Erosion of the cervix: symptoms and treatment
Cervical erosion is pathological, however, a benign process that manifests itself in the form of round formations of red color localized in the region of the mucous neck, the diameter of such formations can reach about two centimeters. Erosion of the cervix, the symptoms of which appear as characteristic formations, can exist in several varieties, being congenital erosion, erosion by true or pseudo-erosion.
First of all, it should be noted that cervical erosion is one of the most common diseases of female genital organs. The course of pathology is characterized by replacement due to the effect of a particular type of normal mucosal epithelial factors in the region under consideration by the cervical cylindrical epithelium.
As a rule, this disease does not represent significant threats, at least for the reason that erosion itself is a benign process, therefore, it can cause serious diseases, including tumors, in rare cases.
This disease occurs, which is also defined as cervical ectopia, in about half of women in the reproductive age group, while women who have passed through the age of forty do not appear. As for the opinion on erosion and its harmfulness in particular, it is somewhat common, but most experts consider it to be a series of normal physiologically variable states. Let’s consider the previously mentioned varieties of erosion in more detail.
Types of cervical erosion
Congenital erosion. The congenital variety of this disease consists in the displacement of the cervical cylindrical epithelium. There is congenital erosion in childhood or in adolescence, with the symptomatology of the disease mostly not manifested. Detection of erosion occurs in colposcopy, where the presence of a bright red region is detected, which is not amenable to staining when using Lugol’s solution. It is noteworthy that congenital erosion does not predispose in its own course to the subsequent development into malignant formations, and therefore treatment is usually not provided.
Erosion is true. With true erosion, its manifestations are localized in the area of the pharynx (on its outer side, in some cases — from the posterior side), it is much less possible to localize in the region Lips of the cervix. The true erosion is manifested in the form of a small, rounded area with a pronounced color, bleeding sometimes occurs. 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 of the order of 10-14 days, then the cervix is covered with epithelial cells belonging to neighboring sites. 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 section of pronounced red, in some cases it does not have a specific shape, the diameter can be several millimeters or several Centimeters. The surface of formation can be characterized by the formation of mucous secretions on it, which in some cases can be purulent. The duration of the course of this type of erosion can be a long time, which is determined by the specific features of the course of the inflammatory process that provoked it. The danger of pseudo-erosion lies in the possibility of recurrence, respectively, in this case the risk of cancer development is also great, which must necessarily be taken into account in treatment.
In addition to the main varieties of erosion, the following variants are also distinguished:
- Ectropion In this case, a kind of reversal of the cervical mucosa is implied, which occurs as a result of abortions or after childbirth.
- Endometriosis of the cervix Characterized by the process of transplantation to the cervical surface of the endometrium of the uterine cavity.
- Leukoplakia. It is characterized by cornification of a planar multilayered epithelium.
- Cervical polyps, cervical polyps.
- Genital warts.
Causes of the disease
- Mechanical injuries , resulting from gross and frequent sexual acts, as well as abortion, childbirth. With physical action, the multilayered flat epithelium begins to thicken, which leads to the subsequent formation of the inflammatory process.
- Sexually Transmitted Infections . Among such viruses are papilloma virus, genital herpes and other diseases.
- Incorrect and untimely treatment of genital tract infections .
- Early sex life, late onset of sexual activity .
- Rare sex, or, conversely, frequent partner changes .
- Actual violations in the hormonal status, irregularities in the menstrual cycle .
- Immunological scale changes (falling immunity) .
- The presence of inflammatory diseases, relevant for the pelvic organs (oophoritis, salpingitis, endometritis, etc.).
- A combination of some of these reasons.
The onset of the disease in elderly patients is possible because of the pressure of the uterine ring. In addition, there is also a «physiological» erosion, determined in women of young age (up to 25 years), which has a tendency to self-healing.
Cervical erosion: symptoms
The overwhelming majority of reported cases in women indicate that it rarely shows itself in the form of a specific clinical symptomatology, and therefore, in most cases, the diagnosis of the disease is made randomly. Meanwhile, it also happens that the treatment of patients to a specialist occurs on the basis of the following symptoms:
- bleeding not associated with menstruation, especially often occurring after intercourse;
- pain during intercourse
- purulent-mucous discharge (whose occurrence is explained by the attachment of the inflammatory disease to erosion, as a result of which it itself deteriorates significantly in the features of its own course), which women are often confused with menstrual secretions, thrush, or precursors of miscarriage in the case of pregnancy.
Diagnosis of cervical erosion
The diagnosis can be made already at the first visit to the doctor. Meanwhile, in many cases, visual inspection is only half the battle in diagnosing the disease. Therefore, patients will need to pass the following tests:
- a smear on the flora;
- Extended colposcopy
- cytological examination
- Diagnosis of PCR, focused on identifying the main types of infections (genital herpes, trichomoniasis, mycoplasmosis, etc.)
- blood test for hepatitis, HIV, syphilis
- bacteriological culture
- biopsy (if there is a suspected malignancy in the patient)
Treatment of erosion
The tactics of a treatment suitable for each particular case are developed individually, based on a variety of erosion and size, for it characteristic, including the presence of infections of a concomitant type. Thus, congenital erosion requires the conduct of dynamic observation, as a result of which its independent disappearance can be noted. In general, the treatment can be conservative or surgical, proceeding, again, from the specific features of the course of the disease.
Conservative treatment presupposes the elimination of the cause that caused erosion. Therefore, based on the concomitant disease identified in the patient, antibiotics with the broadest spectrum of action can be prescribed. Additionally, anti-inflammatory drugs and immunomodulators may be prescribed.
Local treatment of the cervix with drugs leading to chemical coagulation in the area affected. These drugs are used only with benign education, they are more suitable for nulliparous girls, since there is no scars in the cervical region during treatment, which is an essential advantage of the method. Its disadvantage is the possible recurrence of the disease, while it is applicable to any kind of erosion.
If the effect of conservative therapy is negligible or completely absent, then moxibustion is prescribed (which is the surgical method in this case). In addition, any of the following techniques may be used:
- laser destruction
With regard to such widespread proposals for folk remedies in the treatment of erosion, then to these experts are ambiguous — the effectiveness of any of the options in the treatment of erosion is not proven. Among the non-traditional methods of cervical erosion treatment, most often a certain effectiveness is noted with the use of acupuncture (acupuncture) and physiotherapy.
If there is an alarming symptomatology, which is especially important because of the predominantly asymptomatic flow of uterine erosion, it is necessary to consult a gynecologist.