Cervical erosion – to treat or not to treat?
Cervical erosion – one of the most common gynecological diagnoses. Hearing him, one patient mortally frightened, while others try to ignore the problem. But since neither one nor the other is true, let us quietly and consistently see what is cervical erosion, and what methods of treatment allow in the future to hear another doctor’s conclusion – “healthy”!
More than half of women receiving preventive gynecological exam or are examined by a gynecologist about those or other problems, the survey recognize the presence of at cervical erosion. Not very good imagining that it was for the pathology they observed, the ladies begin to frantically search for the most effective (for reviews girlfriends) treatments, rushing from one doctor to another, trying to put together to collect all the received opinions and recommendations, or worse, unconcerned shrug from the problem, believing that eventually “all will pass by itself.” As a result, in the first case are often subjected to unnecessary over-aggressive influences, leading to the development of scar tissue in the cervical tissue, and in the second pass the time, when you can prevent the development of precancerous lesions and cervical cancer.
Understanding the structure of the cervix
In order to understand where the “live” erosion, let us analyze the anatomy and how it is arranged in the cervix of healthy women.
The cervix is the cone (nulliparous) or cylindrical (parous) lower uterine department. His lower part of the cervix into the vagina hanging – this part of the body is available for viewing using the speculum.
It passes inside the cervix duct (cervical canal or cervical canal), which connects the vagina and uterus. The walls of the canal are lined with cells of cylindrical shape, able to secrete mucus (columnar epithelium). For the columnar epithelium is characterized by a bright red color. Outside the cervix is covered with flat epithelial cells (stratified squamous epithelium) – as well as the walls of the vagina. mucous membrane color, covered with squamous epithelium – lilac-pink.
The place where the squamous epithelium of the cervix vaginal part is replaced by columnar epithelium of the cervical canal, called the transition zone. In healthy women of reproductive age the transition zone is located in the external os – holes in the center of the cervix, which ends with the cervical canal.
This term is quite old and not quite correct, but it is widely used by practitioners, especially doctors with many years of work. Diagnosis “Cervical erosion” includes several pathologies which differ both in origin and in methods of treatment and consequences. This is true of cervical erosion, ectropion, ectopia and cervical dysplasia. About cervical dysplasia on our portal there is a detailed scientific and popular article Cervical Dysplasia: forewarned is forearmed, so stop we will not be on this issue, although once again, because of all these cervical disease, this disease is the most serious and It requires urgent attention.
True erosion – is the area of the vaginal portion of the cervix, which as a result of mucosal damage, not normal squamous epithelium. True erosion appears as visible to the naked eye wound or ulcer on the cervix (bright red spot on a pink background intact mucosa). The reasons for the formation of a true erosion are most often:
inflammatory processes in the organs of the reproductive system (most often caused by Trichomonas, chlamydia and viruses);
chemical or physical effects (eg, mucous membrane burns as a result of irrigation solutions containing acids, cervical forceps injury during an abortion and other procedures, improper use of barrier contraceptives and chemical).
True erosion there for 10-14 days, and then (if the cause of the occurrence of the erosion, fixed) occurs her healing. erosion surface is covered by stratified squamous epithelium and gets the usual form and color. In some cases, erosion healing is “wrong” – under a layer of flat epithelial cells is a layer of cylindrical cells. Cylindrical cells produce mucus, which is not displayed anywhere and accumulates inside the mucous membrane, forming cysts Nabothian (Ovula Naboti).
With proper treatment, at which point recovery occurs. A long-term process can be a prerequisite for the development of cervical dysplasia.
Cervical erosion often develops as a result of traumatic childbirth, abortion, dilatation and curettage and other intrauterine surgery, during which the gaps are formed on the cervix. If the gaps are not timely and properly sutured, there is cervical eversion. As a result of cervical mucosa it is partially outside – so formed eroded ectropion. The presence of chronic inflammation supports the existence of ectropion and creates preconditions for the development of precancerous lesions and cervical cancer.
Under ectopia (pseudo) understand the violation of the correct positioning of the cylindrical epithelial cells – they “come out” from the cervix and placed on the outside of (vaginal) surface of the cervix. The basis ectopia are usually hormonal changes the female body. Ectopic may be physiological and pathological.
The physiological ectopia often diagnosed in girls and young women up to 25 years with a transition zone (zone of transition in the columnar epithelium stratified squamous) located outside the external cervical os, which is caused by hormonal features characteristic of a female body in these age periods. In this case, the erosion appears as a smooth red band around the external os with no signs of inflammation and treatment can not be. As a rule, after 25 years of transition zone independently shifted towards the external os and cervix becomes normal appearance and uniform pink color.
It is also considered to be a physiological ectopia arising during pregnancy – it exists within 3-4 months after birth, and then allowed to spontaneously.
In all other cases the ectopia is pathological, and demonstrates the need for hormonal status of women Survey and prescribing, correcting hormonal profile.
Diagnosis of erosion
Diagnosing cervical erosion gynecologist help:
In most cases of cervical erosion occurs completely asymptomatic. In some cases, women suffer from minor bleeding from the vagina after intercourse or use tampons. If the occurrence of erosion due to the inflammatory process, then as the clinical manifestations can be considered unusual vaginal discharge (heavy with the smell, unusual color, irritating the vulva).
Examination in mirrors
On examination of the vagina and cervix with the naked eye using a speculum doctor notes the erosion of the cervix, which looks like a lot of red color of different shapes and sizes on a background of pink unaltered epithelium. Detection of such a plot is an indication to perform a colposcopy.