Erosion of the uterus. Cervical erosion: what it looks like, causes, symptoms, treatment. Normal structure of the cervix

– defect, damage to the squamous epithelium of the cervix on its vaginal part around the external pharynx. More often it occurs as a result of endocervicitis and other inflammatory diseases of the genital area, hormonal disorders in the female body. The course may be asymptomatic or manifested by pathological discharge of a mucopurulent, sometimes bloody nature, nagging pain in the sacral area. It is a risk factor for the occurrence of cervical tumors (polyps, cancer). The main methods for diagnosing cervical erosion are examination of the cervix in the speculum and colposcopy. Methods of diathermocoagulation, laser vaporization and cryodestruction, as well as the radio wave method can be used in treatment

General information

The term “cervical erosion” refers to a defect, a violation of the integrity of the epithelium of the vaginal segment of the cervix. Cervical erosion is one of the most common gynecological pathologies and occurs in 15% of women. The cervix is the lower part of the uterus that protrudes into the vagina, within which runs the narrow cervical (cervical) canal. The upper section of the cervical canal ends with the internal os, the lower section ends with the external os. The external pharynx opens on the vaginal part of the cervix and has the shape of a transverse slit in women who have given birth and a round shape in women who have not given birth. Damage to the stratified squamous epithelium around the external os of the vaginal part of the cervix manifests itself in the form of cervical erosion.

Protruding into the vagina, the cervix is exposed to infections, injury during sexual intercourse and medical procedures. The long-term existence of cervical erosion can lead to changes in epithelial cells and the appearance of benign neoplasms (cervical polyps) and malignant tumors (cervical cancer).

The reasons for the development of cervical erosion can be different. Changes in the cervical mucosa can develop after childbirth, termination of pregnancy, due to inflammatory diseases of the cervix, hormonal disorders. A common cause of cervical erosion is genital infections - chlamydia, gardnerellosis, ureaplasmosis, trichomoniasis, etc., the pathogens of which, penetrating the damaged mucosa, cause inflammation in it. Cervical erosion can occur in adolescence and in nulliparous women.

Types of cervical erosions

Cervical erosions are of the following types:

true;
congenital.

True cervical erosion

It is customary to call true erosion of the cervix, which is formed as a result of damage and desquamation of the squamous epithelium around the external os of the vaginal part of the cervix. True cervical erosion is characterized by the formation of a wound surface with signs of inflammation. The most common cause of the development of true erosion of the cervix is irritation of the mucous membrane by pathological secretions of the cervical canal during endocervicitis. True erosion is usually bright red, irregularly round in shape, and bleeds easily on contact. During colposcopic examination and microscopy of the eroded surface, dilated vessels, swelling, infiltration, traces of fibrin, blood, and mucopurulent discharge are visible. After 1-2 weeks, true erosion enters the healing stage - pseudo-erosion.

Pseudo-erosion

During the healing process, the defect of the squamous epithelium is replaced by a cylindrical one, spreading to the erosive surface from the cervical canal. Columnar epithelial cells are brighter in color than stratified squamous epithelial cells, and the erosive surface remains bright red.

The stage of replacement of flat epithelial cells with cylindrical ones is the first stage of healing of true erosion of the cervix. Usually at this stage, cervical erosion is diagnosed by a gynecologist.

The growth of cylindrical epithelium occurs not only along the surface of the erosion, but also in depth with the formation of branching glandular ducts. In the erosive glands, a secretion is secreted and accumulated, and when the outflow is difficult, cysts are formed - from the smallest to those visible during visual examination and colposcopy. Sometimes large cysts located near the external pharynx look like cervical polyps. Multiple cysts lead to thickening - hypertrophy of the cervix.

There are pseudo-erosions:

follicular (glandular) – having pronounced glandular ducts and cysts;
papillary - having papillary growths on the surface with signs of inflammation;
glandular-papillary or mixed - combining the characteristics of the first two types.

Pseudo-erosion without treatment can persist for several months and years until the causes of its development and existence are eliminated. Pseudo-erosion itself is a source of inflammation in the cervix due to the presence of infection in the erosive glands.

When inflammation subsides independently or as a result of treatment, the process of reverse replacement of the cylindrical epithelium with flat epithelium occurs, i.e. restoration of the normal integumentary epithelium of the cervix - the second stage of healing of erosion. At the site of healed erosion, small cysts (Nabothian cysts) often remain, formed as a result of blockage of the ducts of the erosive glands.

A long course of pseudo-erosions and the accompanying inflammatory process can lead to pathological changes in epithelial cells - atypia and dysplasia. Cervical erosion with the presence of epithelial dysplasia is considered a precancerous disease.

Pseudo-erosions can be small in size (from 3 to 5 mm) or cover a significant part of the vaginal segment of the cervix. The predominant localization is around the external os or along the posterior edge (lip) of the cervix. Pseudo-erosions are a modified area of the mucous membrane of irregular shape, with a bright red color, a velvety or uneven surface, covered with mucous or pus-like secretions. Along the edges of the healing pseudo-erosion, areas of pale pink squamous epithelium and Nabothian cysts are visible.

Pseudoerosions, especially papillary ones, bleed easily during sexual intercourse and instrumental examinations. Increased bleeding is also observed with pseudoerosion dysplasia and during pregnancy. Healing of pseudo-erosion is considered complete if the erosive glands and columnar epithelium are rejected and squamous epithelium is restored over the entire surface of the defect.

Congenital cervical erosion

The formation of congenital erosions of the cervix occurs as a result of displacement of the boundaries of the columnar epithelium lining the cervical canal beyond its limits. Displacement (ectopia) of the epithelium occurs during the prenatal period of fetal development, therefore such erosions are considered congenital.

Congenital erosion of the cervix usually occupies a small area along the line of the external pharynx, has a bright red color, and a smooth surface. An objective examination (in speculum or colposcopy) shows no pathological secretion from the cervical canal and no symptoms of inflammation.

Congenital erosions of the cervix are detected in childhood and adolescence and often heal on their own. If congenital erosion persists until puberty, infection, inflammation and subsequent changes are possible. Occasionally, against the background of congenital erosions of the cervix, flat condylomas develop; malignancy of congenital erosions is not observed.

Causes and mechanism of development of cervical erosion

In the question of the causes and mechanism of development of cervical erosion, the leading role belongs to the inflammatory theory of the origin of the disease. Endocervicitis and cervicitis, accompanied by pathological secretion from the cervical canal and uterus, lead to irritation of the epithelial cover in the area of the external pharynx and subsequent rejection of the epithelium. True erosion is formed, which is populated by the microflora of the vagina and cervix.

The dishormonal theory puts forward changes in the level of sex hormones-steroids as the cause of the development of cervical erosion. Clinical observations show the appearance of cervical erosions during pregnancy and regression in the postpartum period with stabilization of hormonal levels.

Erosions are also formed during ectropion (eversion) of the mucous membrane of the cervical canal due to birth injuries. Cervical erosions (pseudo-erosions - follicular, papillary, mixed), characterized by a long, persistent, recurrent course, not amenable to conservative therapy, having microscopic signs of dysplasia, prone to contact bleeding, are regarded as precancerous diseases.

Diagnosis of erosions and pseudo-erosions of the cervix

Diagnosis of cervical erosion is often difficult due to the absence of characteristic complaints from the patient or the asymptomatic course of the disease. Changes in the subjective state are usually caused by a disease that causes the development of erosion. Therefore, the main diagnostic methods are visual examination of the cervix in mirrors and colposcopy, which allows you to examine the pathological focus in detail under multiple magnification.

The extended colposcopy method is used if malignancy of cervical erosion is suspected. The erosion zone is treated with a 5% alcohol solution of iodine and examined under a colposcope. True erosion (pseudo-erosion) is light pink, the dysplasia zone is yellow, and atypical lesions are white. If areas of erosion that are questionable for dysplasia are detected, a targeted biopsy of the cervix is performed with histological analysis of the resulting tissue.

Treatment of erosions and pseudo-erosions of the cervix

In the treatment of cervical erosions, practical gynecology adheres to the following rules:

monitoring of congenital erosions, no need for their treatment;
true erosions and pseudo-erosions are treated simultaneously with the underlying diseases that caused or maintain them;
if there are signs of inflammation, therapy should be aimed at infectious agents (trichoionases, chlamydia, gonococci, etc.);
erosion in the active stage of inflammation is treated with gentle methods (vaginal tampons with sea buckthorn oil, fish oil, syntomycin emulsion, aerosols containing antibiotics - chloramphenicol, etc.).

Modern approaches to the treatment of cervical erosion are based on the use of the mechanism of destruction of columnar epithelial cells, their rejection and subsequent restoration of squamous epithelium on the surface of pseudo-erosion. For this purpose, diathermocoagulation, laser vaporization, cryodestruction, and radio wave methods are used.

Diathermocoagulation is a method of cauterization of altered tissue by exposure to high-frequency alternating electric current, causing significant heating of the tissue. Coagulation is not used in nulliparous patients due to the risk of scar formation that prevents the dilation of the cervix during childbirth. The method is traumatic; rejection of necrosis of the coagulated surface may be accompanied by bleeding. Complete healing after diathermocoagulation occurs after 1.5-3 months. After diathermocoagulation, endometriosis often develops, so it is advisable to plan the procedure for the second phase of the menstrual cycle.

Laser vaporization or “cauterization” of cervical erosion with a laser beam is carried out on days 5-7 of the menstrual cycle. Before laser vaporization, the patient undergoes a course of thorough sanitation of the vagina and cervix. The procedure is painless, does not leave a scar on the cervix, and, therefore, does not complicate the course of subsequent labor. Laser destruction of altered tissue causes rapid rejection of the necrosis zone, early epithelization and complete regeneration of the wound surface a month later.

Cryodestruction(cryocoagulation) is based on freezing, cold destruction of cervical erosion tissue with liquid nitrogen or nitrous oxide. In comparison with diathermocoagulation, cryocoagulation is painless, bloodless, does not entail the consequences of cicatricial narrowing of the cervical canal, and is characterized by relatively rapid epithelization of the wound surface after rejection of necrosis. The first day after cryodestruction, abundant liquid discharge and cervical edema are noted. Complete epithelization of the defect occurs after 1-1.5 months.

Radio wave treatment cervical erosion using the Surgitron apparatus involves exposing the pathological focus to electromagnetic oscillations of ultra-high frequency - radio waves, which a person does not physically feel. The procedure takes less than a minute and does not require anesthesia or further postoperative treatment. The radio wave method in the treatment of cervical erosion is recommended for previously nulliparous women, since it does not lead to the formation of burns and scars that complicate childbirth.

Diathermocoagulation, laser vaporization, cryodestruction, radio wave treatment are carried out after extended colposcopy and targeted biopsy to exclude an oncological process. If malignant degeneration of cervical erosion is suspected, radical surgical treatment is indicated. Even after curing cervical erosion using one of the above methods, the woman should be monitored and monitored by a gynecologist.

Cervical erosion is a defect of the ulcerative type on the mucosa. During the pathological process, normal epithelium, under the influence of any factors, is replaced by cylindrical epithelium from the cervical canal. Usually such a diagnosis does not portend anything serious. It should be said that erosion is a benign process. In extremely rare cases, it can lead to the development of cancer.

Classification

There are several types of erosion:

Signs of the disease

How can cervical erosion manifest itself? Symptoms of pathology are usually absent. In most cases, the disease is detected suddenly during an examination by a gynecologist. However, it also happens that patients turn to a specialist with complaints of bleeding. With cervical erosion, women may experience pain during sex. In some cases, inflammatory processes may join the pathology. In this case, purulent mucous discharge may be observed. Inflammation significantly worsens the course of the disease. Many women are unaware that they are developing cervical erosion. They confuse the symptoms that accompany the pathology with signs of thrush, menstruation, the threat of miscarriage, and so on. For any of the manifestations mentioned above, a woman should immediately contact a gynecologist so that cervical erosion can be detected or excluded in time. The consequences of pathology can be prevented by adequately prescribed treatment or timely prevention. Among the main complications are the progression of the infectious process, the occurrence of problems with the reproductive system, as well as the possible degeneration of a benign tumor into a malignant one.

Diagnostics

The disease can be detected by visual examination by a gynecologist. However, as a rule, this is not enough. To understand how to treat cervical erosion, the doctor must evaluate the entire clinical picture. To do this, the specialist prescribes some additional tests. Among them:

Therapeutic measures

Today there are many options for treating cervical erosion. Therapeutic tactics will depend on the type of pathology, the size of the lesion and concomitant infections or inflammations. Before talking about how to treat cervical erosion, it should be recalled that therapeutic measures should be carried out under dynamic supervision. Congenital erosion, as mentioned above, can be eliminated on its own. Experts recommend getting rid of other types of pathology in a timely manner. Today there are two main methods for treating cervical erosion. Therapy can be conservative. In difficult cases, various surgical interventions are prescribed.

Conservative therapy

If ectopia is accompanied by an infectious or inflammatory process, treatment begins with its elimination. First of all, the specialist identifies the cause of the development of the pathology. Taking into account the identified diseases, the patient is prescribed a course of antibiotics. The drugs prescribed by the doctor usually have a wide range of therapeutic activity. In addition, anti-inflammatory drugs and immunomodulators are prescribed. It is also recommended to locally treat the cervix with drugs that can cause chemical coagulation in the affected area. Such products contain organic acids: nitric, acetic. These medications are intended only for the elimination of benign formations and are recommended to a greater extent for nulliparous patients, since after their use no scars remain. Among the disadvantages of conservative therapy, the likelihood of re-development of the pathology should be noted.

Surgical intervention

Experts recommend regular examinations by a gynecologist, and if signs of pathology appear, do not delay a visit to the doctor, since cervical erosion in advanced cases can only be treated with surgical methods. There are several ways to eliminate the defect surgically.

Types of surgical intervention

Cauterization of cervical erosion, the price of which varies from 300 to 10,000 rubles, is carried out in various ways using various means. The most common options are:

Suppositories for cervical erosion

Drugs for topical use can be prescribed both during conservative therapy and after surgical procedures. Suppositories are considered the most effective and, therefore, popular. Among the drugs, the following should be noted:

Preparing medications at home

There are quite a lot of means that can help eliminate a disease such as cervical erosion. Traditional treatment is usually used after surgery or in the early stages of pathology. To make suppositories, you should take honey - 5 tablespoons, to which you should add propolis (tincture) - 5 g. Add 150 g of butter to these components. The resulting mass is heated until smooth in a water bath. Once a homogeneous mixture is obtained, turn off the heat. The mass is cooled. After the mixture becomes warm, you need to make candles and place them in the refrigerator. There are 7-8 pieces per course. It is recommended to administer 1 suppository at night every day. Douching is also used at home. Tampons soaked in decoctions and infusions of medicinal herbs are also used. Sea buckthorn oil is also popular. It is hypoallergenic and non-toxic. It is not contraindicated during pregnancy. A cotton swab moistened with sea buckthorn oil is inserted into the vagina at night. The procedure is repeated daily for two weeks. For douching, as a rule, a two percent solution of calendula tincture is used. The procedure is carried out for ten days after visiting the toilet regularly.

Prenatal therapy

It must be said that erosion does not affect the course of pregnancy, just as ovulation does not affect the development of pathology. Surgical intervention is not performed during the prenatal period. This is due to the fact that after cauterization, childbirth will be more difficult - the cervix will stretch and open less easily. Therefore, surgical procedures should be postponed. During the prenatal period, it is allowed to use folk remedies (sea buckthorn oil, for example). But phytotampons, which have recently become increasingly popular, are contraindicated during pregnancy. If an infectious process is detected, the specialist may prescribe a course of antibiotics and local anti-inflammatory drugs. But in most cases, gynecologists simply carry out dynamic monitoring of pregnant patients with this pathology.

How dangerous is the disease?

Experts note that there is no obvious threat to a woman’s health with this pathology. Exceptions, however, are cases of complications. They can be prevented if the disease is not started. Cervical erosion can cause female infertility - damaged tissue can be an obstacle to normal fertilization. In addition, defects in the mucosa during pregnancy can contribute to its termination (miscarriage). Erosion in some cases is the cause of premature birth, colpitis and cervicitis.

Preventive actions

As you know, it is better to prevent pathology than to treat it. To protect yourself, you should follow a number of recommendations:

Visit your doctor regularly (at least twice a year).
Observe hygiene rules. In particular, you should shower at least twice a day, especially during menstruation.
Use condoms when having sex with casual partners to prevent the spread of infections.
Strive for monogamy and regular sex life.
Use protection in cases where pregnancy is not planned. It should be remembered that any abortion complicates the course of the pathology and injures the cervix.

If the gynecologist has identified erosion, it is recommended to lead a healthy lifestyle. You should change pads or tampons regularly during your menstrual period (at least every three or four hours). It must be remembered that erosion contributes to the formation of an ideal environment for the development and subsequent penetration of pathogenic bacteria into the uterine cavity and ovaries.

Finally

It should be noted that in almost all cases (99 out of 100) erosion is treatable. The methods of influence existing today for the most part give excellent results. The main thing is to prevent relapse of the pathology. During rehabilitation after surgical procedures, it is recommended to refrain from heavy physical activity and sexual intercourse for two weeks. This will promote better tissue healing after procedures. During the recovery period, spotting may appear. As a rule, they go away on their own.

Cervical erosion is not a clinical diagnosis of the disease. This term is only a statement by the gynecologist of the presence of changes, not always pathological, but requiring certain diagnostic studies to clarify the diagnosis. To understand what is meant by this concept and why cervical erosion is dangerous, you need to have a general understanding of the structure of the organ.

Brief anatomy of the uterus

The uterus is conventionally divided into sections: fundus, body and cervix. In the latter, in turn, there is an upper part (supravaginal), into which the uterus passes, and a lower part, located in the vagina and accessible for examination by a gynecologist. A narrow cervical (cervical) canal runs throughout the entire cervix, opening with an internal os into the uterus and an external os into the vagina.

All departments differ in their functions, histological structure and, accordingly, diseases. The upper layer of the mucous membrane of the cervical canal is represented by columnar epithelium, and the surface of the cervix on the vaginal side is multilayered flat non-keratinizing, which slightly passes into the canal in the area of the external pharynx. The boundary between these types of epithelium is called the transformation zone. This is exactly the area where erosion forms.

What is erosion

Normally, the transformation zone is visible only when examined using significant optical magnification or during histological examination. In diseases and even in some physiological conditions, the border shifts to the vaginal surface of the cervix and is already determined visually without optical magnification. This occurs due to the growth of the columnar epithelium of the cervical canal beyond the border zone.

Currently, such changes are called ectopia (displacement, movement to an unusual place). Despite the change in terminology, the previous name (erosion) remains more familiar to patients when communicating with a doctor. At the same time, the correct understanding by gynecologists of the meaning and differences of these terms influences their targeted determination of the causes of the pathological condition and how to treat cervical erosion - with conservative or radical methods.

But until recently, all visible changes were called erosion, which was divided into true and false (pseudo-erosion). However, there is nothing in common between them. True erosion (corrosion, destruction) can occur as a result of:

burns due to rejection of the scab formed after treatment with chemicals, cryodestruction, electrical destruction;
inflammatory processes that accompany vaginitis (colpitis) or cervicitis - inflammation of the vaginal mucosa or the mucous membrane of the cervical canal;
trophic disorders (impaired blood supply) in postmenopause, with uterine prolapse, after radiation therapy;
disintegration of a cancerous tumor;
primary syphilis during the formation of chancre on the cervix.

In the first two cases, healing of erosion usually occurs on its own within a maximum of two weeks or can turn into pseudo-erosion (ectopia).

1. Cervix without pathology
2. Cervical ectopia

Causes of ectopia

In girls and young women under 18 years of age, erosion can be congenital and detected after the start of sexual relations. Many experts classify ectopia in all nulliparous women as congenital. In girls under 21 years of age and women during pregnancy, as well as during the period of involution, erosion is considered the result of hormonal changes. In these cases, changes often go away on their own and require only examination and observation.

However, ectopia occurs in more than 50% of women with cervical pathology and is dangerous because it can be a background, that is, a nonspecific sign of precancerous diseases and sexually transmitted infections. Therefore, it is classified as a group of “background” pathological conditions. In the structure of the general morbidity of the female genital organs, it is 9%; during preventive examinations, it is detected in various forms on average in 38.8%, of which 17-22% are nulliparous young women.

Specialists in various fields of medicine have identified and proven multiple causes of cervical erosion, among which there are factors both exogenous (external) and endogenous (in the body itself). The first include:

Early sexual debut (beginning of sexual intercourse before the age of 16-18).
Early first pregnancy (before 18 years of age).
Sexual contact with several partners or frequent changes of the latter.
Refusal to use barrier methods of contraception.
Dysbacteriosis, infections that are mainly sexually transmitted - gonorrhea, chlamydia, trichomoniasis, human papillomavirus, herpes virus. These infections first cause inflammatory processes and then contribute to the formation of precancerous diseases.
Inflammations caused by conditionally pathogenic microorganisms - Gardnerella vaginalis and candidomycosis.
Frequent abortions and damage to the cervix during abortion or complicated childbirth, as well as chemicals and some medications.
Low social, cultural and economic living standards.

Endogenous causes:

Hormonal dysfunctions during puberty, pregnancy, menopause, and also when using hormonal contraceptives.
Dysfunction of the endocrine glands - the thyroid gland, adrenal glands, ovaries.
Changes in the immune state of the body.
Metabolic disorders.

Symptoms of cervical erosion

Sometimes, in 2-6% of cases, cervical erosion does not manifest itself in any way and is diagnosed during preventive gynecological examinations or examinations not related to cervical pathology. Most often women complain about:

The discharge is yellowish or white (on average 80%).
Contact bleeding (in 6-10%). They consist in the fact that bloody discharge due to erosion of the cervix occurs during sexual intercourse or after physical exertion on the abdominal muscles.
Dyspareunia is difficulty in sexual intercourse due to the occurrence of psychological disorders or pain before, after or during sexual intercourse.
Menstrual irregularities.
Unexpressed and intermittent pain or heaviness in the lower abdomen.

Diagnostics

Examination using a speculum

When examined by a gynecologist using mirrors, a bright red area with uneven contours is visually identified in the area of the external pharynx, which may bleed slightly with a light touch.

Colposcopy

A highly informative, accessible and painless diagnostic method is a simple colposcopy for cervical erosion, which allows, using a 10-fold magnification, to roughly examine and get an idea of the condition of the mucous membrane, its epithelium and underlying vessels. The surface of a healthy mucous membrane is shiny and pink in color. The vessels underneath are not visible.

Ectopic areas, depending on the severity of the process, have the appearance of cluster-shaped bright red clusters of elongated shape or spherical papillae. In the transformation zone, you can see ectopic fragments and open glands in the form of dark dots around the external pharynx, areas of immature epithelial cells in the form of “tongues,” vesicles with yellowish contents (retention cysts).

A clearer picture is presented during extended colposcopy using simple additional tests - acetoacetic and Schiller. The first is that unchanged areas of the cervical mucosa become pale after treating them with acetic acid (3% solution). In this case, clusters of papillae become glassy and resemble grape bunches in shape, and the vessels are sharply narrowed.

When performing the Schiller test (lubrication with Lugol's solution), unchanged areas of the surface of the cervix become uniformly dark brown as a result of the combination of iodine contained in the solution with epithelial glycogen. The intensity of the color depends on the amount of the latter in the cells. The transformation zone takes the form of a clear, even line. Ectopic zones do not stain as a result of treatment with Lugol's solution.

Required laboratory tests

When diagnosing ectopia, mandatory tests will also include:

smear for bacteriological examination (for flora);
tests for urogenital infections, HIV, RW, hepatitis HBS and HCV;
scraping for cytological examination;
if necessary, cervical biopsy.

Treatment of cervical erosion

The decision on the need for dynamic observation or treatment, and the choice of conservative or surgical treatment methods, is made only after examining the woman by a gynecologist using laboratory and instrumental methods, as well as consulting an endocrinologist (if necessary).

Conservative therapy

Conservative treatment of cervical erosion consists of:

carrying out nonspecific anti-inflammatory therapy;
treatment with drugs that suppress the growth and development of fungal bacteria and sexually transmitted viral infections (if detected);
correction of hormonal and immune disorders;
the use of physiotherapeutic techniques (rarely) - vaginal tampons with therapeutic mud, irrigation with mineral waters, iontophoresis with drugs, ultraviolet and short-wave ultraviolet therapy, microcurrent and ozone therapy, helium-neon laser.

In some cases, removal of cervical erosion is carried out using chemicals that lead to a chemical burn (chemical destruction). One such remedy is Solkovagin. It is an aqueous solution of zinc citrate, nitric, oxalic and acetic acids. The solution is characterized by a selective coagulating effect on the columnar epithelium of the cervical canal without involving the stratified squamous non-keratinizing epithelium. As a result of treating the mucous membrane, it penetrates to a depth of 2.5 mm and has an effect after a single, or in extreme cases, a double procedure.

Another drug is an aqueous 36% solution of Polycresulene, which has cauterizing, antiseptic and astringent effects.

Surgical methods

Cryodestruction

A safe, easy-to-use and easily tolerated surgical procedure that does not require hospitalization is freezing cervical erosion with liquid nitrogen, or cryodestruction. It is based on the formation of tissue necrosis under the influence of very low temperatures that occurs during the rapid evaporation of liquid nitrogen. However, the effect of exposure is uncontrollable and can extend to a tissue depth of up to 5 mm or more, and therefore the formation of a narrowing of the external os of the cervical canal is possible. In addition, the cryodestruction procedure often requires repetition.

Laser vaporization

Sometimes laser destruction (vaporization) is used - removal of cervical erosion with a laser, for which high-energy laser radiation devices are used. This includes ruby, argon, carbon dioxide and neon lasers. The advantages of this method are the ability to control the area and depth of tissue necrosis, and the absence of bleeding and inflammatory processes after the procedure. Disadvantages include pain and high cost of laser treatment.

Radio wave surgery

Currently, the Surgitron device is widely used in medical centers, antenatal clinics and hospitals. The method is a controlled, limited incision of tissue without contact with it. This is possible due to the high thermal energy generated when the radio waves emitted by the device are exposed to the pathological area of the mucous membrane. As a result of the influence of concentrated energy, cell destruction and evaporation occurs.

The advantage of removing ectopia using the radiosurgical method is the speed of the almost painless (due to the coagulating effect of the nerve endings) procedure, the absence of pain after surgery, the accuracy of the effect, the absence of bleeding, the bactericidal effect and the rapid healing of the wound without the formation of scars, leading to cervical rigidity and the possibility of its rupture during childbirth This method is successfully used for.

The isolated use of conservative or surgical methods sometimes does not allow achieving lasting results. Only comprehensive treatment taking into account endogenous and exogenous factors, prevention and adherence to a culture of sexual relationships, and the use of modern contraceptive methods make it possible to prevent the formation of new cervical erosion.

Main symptoms:

Pain during sexual intercourse
Purulent mucous vaginal discharge
Bloody discharge during sexual intercourse

Cervical erosion is a pathological, but benign process, manifested in the form of rounded red formations localized in the area of the cervical mucosa; the diameter of such formations can reach about two centimeters. Cervical erosion, the symptoms of which manifest themselves in the form of characteristic formations, can exist in several varieties, being congenital erosion, true erosion or pseudo-erosion.

general description

First of all, it should be noted that cervical erosion is one of the most common diseases of the female genital organs. The course of the pathology is characterized by replacement due to the influence of one or another type of factor of the normal mucous epithelium in the area under consideration by the cervical columnar epithelium.

As a rule, this disease does not pose a significant threat, if only for the reason that erosion itself is a benign process, and accordingly, it can become the cause of serious diseases, including tumor processes, in the rarest cases.

This disease, which is also defined as cervical ectopia, occurs in about half of women of reproductive age, while it does not occur in women who have passed the age of forty. As for the opinion regarding erosion and its harmfulness in particular, although it is somewhat common, for the most part experts attribute it to a number of normal physiologically variable conditions. Let us consider the types of erosion we previously noted in more detail.

Types of cervical erosion

Erosion is congenital. The congenital variety of this disease consists of displacement of the cervical columnar epithelium. Congenital erosion is observed in childhood or adolescence, while the symptoms of the disease mostly do not manifest themselves in any way. Detection of erosion occurs when, where the presence of a bright red area is determined that cannot be stained using Lugol’s solution. It is noteworthy that congenital erosion does not predispose in its course to subsequent development into malignant formations, and therefore treatment, as a rule, is not provided.

Erosion is true. With true erosion, its characteristic manifestations are localized in the area of the pharynx (on its outer side, in some cases on the back); localization in the area of the lip of the cervix is much less common. True erosion manifests itself in the form of a small rounded area with pronounced coloring, sometimes bleeding is noted. For this type of erosion, a characteristic manifestation is often endocervicitis, as a result of which the damaged part of the mucosa may have purulent discharge. The duration of true erosion is about 10-14 days, then the cervix is covered with epithelial cells belonging to neighboring areas. Pseudo-erosion is in this case the next stage in the development of the disease.

Pseudo-erosion. It appears in the form of a rounded area of pronounced red color, in some cases it does not have a specific shape; the diameter can range from several millimeters to several centimeters. The surface of the formation may be characterized by the formation of mucous discharge on it, which in some cases may be purulent. The duration of this type of erosion can be quite a long time, which is determined based on the characteristics of the inflammatory process that provoked it. The danger of pseudo-erosion lies in the possibility of recurrence; accordingly, in this case there is a high risk of developing cancer, which must be taken into account in treatment.

In addition to the main types of erosion, the following variants are also distinguished:

Ectropion. In this case, we mean a kind of eversion of the cervical mucosa, which occurs as a result of abortion or after childbirth.
cervix. It is characterized by the process of transplantation of the endometrium of the uterine cavity to the surface of the cervix.
. Characterized by keratinization of squamous stratified epithelium.
Polyps of the cervical canal, polyps of the cervix.
Genital warts.

Causes of the disease

Mechanical injuries appearing as a result of rough and frequent sexual intercourse, as well as during abortion and childbirth. With physical impact, the stratified squamous epithelium begins to thicken, which leads to the subsequent formation of an inflammatory process.
Sexually transmitted infections. These include genital and other diseases.
Incorrect and untimely treatment of genital tract infections.
Early onset of sexual activity, late onset of sexual activity.
Rare sexual contacts, or, conversely, frequent changes of partners.
Current disturbances in hormonal status, disturbances in the menstrual cycle.
Changes in the immunological scale (decrease in immunity).
The presence of inflammatory diseases relevant to the pelvic organs (, etc.).
A combination of some of the above reasons.

The occurrence of the disease in elderly patients is possible due to the pressure exerted by the uterine ring. In addition, there is also “physiological” erosion, determined in young women (up to 25 years), which has a tendency to heal independently.

Cervical erosion: symptoms

The vast majority of reported cases of the disease in women indicate that it extremely rarely manifests itself in the form of specific clinical symptoms, and therefore in most cases the diagnosis of the disease is made randomly. Meanwhile, it also happens that patients turn to a specialist based on the occurrence of the following symptoms:

spotting not associated with menstruation, especially often appearing after sexual intercourse;
pain during sexual intercourse;
purulent-mucosal discharge (whose occurrence is explained by the addition of an inflammatory disease to erosion, as a result of which the disease itself significantly worsens in the peculiarities of its own course), which women often independently confuse with menstrual discharge, thrush or harbingers of miscarriage in the case of pregnancy.

Diagnosis of cervical erosion

The diagnosis can be established already at the first visit to the doctor. Meanwhile, in many cases, visual examination is only half the battle in diagnosing the disease. Therefore, patients will need to undergo the following tests:

flora smear;
extended colposcopy;
cytological examination;
PCR diagnostics, aimed at identifying the main types of infections (genital herpes, trichomoniasis, mycoplasmosis, etc.);
blood test for hepatitis, HIV, syphilis;
bacteriological culture;
biopsy (if the patient is suspected of having a malignant tumor).

Treatment of erosion

The tactics of treatment suitable for each specific case are developed individually, based on the type of erosion and the size characteristic of it, including the presence of concomitant infections. Thus, congenital erosion requires dynamic observation, as a result of which its independent disappearance can be noted. In general, treatment can be conservative or surgical, again based on the specific characteristics of the course of the disease.

Conservative treatment involves eliminating the cause that provoked the erosion. Therefore, based on the concomitant disease identified in the patient, antibiotics with a wide spectrum of action can be prescribed. Additionally, anti-inflammatory drugs and immunomodulators may be prescribed.

The cervix is treated locally with drugs that lead to chemical coagulation in the affected area. These drugs are used only for benign formations; they are more suitable for nulliparous girls, since the treatment does not leave scars in the cervical area, which is a significant advantage of the method. Its disadvantage is the possible relapse of the disease, but it is applicable to any type of erosion.

If the effect of conservative therapy is insignificant or completely absent, then cauterization is prescribed (which is the surgical method in this case). In addition, any of the following methods can be used:

electrosurgery;
cryosurgery;
laser destruction;
radiosurgery;
thermocoagulation.

As for such widespread proposals regarding folk remedies in the treatment of erosion, experts have ambivalent attitudes towards them - the effectiveness of any of the options in the treatment of erosion has not been proven. Among non-traditional methods of treating cervical erosion, some effectiveness is most often observed with the use of acupuncture (acupuncture) and physiotherapy.

If alarming symptoms appear, which is especially important due to the predominantly asymptomatic course of uterine erosion, you should consult a gynecologist.

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