves that a person does not feel physically. The procedure takes less than a minute, does not require anesthesia and subsequent postoperative treatment. Radio wave method in the treatment of cervical erosion is recommended before nulliparous women, t. To. Does not lead to the formation of scars and burns complicating delivery.
Diathermocoagulation, lazerovaporizatsiya, cryosurgery, radio wave treatment method is carried out after an extended colposcopy and targeted biopsy to exclude onkoprotsessa. If you suspect a malignant transformation of cervical erosion for curative surgery. Even after treatment of cervical erosion of one of these methods, a woman must be on the dispensary observation and a gynecologist.