Erotic ectropion of the cervix. Cervical ectropion - what is the danger, how to treat

If a doctor talks about an anomaly of the cervix, then in about half of the cases we are talking about ectropion. This term is used to designate a pathology, a characteristic feature of which is the inversion of the corresponding part of the organ into the internal cavity of the vagina. Ectropion can develop completely asymptomatically over a long period of time. However, this condition is assessed by specialists as precancerous and requires mandatory treatment.

Causes and types

Depending on what factors contributed to the development of ectropion, it can be:

1. Innate.

In this case treatment may not be prescribed if there is no infection or signs of inflammation. After some time, the condition should normalize without external intervention.

1. Acquired.

This type of ectropion is caused by trauma:

• during abortions and other cases of artificial expansion of the uterus;
• during childbirth(due to mechanical damage or scar formation associated with rupture of muscle fibers);
• during multiple pregnancy or the birth of a large child;
• when using obstetric forceps during the process of obstetrics.

The views of gynecologists on erosion - a pathological condition of the cervix - today are ambiguous. Some doctors make this diagnosis very often, while others believe that there is no need to rush into treatment. In what cases are we talking about pseudo-erosion, what should be considered erosion? What are the causes of such conditions, and what is the right thing to do?

When examining the cervix in the speculum, the doctor sees redness on the surface. Such changes are also possible in other conditions (for example, cervicitis and colpitis). Today they distinguish:

• True erosion;
• Congenital;
• Pseudo-erosion of the cervix.

A smear cytology examination allows for a correct diagnosis.

Pseudo-erosion of the cervix (ectopia) is today considered the norm - the reddened frame of the pharynx is a protruding cylindrical epithelium. Over time, it is replaced by squamous epithelium. Ectopia is caused by:

• Exposure to hormones in newborns and adolescents;
• Use of oral contraceptives, pregnancy;
• Mechanical damage,
• Infections;
• Irritation due to chemical exposure.

If pseudo-erosion is not complicated, then no treatment is applied.

True cervical erosion is characterized by infection, ulceration and inflammation of the surface. The eroded area of ​​the cervix has a loose structure, red color, and often bleeds. Sexual intercourse is painful. Pathology requires timely action:

• If the source of its occurrence lies in a traumatic factor, excluding it is a sufficient measure;
• If an infection develops, a course of treatment is required.

Pathology can develop:

• During pregnancy;
• When taking and stopping hormonal contraceptives;
• After childbirth.

The cause of erosion may be:

• Excess estrogen;
• Violation of the menstrual cycle;
• Ovarian dysfunction;
• Low immunity;
• Diabetes mellitus and other chronic diseases.

Stabilization of hormonal levels and cessation of exposure to irritants, the process of cell replacement is activated, the epithelium is normalized, becoming flat, healthy pink.

How do symptoms appear?

Uncomplicated erosion is asymptomatic, but when infected or inflammatory, unpleasant manifestations occur:

• Discharge in the form of copious leucorrhoea;
• Bleeding during sexual intercourse;
• Pain in the lower abdomen;
• Frequent urination;
• Feeling of discomfort, burning and itching.

How is diagnostics carried out?

A certain set of procedures is envisaged:

• Blood test for Wasserman reaction and HIV infection;
• Submission of smears for examination with bacterioscopy to detect trichomonas and gonococci;
• Detection of mycoplasma and chlamydia;
• Colposcopy;
• For special indications - biopsy and histological examination;
• Blood test for progesterone and estrogens;
• Determination of immunity indicators (if indicated).

Detailed diagnostics will help determine the forms of pathology and prescribe optimal treatment.

Is treatment necessary?

If the patient has pseudo-erosion in an uncomplicated form, then treatment is not carried out. It will be enough:

• Correct the menstrual cycle;
• Choose a suitable contraceptive.

If the patient has complicated pseudoerosion, anti-inflammatory treatment is recommended. In some cases, it is necessary to remove the altered cervical tissue. Treatment of ectopia is carried out depending on the causes of the development of the pathology. Congenital erosions are observed, and if negative dynamics do not manifest themselves, no therapeutic measures are taken. Therapeutic measures include methods of treating the diseases that led to their occurrence and their long-term course. In the presence of inflammation, therapy takes into account the nature of the pathogen.

Severe inflammation requires the use of gentle treatment methods:

• Tampons with antibacterial emulsions are inserted into the vagina;
• Inflammation is treated taking into account the effect on a specific pathogen.

The latest treatment methods include:

• Destruction of pathological pathogens of erosion;
• Rejection of problematic tissues;
• Regeneration of damaged surfaces.

Radio wave therapy successfully treats pseudo-erosion and helps eliminate cervical deformity. Exposure to radio waves causes:

• Rejection of necrotic tissue;
• Healing of damaged surface;
• Epithelization of the defect.

Almost all patients achieve a positive effect. A negative reaction – bleeding and exacerbation of pathology – is a rare occurrence.

Cryocoagulation is actively used for the effective treatment of pseudo-erosions. The technique involves the use of a device for local exposure and liquid nitrogen for local exposure:

• The treatment is painless, since the sensitive nerve endings are destroyed quickly;
• The vasoconstrictor effect ensures the absence of bleeding.

The cryocoagulation process is accompanied by severe swelling of the cervix and watery discharge. Dead areas are rejected, the process of regeneration and epithelization of the affected area begins. 30-40 days after the procedure, complete healing of the wound occurs, the normal structure of the epithelium is completely restored.

Laser therapy is one of the most effective methods of treating cervical pseudo-erosion at present. Laser radiation stimulates regeneration processes. Scarring of tissue is minimal. Epithelization occurs within 3 weeks.

Radio wave exposure, laser and cryodestruction are used after extended colposcopy. A biopsy is taken (according to indications) to exclude malignant degeneration of the pathology. If the patient shows signs of dysplasia, more serious treatment measures are taken, including amputation of the neck. Careful clinical observation is necessary after they are carried out.

Ectropion is an eversion of the mucous membrane of the cervical canal.

This pathology affects the lower part of the cervical canal.

Causes:

• Bilateral cervical ruptures during spontaneous labor;
• Incorrectly applied sutures to damaged cervical tissue;
• Dilation of the cervical canal during induced abortion.

Diagnostics

Pathology is detected when examining the cervix. Recognize:

• Scarring;
• Deformation;
• Inverted mucous membrane - rough or smoothed;
• Folded surface of the mucous membrane.

How is the treatment carried out?

The doctor’s task is to correct the cervix in order to restore its functions and prevent malignant degeneration of the pathology.

If the damage is significant, reconstructive plastic surgery is performed. It is first necessary to eliminate the causes of the development of pathology.

The condition of the cervix determines whether a woman can bear a fetus during pregnancy, as well as give birth normally. Cervical ruptures, disruption of the structure of the mucous membrane, inflammation - all these are serious pathologies that can lead to a significant deterioration in reproductive health and even serious complications. One of the common diseases is ectropion of the cervix. The severity of the condition depends on the cause of its occurrence. If a woman wants to become a mother, she should pay special attention to the timely treatment of this disease.

Ectropion- This is a condition in which approximately 1/3 of the lower part of the canal is turned outward, so that the columnar epithelium is located in the vagina. But it does not pass into the area of ​​squamous epithelium.

There are other types of diseases that are similar in name.

Ectopia. With this pathology, the cervical canal is not modified, but its mucous membrane crosses the border between it and the pharynx of the cervix. Columnar epithelial cells appear on top of squamous epithelium, which leads to the formation of cysts (they are called Nabothian cysts). This disease is also called pseudo-erosion.

Cervical erosion– this is damage to the mucous membrane of its pharynx with the normal shape of the canal and the location of the epithelial cells.

Complicated forms of the disease may occur when ectropion is accompanied by ectopia and erosion.

Video: Ectropion and other diseases. Diagnostic methods

Types of ectropion, causes

There are 2 types of ectropion: congenital and acquired. The pathology may not manifest itself in any way and not cause discomfort if there is no inflammation. It is detected, as a rule, during the first gynecological examination of a woman who has begun to be sexually active.

Congenital ectropion

The formation of ectropion of the cervix can occur during the formation of the genital organs of the fetus. This happens as a result of a certain hormonal shift in the body of the expectant mother. Usually, as a girl grows and develops, her ectropion disappears. By adolescence, the cervical canal usually takes on a normal appearance.

If this does not happen, then they speak of a functional disorder of the development of the genital organs, the cause of which is a hormonal imbalance in the body. This disorder can also manifest itself with other symptoms: cycle irregularity, deviations in the nature of menstruation.

Acquired ectropion

Its occurrence is said to occur when a change in the shape of the cervical canal occurs in a woman who has not previously had such a pathology. This condition is also called post-traumatic. Ectropion appears as a result of ruptures in the wall of the cervical canal, which can occur during childbirth, abortion, or the insertion of instruments during diagnostic and therapeutic procedures.

The causes of ruptures during childbirth are:

• the birth of a large child;
• the birth of several children;
• incorrect placement of the fetus in the uterus;
• labor progressing too quickly;
• premature birth of a child, when the cervix is ​​not yet elastic enough;
• the need to insert obstetric forceps into the cervix to remove the baby;
• carrying out artificial childbirth in late pregnancy, when it is necessary to use special instruments.

After suturing, scars remain at the site of the tears, deforming the cervical canal, causing it to turn outward.

Possible consequences of ectropion

Violation of the structure of the cervical canal with ectropion of the cervix leads to the fact that the opening of the pharynx remains slightly open, which facilitates the penetration of infection from the vagina into the uterus.

The acidic environment of the vaginal mucosa is harmful to harmful microbes (bacteria, fungi, human papillomavirus). Penetrating inside the canal, they enter an environment that is much less acidic, which facilitates their reproduction. As a result, cervicitis develops (inflammation of the mucous membrane of the pharynx), (inflammation of the mucous membrane in the uterine cavity).

Eversion of the cervical canal leads to the fact that its epithelial membrane is exposed to an acidic environment, which contributes to its irritation and the appearance of pseudo-erosion and true erosion. Death of epithelial cells (mucosal atrophy) may occur.

Possible consequences include dysplasia (gradual atypical degeneration of mucosal cells). Atypical cells (with a disrupted structure) often degenerate into cancer. Therefore, ectropion in an advanced and complicated form can cause a malignant tumor.

Effect on conception and pregnancy

By itself, protrusion of the cervical canal cannot prevent sperm from entering the uterus, so conception occurs quite successfully.

If a woman with a pathology such as ectropion experiences infertility, then the cause is not mechanical interference that prevents the penetration of sperm, but concomitant pathologies. These include hormonal imbalance, obstruction of the fallopian tubes, abnormal degeneration of the endometrium and other conditions. Hormonal imbalance, in turn, provokes disruption of mucus production in the cervix, changes in the structure of epithelial cells and worsening the development of ectropion.

Complications during pregnancy are associated with processes that often accompany ectropion of the cervix (infectious diseases, scarring of tissue after inflammation). Therefore, miscarriages and intrauterine infection of the fetus often become the consequences of such a pathology. Loss of the shape and elasticity of the cervix leads to complications of childbirth: the appearance of ruptures, decreased tone of the uterus and the need for a cesarean section, as well as the development of postpartum inflammatory processes.

Note: After eliminating timely detected ectropion and carrying out anti-inflammatory treatment, conception occurs normally, pregnancy proceeds without complications.

Symptoms of ectropion

Ectropion as an independent pathology has no symptoms. However, almost always in women of reproductive age this condition is accompanied by inflammatory processes and erosion. Therefore, it is often found in women who consult a gynecologist about the following symptoms:

1. Copious white or yellowish vaginal discharge. Sometimes the mucus contains impurities of pus, has a strong unpleasant odor, and irritates the skin.
2. The appearance of bleeding between menstruation or after sexual intercourse or physical activity.
3. Burning and itching in the vagina.
4. A feeling of discomfort in the lower abdomen or pain radiating to the lower back and sacral area.
5. Cycle disorder - heavy, frequent periods or scanty and infrequent periods.

During a routine gynecological examination using mirrors, cervical protrusion can be noticed visually. Erotic ectropion of the cervix is ​​manifested not only by eversion of the mucous membrane, but also by the formation of white and red spots on it - areas of displacement and damage to the epithelium.

Diagnostics

To clarify the condition of the cervical epithelium, after a visual examination in the mirrors, colposcopy is performed - studying the surface of the canal using an optical device that illuminates it and magnifies the image many times.

Colposcopic signs of congenital ectropion are the presence of evenly spaced folds in the canal, and acquired ones are their chaotic arrangement. Complications are indicated by uneven color and structure of the mucous membrane.

If signs of inflammation are detected, a microscopic examination of a smear from the vagina and cervical canal is performed to detect infections. To clarify their type, methods such as bacteriological culture of mucus and genetic analysis of microflora (PCR) are used.

If suspicious areas are found on the cervix, they are checked for oncology, for which a biopsy and histological examination of the material are performed. To find out the cause of ectropion, which is accompanied by menstrual disorders, a blood test for hormones is performed.

Treatment

Treatment is aimed at eliminating damage to the cervix surgically and subsequent anti-inflammatory and antibacterial therapy.

Surgery

Cryodestruction, laser therapy, radio wave destruction, electrocoagulation, and diathermocoagulation are used as minimally invasive surgical methods.

Sometimes conization of the cervix is ​​performed (removal of a cone-shaped area of ​​the affected epithelium using a radio wave knife) or electroexcision (removal of tissue using a special electrode). Such operations are performed if pronounced ectropion of the cervix is ​​complicated by dysplasia of the mucous membrane, that is, there are precancerous changes in it. In some cases, the shape of the uterus is corrected using plastic surgery.

If ectropion is detected in a pregnant woman, her condition is constantly monitored to prevent complications. An operation to eliminate the pathology is performed several months after birth.

Drug therapy

When carrying out drug treatment of inflammatory and infectious complications, antiviral and anti-inflammatory tablets (ciprolet, acyclovir, virolex), as well as suppositories (suporon, depantol, hexicon) are used. If necessary, antibacterial drugs (doxycycline, metronidazole) and antifungal drugs (Diflucan) are prescribed.

For hormonal disorders, therapy is carried out with agents that regulate the level of estrogen in the body. Among them are Diana 35, Yarina and others.

In order to eliminate the risk of damage to the cervix and the occurrence of pathologies in it, doctors advise preventing the onset of unwanted pregnancy by using suitable contraceptives. This will avoid abortions. If signs of gynecological diseases appear, you should immediately consult a doctor, especially if you are planning to conceive and give birth to a child.

Gynecological diseases are not fully understood by science. Some pathologies do not manifest themselves for a long time and pass without symptoms. Others bother a woman already at the initial stage.

From this article you will learn what it is - cervical erosion and ectropion, what are the similarities and differences between the diagnoses, what are the symptoms.

What is it, ICD-10 code

Erosion (ectopia,) is a change in the layers of epithelium lining the layer of the cervix on the vaginal surface.

This condition of organ tissue occurs in almost half of women of childbearing age. Erosion is associated with the transformation zone - the constant transformation of epithelial cells.

Under normal conditions, the cervix is ​​lined with a multilayer membrane with a flat structure. During the transformation process, this layer is replaced by a columnar type of epithelium.

Changes occur with the growth of reserve cells. This process is cyclical. In medicine, this transformation is called squamous metaplasia.

When examined on a gynecological chair, the doctor sees a change in the epithelial layer. The cervix turns red with erosion. Its structure with such changes is heterogeneous.

Modern doctors consider this condition a variant of the norm, because The epithelial layer is periodically renewed.

Ectopia is not considered a disease, therefore it is not registered in the International Classification of Diseases (ICD-10). The condition refers to a number of physiological characteristics.

Ectropion is a complicated form of erosion. The disease can be congenital or acquired.

With ectropion, inversion of the mucous membrane occurs in the canal of the lower part of the cervix. This condition is considered a pathology.

Complicated cervical erosion, like ectropion, requires treatment, disease code according to ICD-10 is No. 86.

What is ectropion and cervical erosion:

Differences and Similarities

How do the concepts differ:

There are common features between these conditions upon visual examination of a woman. The mucous surface is noticeably prominent in both cases and is covered with red heterogeneous foci.

Often, erosion and ectropion of the cervix are joint conditions, complementing each other. The reason for this phenomenon is the relationship of pathological processes associated with changes in the structure of the epithelium.

Symptoms

Both with erosion and with ectropion there may be no signs at all. The initial stages of changes in the epithelium are sometimes accompanied by slight deviations in well-being.

Symptoms become severe during inflammation or infection of the genital organs.

Signs of ectropion and ulcerated areas:

Consequences

Erosed ectropion - a complicated form of erosion. With it, the cervix becomes vulnerable.

Local immunity weakens. The risk of inflammation, infections, and cancer increases significantly. Therefore, the disease is dangerous for women.

Ectropion leads to the development of gynecological pathologies:

If a woman undergoes testing and treatment, the risk of complications is reduced.

Treatment

The choice of therapy depends on factors:

Removal of the pathological layer of epithelium is carried out in several ways:

Methods for treating cervical erosion:

If, after removing erosive foci, the vaginal area is deformed, plastic surgery is required. After it, the appearance and functions of the genital organs are restored.

In the treatment of ectropion, destructive methods of therapy are used.. assigned as an additional

The main direction is to restore the protective and reproductive functions of the cervix. For this purpose, drug therapy is used.

Depending on the degree of damage to the organ and the woman’s well-being, prescribe medications:

After eliminating the local inflammatory process, it is determined using colposcopy and cytological analysis.

According to the survey results There are several types of cervical injury:

• physiological;
• true erosion;
• ectropion.

When the damage is minor and associated with physiological processes, treatment is not required. The epithelium is gradually replaced.

True erosion is provoked by vaginal trauma. This often happens after childbirth. Contraceptive caps, douching, and forced sexual contact can provoke injury.

Minor ulcerations recover if the source of injury is eliminated. For quick healing, special ointments are used that are inserted into the vagina.

If ectopia is complicated by ectropion, drug treatment is prescribed as an adjunct. The removal method depends on the degree of damage and the presence of concomitant diseases.

Small areas of ectopia do not require treatment. Ectropion is removed surgically and combined with medication.

Removing ulcerations reduces the risk of cells degenerating into a malignant tumor. The pathology most often passes without any symptoms.

To prevent the disease from reaching a severe stage, a woman needs to regularly visit a gynecologist.

There are many pathologies of the genital organs that women face, and eroded ectropion of the cervix is ​​one of them. It is diagnosed in different age groups, both in young girls (as it can be congenital) and in women who have given birth (in the case of an acquired form). It is not prone, like erosion, to self-healing, therefore it requires treatment, which can be easily treated while preserving the reproductive function of the body.

Ectropion: what is pathology

By eroded ectropion of the cervix we understand a pathological phenomenon represented by the outward turning of part of the mucous membrane lining the inner surface of the cervical canal. This protrusion looks like an eroded surface (which is how the phenomenon got its name). Eversion can be bilateral or unilateral.

Attention! In medical practice, it is often mistaken for a complicated form of ectopia. But here you should understand an important nuance: with ectopia, partial replacement of the tissues of flat multilayered epithelium with cylindrical (covering the internal cavity) occurs in the area of ​​​​the junction of these layers at the outer pharynx of the cervix, and forectropionand the so-called “turning inside out” of part of the inner surface of the cervical canal is characteristic.

About the consequences and dangers of an anomalous phenomenon

When eversion occurs, mucosal cells enter an unusually acidic environment. This gradually leads to maceration (separation of cells due to the dissolution of the intercellular substance), which is accompanied by a decrease in protective functions. The inflammatory process can contribute to the development of:

• endocervicitis;
• leukoplakia;
• dysplasia.

Thus, eroded ectropion becomes a favorable basis for the development of precancerous conditions and, accordingly, a malignant process.

In gynecology, there are two forms of this pathology:

• simple;
• complex.

The second is accompanied by various inflammatory and infectious diseases of the reproductive system; it is more dangerous and requires longer, more complex treatment.

The causes of this pathology

The main cause of the formation of eroded ectropion on the cervix is ​​considered to be injuries resulting from abortion or childbirth. Tissue ruptures are a fairly common occurrence during the birth of a large fetus; mechanical damage to the mucous membrane is possible as a result of some manipulations used in obstetrics for obstetrics.

The second reason is considered to be hormonal imbalance. It leads to abnormalities at the cellular level in women who have never given birth and who have never had an abortion. This also explains disturbances in the formation of the system during intrauterine development of the fetus.

Symptoms indicating the development of pathology

In most cases, there are no symptoms with eroded ectropion of the cervix, and it is discovered only when visiting a gynecologist.

If we are talking about a complex form of pathology, then the complaints of patients can be very diverse, these are:

• the appearance of copious vaginal discharge (milky white, transparent);
• aching pain in the lower abdomen;
• menstrual irregularities;
• the presence of scanty bleeding between menstruation;
• itching in the genital area;
• pain during sexual intercourse.

Diagnosis of this pathology

The presence of eroded ectropion at the entrance to the cervical canal will be primarily detected by a gynecologist during a visual examination of the vagina using gynecological speculum. Then, this pathology must be differentiated from other phenomena (for example, pseudo-erosion, endocervix eversion), identify inflammatory and infectious processes, and check doubtful areas for dysplasia. Therefore, the diagnostic program includes:

1. colposcopy (detailed examination using a special optical device - colposcope);
2. scraping from the pathological surface for bacteriological examination;
3. cytological tests;
4. biopsy (with further histological examination of the material);
5. laboratory tests (including to determine hormonal levels).

For your information! The diagnostic program is compiled individually; if abnormalities are detected, it can be supplemented with other procedures and consultations with specialists (for example, an endocrinologist).

Modern methods of treating pathology

The main goal of treating eroded ectropion of the cervix is ​​to restore the anatomical structure, eliminate inflammatory and infectious diseases, normalize the microflora and prevent the development of cancer.

The chosen treatment tactics for eroded ectropion will depend only on the diagnostic results. In modern clinics, preference is given to minimally invasive and safe techniques aimed at preserving reproductive function. Among the methods of local surgery, choose:

• cryodestruction (the method is based on freezing pathological tissue with liquid nitrogen, which leads to its death);
• laser destruction (its essence is the removal of tissue with a high-intensity laser beam);
• diathermocoagulation (the technique is based on the impact of alternating current at high frequency on the pathological area);
• radio wave surgery (tissue removal is performed by exposing them to high-frequency radio waves).

For severe deformities, the following may be indicated:

• excision (deep removal of epithelial tissue);
• conization (cone-shaped removal of a segment of the cervix with eversion).

In addition to surgical intervention, eroded cervical ectropion requires a medical course of treatment. The patient is prescribed drugs that eliminate inflammation, antiviral and antibacterial. Hormonal levels must be adjusted (if abnormalities are detected). Additionally, you may need vitamins and medications that help strengthen the immune system.