One of the most common gynecological diseases that threaten the female body is cervical erosion. Sometimes the pathology of this body leads to serious complications, including oncology. To minimize the risk of dangerous consequences, timely professional treatment of cervical erosion is necessary. After detection of the disease, the doctor prescribes a complex therapy, which will help eliminate the pathological processes in the body and get rid of the causes that caused them.
What is erosion?
Many women do not know what erosion of the cervix is and how dangerous it is, and for the first time they hear about this disease in the gynecologist's office during examination. The danger of the disease is that it does not cause obvious painful symptoms, does not manifest itself at the initial stage, but during development it can lead to irreversible processes in the cervical canal. The term "erosion", which is widely used by doctors in medical practice, is not entirely accurate. It combines several diseases that differ in origin, manifestation, symptoms and subsequent treatment:
- True erosion. Pathology is a violation of the structure of the mucous membrane of the cervix, which is localized on the vaginal part of the organ. This is an ulcer or a wound, when examined by a gynecologist sees it with the naked eye. At the site of injury the squamous epithelium carpeting the cervical canal is absent. Recovery takes place within a couple of weeks if the factor that caused the damage is eliminated. If healing is not correct, cysts with mucus form at the site of the wound. They require immediate treatment.
- Ectropion. The disease is combined with true erosion in the international classification of diseases (ICD code 10 - 86). This erosion has the form of ruptures in the cervix due to birth injuries, abortions, etc. Ectropion causes inversion of the cervix, the mucous coating of the cervical canal is outside. The development of the disease contributes to chronic inflammation at the site of erosion. Pathology requires treatment, as it causes oncology.
- Ectopia. The cylindrical epithelium, which covers the cervical canal, sometimes goes to the vaginal canal of the cervix, causing erosion. In most cases, physiological ectopia in pregnant women and women who have not given birth to 25 years passes by itself. Pathological processes are caused by hormonal disruptions, and therefore require examination and treatment.
- Dysplasia. By this disease is meant structural changes in cervical cells, which are characterized by the presence of additional nuclei, changed in size. When the cell form changes, the division of the epithelium into layers disappears. Early treatment of dysplasia helps to avoid the development of cancer processes.
The emergence of eroded processes in the cervical canal of the uterus of a certain nature can provoke various reasons that the gynecologist determines during anamnesis, genital examination and additional research. Identification of the disease development factors will give the doctor the opportunity to prescribe the correct effective treatment. What causes cervical erosion:
- damages and injuries of a natural, mechanical nature (generic process, abortion),
- hormonal disorders,
- chemical exposures (improper use of chemical contraception, acid douching burn),
- reduced immune defense
- vaginal dysbacteriosis,
- inflammatory processes caused by STDs - herpes simplex virus, chlamydia, trichomoniasis, etc.
Symptoms of cervical erosion
The disease in most cases appears asymptomatic, thus cervical erosion and dangerous. Many patients do not go to the doctor’s office until serious complaints arise, so the pathology develops. However, there are several signs of the disease that women should not ignore and, if they appear, go to a gynecologist:
- after intercourse, the cervix may be bleeding, causing unpleasant sensations or bloody discharges,
- the secret of uncharacteristic color, having an unpleasant smell, changed texture,
- itching and burning,
- cramps when urine comes out.
All these symptoms are not specifically signs of erosion, but they often accompany the processes that caused it: inflammation, infectious diseases.
The preliminary diagnosis is made by the doctor when the patient comes to the examination. The specialist determines the erosion of the cervix by visual changes in the epithelium. After examination, the gynecologist prescribes additional diagnostic procedures that show the type of pathological changes and the degree of their development. Diagnostic methods for detecting cervical erosion:
- colposcopy (examination of the penis by a colposcope - a special device with an optical system),
- biopsy (removal of a piece of tissue from a suspicious area for examination under a microscope),
- smear on flora,
- cytology analysis,
- seeding microflora,
- blood tests for STDs, viral hepatitis.
Many women wonder if erosion of the cervix can pass by itself and what will happen if it is not treated. In some cases, the disease resolves on its own, if the patient has physiological ectopia or true erosion. The doctor decides on the need for treatment on the basis of the data obtained in the diagnosis. The treatment is surgical methods with surgical removal, medical drugs, folk remedies.
Diathermocoagulation is an operational method of treatment, which is cauterization of erosion sites by electric current. This procedure has a low cost, takes little time and is performed without local anesthesia. Its main drawbacks are the long-term healing of the burnt areas (up to three months), injury to healthy epithelium sites, the occurrence of scarring.
Complications of diathermocoagulation are expressed in the fact that the cervix may bleed, as well as a high risk of infection and recurrence of erosion processes, if the affected area is not completely removed. The procedure is not carried out during erosion in births, since after diathermocoagulation often appear defects - scars on tissues, which can significantly complicate childbirth.
During the operation of cryodestruction, low temperature liquid nitrogen acts on the affected areas of the cervix. The advantages of the procedure are short duration, healthy tissues around erosion are not injured or injured minimally, the absence of serious complications with properly performed cryotherapy. After freezing the damaged cells, they completely leave the body within a few months.
The duration of the procedure is half an hour. After surgery, the risk of infection is low, the cervix does not bleed due to short-term thrombosis of cold-spasmed vessels. This method can be used to treat erosion in unborn women: no scarring is formed in the cervical canal, the tissues retain elasticity, which does not prevent the patient from healthy natural delivery.
Laser treatment of cervical erosion is a new procedure that allows point effect on the affected areas of the epithelium. During the operation, the women do not hurt, it lasts about twenty minutes. The laser light beam evaporates eroded areas without affecting living tissue. The treatment procedure is carried out at the initial stage and in patients with advanced erosion.
Advantages of vaporization - painlessness, short duration of the operation, accurate removal of damaged tissues of small and large size, low risk of edema, no rough scars. The recovery period takes up to two months - the length depends on the age, health condition of the patient, lifestyle. After vaporization, medical supervision is required.
Radio wave method
Radiowave treatment is carried out using a special radio knife "Surgitron". High-frequency radio waves help to cure erosion without contact, evaporating damaged epithelial tissue. The advantages of the method are a point effect on the operated tissue without damaging healthy ones, the absence of scarring after the operation, the antibacterial effect, a painless and short-term recovery period (one and a half months). Preparation for surgery includes confirmation of the diagnosis, bringing the vaginal environment back to normal, treating inflammations, restoring immune protection.
Chemical coagulation is a common method of treating a disease of erosion. During the operation, mixed acids are used by the doctor (“Solkovagin”, “Vagotil”). The gynecologist applies the mixture to the damaged areas using a colposcope. Acids destroy the surface cell layer, on the site of which healthy tissues are then formed. Dead cells depart in a few days.
Coagulation with chemicals does not require anesthesia, has a low cost, it is used in the presence of polyps, different types of hyperplasia. However, the operation has low efficiency, has the possibility of damage to healthy tissue, the risk of recurrence, scarring, pregnancy complication. The procedure is carried out only for small sizes of erosion.
Drug treatment of cervical erosion with drugs
Drug treatment of cervical erosion includes a wide range of drugs that act on eroded sites and help to cope with the causes of the disease. In order to cure the pathology, used ointments, suppositories, medications in the form of tablets, tampons, douching. Taking medicine, the duration of the course is prescribed by the doctor after an accurate diagnosis. The names of candles, ointments, tablets and other drugs that are used in the treatment of erosion:
- Miramistin (analogue - Chlorhexidine). Topical antiseptic. In gynecology for the treatment of erosion is used in the form of a solution for tampons or douching. It has antimicrobial, antiseptic, bactericidal, antifungal effects.
- Malavit. Naturopathic drug. It is used in the form of ointment, has antipruritic, analgesic, anti-edema action. Used as an additional tool in the treatment of cervical erosion.
- Epigenes. The active ingredient is glycyrrhizic acid. Epigen-spray of local intravaginal (for the treatment of erosion) use has antiviral, immunostimulating effects. The drug relieves itching and inflammation, heals.
- Hydrogen peroxide. Used to disinfect damaged tissues in the form of a solution for douching. It has a depressant effect on fungi, viruses, bacteria that could cause a disease or get hurt.
- Depantenol. In the treatment of eroded areas using a tool in the form of candles. The drug disinfects, regenerates, is effective against infections. It is applied after surgery, during the treatment of true erosion.
- Spray Chlorophilipt. The drug is a local action, is used inside the cervix with the application on a tampon. It regenerates wounds, breaks, relieves inflammation.
- Solcoseryl. For the cervical canal of the uterus is used in the form of ointment or jelly dissolved in the bath. It is prescribed as rehabilitation therapy after chemical coagulation.
- Vishnevsky ointment. The drug dries, stimulates the regenerative processes of tissues, softens. For treatment of the cervix, a portion of the ointment is applied to the swab and inserted into the vagina.
Treatment of folk remedies
Treatment of cervical erosion using folk remedies is the best way to get rid of the disease. Before therapy, the patient should be examined by a doctor, who will determine the type of erosion and give recommendations. Treatment with folk remedies is carried out under the supervision of a gynecologist in order to avoid complications. This type of therapy received a lot of positive feedback from patients. Treatment methods eroded areas of the cervical canal folk remedies:
- Sea buckthorn oil to relieve inflammation. Recipe: means is applied on a tampon, which is inserted into the vagina at night. Retrieved in the morning. A plus method - no need to conduct douching with water to get rid of oil residue. The agent remaining on the walls of the cervix continues to heal. In order not to dirty clothes, it is advisable to use pads. The duration of treatment is 60 days, tampons are used 2 weeks after the end of the cycle.
- Mumie from inflammation. Recipe: 2.5 grams of the substance dissolved in half a glass of water, put on a tampon. Treatment is similar to treatment with sea buckthorn oil.
- Propolis for rapid healing of erosion. Recipe: 10% propolis ointment placed on a swab. It is applied in the same way as sea buckthorn oil. The tool helps to heal the epithelium, activates regenerative processes, improves the nutrition of damaged areas, improves immunity.
- Honey for tissue regeneration. Recipe: in the ratio of 1: 1, mix honey with water, put on a tampon, leave overnight. The course of treatment is 2 weeks.
- Calendula Flower Treatments and herbs for inflammation, germs, bleeding. Recipe: Mix in two tablespoons in equal part flowers of calendula, chamomile, yarrow, pour a half cups of hot water. Wait 2 hours, use the resulting solution for douching. Douching is carried out in the morning, once a day, except for the days of menstruation.
In women, there should be no doubt about the question - cervical erosion: is it dangerous? The development of the disease leads to difficult childbirth, oncology, complicates intimate life. Preventive measures help to avoid the occurrence of pathological structural changes in cervical cells and relapse after treatment. Prevention of genital organ disease:
- personal hygiene (must be observed by a woman and her sexual partner),
- the use of contraceptives with new sexual partners to prevent STDs causing erosion,
- avoid frequent change of sexual partners (such a way of life leads to a change in the microflora of the vagina, the risk of infection increases)
- examinations by a gynecologist of a planned nature (every six months or more often),
- unscheduled trips to the doctor if unpleasant painful symptoms are present.
Doctor's advice will help patients with cervical erosion to conduct effective treatment of the disease. The correct approach to treatment speeds up the healing process, avoids complications, improves overall health during the recovery period, if an operation is performed. Recommendations of gynecologists for women suffering from cervical erosion:
- Do not delay the prompt and medical treatment of erosion, if the doctor insists on it,
- Strictly follow the rules for taking medications,
- Increased attention to personal hygiene,
- Do not ignore the symptoms (itching, secret with an unpleasant smell),
- Reduce sexual contacts for the period of therapy.
Types of erosion and their symptoms
The term "erosion" (lat. "Corrosive") combines a group of diseases of the cervix with similar external manifestations. Classify them as follows:
- Pseudo-erosion (ectopia) is the replacement of the flat epithelium of the vaginal part of an organ with a cylindrical one, characteristic of the inner surface of the cervical canal. The color of the pseudo-erosion surface is bright red, resembling an open wound. It differs markedly from the color of the vaginal mucosa. Pathology can be congenital or arising under the influence of any factor. Ectopia is often asymptomatic and is detected only during a gynecological examination. The need for treatment and adequate methods are determined by the doctor individually.
- True erosion is the destruction of the squamous epithelium covering the vaginal part of the cervix. It is an open wound surface, can bleed and cause pain. In addition, the damaged area becomes a place of accumulation and reproduction of pathogenic microflora, so the disease is often accompanied by whitening - purulent vaginal discharge. Congenital true erosion can not be, it develops during life under the influence of damaging factors. Depending on the type and cause of tissue damage, several subspecies of true erosion are distinguished: specific, cancerous, traumatic.
These pathologies differ in their nature, treatment methods, and prognosis. Combine them because of the similar appearance. During a gynecological examination, both varieties look like patches of bright red color around the cervical canal.
The main causes of the disease
The list of factors provoking the development of true erosion is quite extensive. The disease often leads to:
- Hormonal disorders. Malfunctions of the endocrine system, chronic imbalance of sex hormones in the body contribute to the development of various diseases of the reproductive system, including true erosion.
- Mechanical damage. Surgical interventions, abortions, childbirth, the use of the intrauterine device, rough sexual intercourse and other effects injure the mucous membrane and lead to the destruction of the epithelial layer.
- Chronic female inflammatory diseases.If untreated, they progress and negatively affect the state of the neighboring organs. Therefore, against the background of chronic endometritis, colpitis, endocervicitis and other inflammations in the reproductive system often develops a complication in the form of true or pseudo-erosion.
- Sexually transmitted infections. Conducting promiscuous sex life, frequent changes of partners lead to infection with dangerous microorganisms. Chlamydia, trichomoniasis and other STDs often cause erosion.
- Genetic predisposition. The presence of the disease in close relatives in the history indicates an increased risk of manifestation of this pathology.
- Weakening of general and local immunity.
True erosion develops under the influence of one or more of the factors listed above. The occurrence of ectopia is usually associated with the impact of these same reasons. However, medicine cannot yet give an unambiguous answer as to why, in the vaginal part of an organ, the flat epithelium is replaced by a cylindrical one. Disputes on this issue are still ongoing.
True cervical erosion
True erosion is the destruction and rejection of flat multi-layered epithelium. At the same time, the lower - subepithelial layers are exposed, forming an open wound surface. The reasons for the development of true erosion are different - it can be mechanical damage, hormonal failure, infection. Often the disease is associated with endocervicitis - inflammation of the internal canal of the cervix.
Symptoms of true erosion
The symptomatology of the disease depends on the degree of damage to the epithelium, the vastness and depth of the mucosal defect:
- A small true erosion can in no way manifest itself and be discovered by chance.
- If the cervical tissue is significantly affected, the disease may be accompanied by bleeding, pain, which increases after sexual intercourse.
- In the presence of infection, symptoms of inflammatory processes may appear - purulent vaginal discharge, fever.
Timely detection can cure the disease quickly and with minimal effort. Therefore, even in the absence of warning signs, it is necessary to regularly visit a gynecologist for a routine examination.
Treatment of cervical erosion
The methods of therapy in each case are selected by the doctor individually based on the results of examinations and the clinical picture as a whole. Only a doctor can determine if a medical treatment for cervical erosion is sufficient or if surgery is necessary.
Pathology rarely develops in isolation, so it is necessary not only to eliminate the defect of the epithelium, but also to treat comorbidities, to exclude the cause, to restore the normal microflora of the vagina.
If true erosion is small, uncomplicated and does not pose an oncological threat, local conservative treatment gives a good result. For healing of the damaged epithelium, vaginal tampons soaked with healing compounds (ointment, sea buckthorn oil, fish oil or other means at the discretion of the doctor), vaginal suppositories, and douching are prescribed.
In addition, physiotherapy, antibiotics (in the case of the infectious nature of the disease) are used for treatment, and, if indicated, antifungal and antiviral agents.
In addition to restoring the integrity of the mucous membranes, it is necessary to treat other existing diseases, to take measures to improve immunity and improve overall health. An integrated approach will speed up tissue regeneration and prevent relapses.
If conservative treatment methods fail, the disease is neglected or there is a threat of oncology, there is a need for more radical ways to solve the problem. In such cases, resorting to various types of cauterization of the modified mucous area:
- Diathermocoagulation - exposure to high frequency current. This method is widely used in public clinics in the territory of the Russian Federation.
- Cryodestruction - freezing of damaged epithelium using liquid nitrogen. Within a month after the procedure, the death of the treated fragment and the renewal of the mucous membrane occur.
- Laser therapy - leads to the formation of a small burn that heals quickly.
- Radio wave treatment - the destruction of damaged cells using radio waves. This method does not require anesthesia, does not provoke the formation of scars, so it is recommended to women who have not given birth.
- Chemical coagulation (treatment with caustic chemical compounds) or excision of damaged tissues with an electrocautery is extremely rarely used.
Various pathologies of the cervix uteri are a common phenomenon, therefore the methods of their treatment are constantly being improved and replenished with new developments. If no malignant changes are found, the prognosis for true erosion is positive. However, after successful therapy it is necessary to follow a number of rules to avoid relapses.
Provocative factors for the development of the disease
In the role of factors that are not direct etiological causes, but significantly increase the risk of developing pathology, are:
- early intimacy, when the complete formation of all cellular structures did not take place (incomplete maturation of the mucous membrane), and hormonal balance was not established,
- primary and secondary immunodeficiencies,
- diseases accompanied by an imbalance of hormones
- inadequate hygiene of the genitals.
Cervical erosion, the causes of which can be both external (trauma) and internal (infection) is most common in those women who are most exposed to the above mentioned predisposing factors.
Having an idea of what erosive damage is, one should pay attention to the types of the pathological process. So, depending on the reasons for the appearance and nature, all damages to the lining of the uterine cervix can be divided into 2 large groups:
- true erosion - violation of the integrity of the normal epithelium,
- pseudo-erosion or ectopia - characterized by abnormal (not necessarily pathological) development of mucosal epithelium. That is, there is some shift in the border zone between the epithelial cells lining the uterine canal (here it is single-layered) and the epithelium that is located on the surface of the vaginal part of the neck (multi-layered). In many cases, ectopia does not constitute a danger, but is the normal physiological condition of women at different age periods of life.
Sometimes you can find the concept of congenital erosion of the cervix. In this case, we are also talking about ectopia, which does not have a negative impact on the health of the woman.
Among all true erosion, several groups of pathological processes can also be distinguished, the causes of which can also vary from hormonal disruptions to mechanical damage. These include:
- endometriosis - displacement with superposition on each other of the cytological structure of the cells of the uterus and cervical canal,
- ectropion - the displacement of the epithelial zone, which lines the mucosa of the cervical canal into the cavity of the vagina. It is a consequence of intense mechanical stress (late abortions, severe complicated labor activity)
- leukoplakia - hardening of the epithelium on any of the sections of the mucous membrane,
- polyps and condylomas of viral genesislocalized in the area of the cervical canal.
As for pseudo-erosions, they are classified according to their appearance depending on the type of growth:
Symptoms of cervical erosion may vary depending on its specific type and location.
Conservative treatment of true erosion is based on the use of antibacterial drugs that have a detrimental effect on the selected microorganism in the presence of infection. Parallel administration of drugs that restore the natural microflora is considered mandatory. These include products containing lacto-and bifidobacteria.
Surgical treatment of the erosive process is prescribed in the period corresponding to the first week after the end of menstruation. This is due to the fact that any operation should be carried out in the most clean conditions.
Before any surgery on the cervix (as well as on any other organ of the reproductive system) are required to clarify: the good quality of the modified area, the presence of concomitant diseases.
The main methods of radical treatment of the disease are:
- diathermocoagulation - The most effective method to guarantee the complete removal of erosion (sometimes after repeated procedures). Its essence lies in cauterizing the affected area of the mucous membrane with an electric current. The disadvantages of diathermocoagulation are considered to be an aggressive effect on the mucous membrane, which leaves behind cicatricial changes, which subsequently can prevent the onset of pregnancy and complicate childbirth. The uterine cervix loses its physiological elasticity, the risk of ruptures increases,
- chemical coagulation - this method produces cauterization of the eroded area with a chemically aggressive substance. Most commonly used Solkovagin. This type of coagulation is used for erosion of a small size and mainly in nulliparous young women. The disadvantages of the technique are: the lack of a 100% guarantee of complete recovery, as well as a long course of treatment consisting of several procedures,
- laser therapy - One of the most popular methods of treatment, which is a priority for young women who are planning a future pregnancy. The big advantage is the absence of changes (cicatricial or adhesive) at the site of exposure,
- cryotherapy - removal of erosion by burning it with liquid nitrogen. Manipulation is practically painless and can cause only mild discomfort. The rehabilitation period lasts 1 month. At this time, the patient should completely eliminate sexual contact and physical activity,
- radio wave radiation - the most gentle method of exposure that does not require direct contact with the body. In this case, the radio wave is sent to the changed area, which completely evaporates the damaged layer of epithelial cells. The rehabilitation period lasts about 1 month,
- electro excision - complete excision of the neck with a special electrocautery. Applies only if the disease becomes malignant.
Treatment of cervical erosion by surgery in nonpartum women of reproductive age should, if possible, be delayed until pregnancy and childbirth. This is due to the fact that, after a radical method of exposure to a defect, the risk of developing secondary tubular dysfunction, functional inferiority of the cervix and, as a result, infertility increases. It can also significantly prevent the formation of scars and deformities on the uterine cervix at the site of erosion removal.
In addition, the operated erosion of the vagina and cervix can cause premature birth even during pregnancy.
Nontraditional (folk remedies)
Regardless of the cause of cervical erosion, each patient should be given a comprehensive treatment. The use of traditional medicine recipes is also possible after prior consultation of a qualified specialist.
Currently, the most widely used tools such as:
- sea buckthorn oil, which are moistened with gauze tampons and inserted deep into the vagina before bedtime. Sea buckthorn oil has a pronounced anti-inflammatory and antibacterial effect, and also prevents further growth of the damage zone. Apply the product for 1-1.5 weeks,
- mummy, which is also soaked with tampons and introduced into the genital tract. The course of treatment is 7-10 days,
- a mixture of herbs - in equal proportions, mix oak bark, chernobyl grass, birch leaves, chamomile flowers, eucalyptus leaves. 2 tbsp. tablespoons chopped mixture pour 500 ml of boiling water, let it brew for 2 hours under the lid, strain it thoroughly. The resulting infusion is used for douching the vagina twice a day. The course of treatment is 1-2 weeks.
With regard to dietary nutrition during erosion, it is recommended to exclude sweets, flour products, gluten-containing products, marinades and citrus fruits. The daily diet should be enriched with fiber-containing foods, biokefir, yogurts with live lactic acid cultures.
Prognosis for patients
The prognosis for erosion is favorable if it is diagnosed in the early stages of its development and treated promptly. Dangerous erosion in women of any age due to the fact that it is a favorable (provoking) factor for the development of malignant education in this place. In addition, cystic cavities, scars, polyps form very quickly at the site of injury, which further complicates the possibility of the desired pregnancy.
That is why it is extremely important to engage in the treatment of erosion immediately after the detection of the disease.
Biopsy of cervical erosion
This method is considered highly accurate and informative. It allows you to confirm the diagnosis and exclude malignant changes at the site of erosion itself. As practice shows, cervical erosion biopsy in 9 out of 10 patients confirms the diagnosis. It also helps to detect precancerous conditions in time.
In the course of its implementation, a microscopic piece of cervical tissue is taken from a woman for a histological examination. It allows you to accurately determine the state of cells in the pathological area, the presence and type of infectious agent. A biopsy makes it possible to confirm or refute the gynecologist's suspicions for various diseases, signs of which he could not recognize during colposcopy.
note: biopsy of the cervix is not performed for problems with blood clotting and inflammatory processes in the vagina in the acute stage. The procedure itself does not require anesthesia, because the cervix has no pain receptors. Anesthesia is performed if necessary to take a large amount of material and in cases where a woman has a low pain threshold.
Cauterization of cervical erosion
This procedure is properly called diathermocoagulation. It is based on the impact of electric current on the pathological focus on the neck. At the same time, a burn is formed at the site of impact, and then a scar.
In advanced cases, they resort to diathermoconization - the complete removal of the affected tissues. This procedure is most popular, because the equipment for its implementation is available in almost every antenatal clinic. This also makes it affordable. A significant disadvantage of such erosion treatment is pain during the procedure and unpleasant cramping contractions of the uterus. After cauterization for 4 weeks, discharge of different nature, pain in the lumbar region may occur.
The procedure is advisable to carry out only in the case of pseudo-erosion, when there is a substitution by the multi-layered cylindrical epithelium. Therapy of true erosion by cauterization will be very painful and can provoke complications.
Do cauterization physicians say a number of advantages, thanks to which it has been popular with women for many years. These include:
- good performance (in more than 90% of cases, erosion is cured),
- ease of implementation,
- affordable cost of the procedure.
Among the shortcomings and complications of the procedure arerizhiganiIcervixcelebrate:
- difficulty opening the cervix during labor
- possibility of bleeding,
- exacerbation of inflammatory diseases,
- inability to endure a child.
Today, there are a number of alternative modern methods that are not only less traumatic, but also less painful for a woman, which allowed them to move the cautery away. In addition, this method is prohibited for use in non-giving women because of a number of complications observed after conducting diathermoconization.
Radiowave treatment of cervical erosion
This is a new technology, which is the use of a radio wave knife to remove erosion. Its distinguishing feature is the non-contact treatment of the pathological area on the cervix. Radio waves stimulate the inner cellular energy, resulting in destruction and direct vaporization, that is, the evaporation of abnormal cells.
The procedure itself lasts no longer than 15 minutes and does not bring any painful sensations. Scars after treatment with radio waves does not happen, only the allocation of ichor can be observed. Full healing occurs a month after the session. This method is recommended for women who have not given birth.
Indications for radio wave treatment for cervical erosion are as follows.:
- cervical dysplasia,
- pseudo-erosion of congenital nature,
- erosion in combination with infection (staphylococcal, chlamydia, fungal, viral damage, etc.),
- papillomas, condylomas, polyposis.
Contraindications to the use of this technology are such states:
- inflammatory processes in the pelvis in the acute stage,
- наличие имплантированного кардиостимулятора.
The main advantage of this technique is the ability to remove erosion without damaging the muscle structure of the cervix, which in the future will prevent ruptures of the cervix during labor. It will also minimize the risk of recurrence.
Among the advantages of radiowave treatment, cervical erosion is:
- high precision impact
- pronounced bactericidal effect, making treatment effective even in advanced cases,
- the speed of treatment
- restoring the structure of the cervix without scarring in short lines,
- painless postoperative period.
The disadvantage of this technique is only one - the cost, which is relatively higher than the usual cauterization. But given the almost 0% probability of recurrence of erosion after cauterization using radio waves, and the absence of possible complications, the price justifies itself.
You can get more detailed information about the radio wave method of treating cervical erosion by viewing this video review:
Laser treatment of cervical erosion
This procedure is called laser vaporization. This is the most modern method of treating cervical erosion to date, allowing you to radically get rid of the problem. It is important that the procedure is performed by an experienced and qualified doctor. Laser treatment is harmless and absolutely safe.
The equipment for this procedure is quite expensive, so it is not offered in every clinic. The essence of manipulation is in evaporation of unhealthy cells in the area of erosion on the cervix. The high-frequency laser beam sighting directly affects the pathological area, and the process itself is controlled by a video colposcope up to a millimeter of depth of destruction.
General anesthesia is not required, only local anesthesia is performed. The procedure is performed on the 7-9 day of the woman's menstrual cycle, after which it takes a month to heal, there are no scars after laser therapy.
The procedure can be carried out to women who have not given birth, because it does not have negative effects on the cervix during labor. That is why most often it is prescribed to young girls.
Laser treatmentapplicable to erosion if present:
- endometriosis localized on the cervix,
- cervical dysplasia (1.2 tbsp.),
- scar changes on the neck,
- nabot cysts in the plural,
- polyps located at the bottom 1/3 of the cervicum,
- cervicitis (chronic and acute stage), with a lack of effectiveness of conservative therapy.
It is not used if the patient has such conditions.:
- early and late postpartum,
- inflammation of the cervix and other organs of the reproductive system,
- cervical cancer and any other malignant processes of the uterus.
The advantages of laser therapy for cervical erosion are::
- painless procedure,
- high efficiency,
- minimal risk of complications
- lack of scars on the cervix,
- rapid healing of the eroded surface.
The disadvantages of laser treatment include its cost as well as the likelihood of a relapse, although it is rather low.
Advantages and disadvantages of treatment with candles
Benefits of Erosion Candle Therapy:
- contact erosion treatment,
- rapid restoration of the surface epithelial layer,
- rapid healing of small wounds and ulcers on the neck,
- evenly spread on the neck of the active substances, enveloping her,
- clear the vagina from pathogens,
- do not have a traumatic effect.
The disadvantages of treatment with candles are their effectiveness only in the initial stages of erosion and in complex therapy after different types of cauterization. As an independent method, they do not give the expected result.
Features of the disease
Cervical erosion is a fairly common phenomenon: it is diagnosed in about half of women of reproductive age. This disease is a defect in the epithelium covering the vaginal part of the cervix. Doctors distinguish two types of this disease. The first is pseudo-erosion. It occurs when normal cells that cover the cervix change at a certain location, which usually occurs as a result of inflammatory diseases or hormonal disorders. True erosion occurs when a portion of the mucous membrane of the cervix is destroyed and a wound forms in its place. The causes of erosion can be several: mechanical injuries (as a result of childbirth, abortion), thermal or chemical damage (often as a result of home-grown contraception), sexually transmitted infections, the same hormonal disorders.
To treat or not to treat?
In the part of the cervix where erosion has occurred, inflammation caused by pathogens can begin. The inflammatory process, in turn, can move to other internal genitals of the woman. And the most serious danger lies in the fact that long-existing erosion, if not treated, can degenerate into a tumor. However, before proceeding with the treatment, it is necessary to pass the necessary tests and find out if the woman has sexually transmitted diseases. If they are found, you should first get rid of them and only then proceed to treatment. If erosion of the cervix is found during pregnancy, it is usually only observed, and treatment immediately after childbirth.
What is cervical erosion
The cervix is an organ (a cylindrical cavity filled with mucus) that is the channel that connects the vagina and the uterus. The mucous membrane of the cervix consists of a prismatic epithelium in the cervical canal and squamous epithelium on the side of the vagina. Cervical erosion is the formation of small ulcers on the mucous membrane.
Experts identify two types of erosion: pseudo-erosion and true erosion. The first happens in young women with high levels of estrogen in the blood, the essence of the condition is that the prismatic epithelium extends beyond the canal of the cervix. The second is a wound in the form of a red spot on the light pink mucous membrane.
If cervical erosion is suspected, the doctor will prescribe laboratory tests, the main purpose of which is to assess the depth of uterine epithelium damage. The survey includes:
- blood test for hormone levels
- cytological and bacteriological studies,
- colposcopy (studies the depth and structure of the epithelium lesion),
- biopsy (in case of suspicion on the degeneration of epithelial cells).
Types of erosion and their symptoms
The cervix is the lower conical part of the uterus that extends into the vagina. The canal itself is covered from the inside by an epithelium with cylindrical cells. Here are the glands that produce mucus that moisturizes the vagina.
The pharynx of the cervix (the area that goes into the vagina) is covered with a different type of epithelium, with flat cells. Erosion occurs on this site and is a violation of the structure of the mucous membranes.
Depending on the nature of the changes, there are two types of cervical erosion.
Pseudo-erosion, or ectopia
Caused by the displacement of the cylindrical epithelium in the vaginal region of the cervix. The mucous membrane is not damaged. Pseudo-erosion, as a rule, does not require treatment. This condition is congenital, the defect disappears on its own by about 20 years. Often, there is an inversion of the cervical canal, when its mucous membrane is outside. This is called ectropion. It can also exist from birth, but it can also be acquired.
Pseudo-erosion is detected during a gynecological examination visually. A sign of ectopia is a red ring (may have an irregular shape) around the opening of the cervical canal. The width of the rim comes to several centimeters. The ectopic site is clearly visible against the background of the surrounding pale pink vaginal surface.
Usually, in order to make sure that it is pseudo-erosion, the throat area and surrounding tissues are covered with Lugol solution (a mixture of iodine, potassium iodide and water). At the same time, the surrounding tissues darken, while the ectopic site remains red.
Note: Pseudo-erosion often turns into true erosion, when factors affecting the mucous membrane affect the cervix. This can happen even to a little girl, if due to poor care or infection in the vagina an inflammatory process occurs.
What is dangerous erosion
The cervix plays the role of an obstacle to the penetration of pathogens into the uterus. It produces thick mucus, which has an acidity that is detrimental to them.
As a result of cervical erosion, the glands that produce this mucus are damaged. Conditionally pathogenic microbes are found in the vaginal microflora, which under normal conditions do not harm the body. But with a weakened immune system, a violation of the acidity of the vagina, the infection easily penetrates into the internal organs. At the same time, inflammatory processes occur in the endometrium, tubes, ovaries, resulting in even infertility.
A damaged mucosa sometimes blocks the entrance to the cervical canal and makes it impossible for sperm to enter the uterus. As a result, conception becomes impossible.
Cervical erosion does not turn into cancer, but it sets the stage for tissue regeneration. Chronic inflammatory processes lead to the appearance of scars, the formation of cystic cavities, polyps. At the same time, the possibility of pregnancy becomes difficult, the risk of its termination or premature delivery increases. In addition, atypical and then cancer cells can appear at the site of benign neoplasms. Especially high risk of cancer when infected with human papillomavirus.
Therefore, it is imperative to be treated for erosion, avoiding such complications. First of all, it is necessary to get rid of its causes: infectious and inflammatory diseases.
Erosion during pregnancy
If, planning a pregnancy, a woman undergoes a gynecological examination and cervical erosion is found in her, the doctor determines the need for treatment individually. In the absence of the threat of infertility and symptoms of inflammatory and infectious diseases, the condition is simply controlled.
If erosion is found in a pregnant woman, then treatment is also carried out after delivery, as the disease does not affect the course of pregnancy and the condition of the fetus. Symptoms of erosion in a pregnant woman can be impurities of blood in the discharge, as well as burning and itching during intercourse. Damage and thinning of the cervical mucosa causes ruptures at birth. In some cases, after the baby is born, signs of erosion disappear. If this does not happen, the symptoms of erosion intensified, then it is usually cauterized to prevent complications.
One of the most important factors affecting the state of the mucous membranes of the genital organs, including the uterus, is the ratio of sex hormones. In women of reproductive age, hormonal processes in the body take place with maximum activity, therefore, a violation of the state of the epithelium occurs most often.
With the onset of menopause, the production of estrogen and progesterone in the body gradually decreases, so erosion does not occur. Chronic erosion that existed before, with the onset of menopause disappears.
Causes of true cervical erosion
The reasons for true erosion of the cervix are somewhat diverse, and in order to prescribe an effective therapy, the specialist must present a complete clinical picture of the disease, only this way you can decide on the "provocateur" of the disease. Doctors distinguish between acquired and congenital cervical erosion. As the name implies, congenital pathology is a disease with which a person has already been born. But on the pages of this article we will try to deal in more detail with the (true) cervical erosion acquired in the process of life.
So what can lead to true cervical erosion?
- The consequence of inflammation caused by such invasive microorganisms as streptococci, gonococci, herpes virus, chlamydia, ureaplasma, yeast fungi, human papilloma, staphylococcus, trichomonads.
- Cervical injury to the cervix (cervix uteri, cervix), obtained during obstetric aid, abortion or surgical intervention, can provoke this pathology. Trauma may also be due to too young or late childbirth. Other factors can trigger injury.
- Endocrine diseases.
- The cause of the disease can be transferred colpitis (inflammation of the mucous walls of the vagina, of various origins).
- Early or, on the contrary, rather late onset of sexual activity.
- Irregular sexual relations.
- Multiple, frequently changing partners.
- Vaginal dysbiosis.
- Hormonal failure in a woman's body: ovarian dysfunction, failure of the menstrual cycle, and so on.
- Immune disorders.
- Endocervicitis is an inflammation of the mucous membrane of the cervical canal of the uterus, accompanied by enhanced secretion of the glands of the cervical epithelium.
- Endometritis is an inflammation of the inner layer of the uterus. As a result, discharge from the cervical canal begins. If this process takes quite a long time, the outer layer of the epithelial lining begins to soften and peel off. This process has a specific name - desquamation. During these changes, after the peeled epithelium, a wound remains on the mucous membrane.
- Collapsing polyps. The process of formation of erosion is similar to the previous one. Destroyed, the dead cells leave the uterine cavity in the form of pathological secretions. Erosion is essentially an “open gate” that allows pathogens to freely enter the body.
- Myoma nodes
Treatment of true cervical erosion
The principle of any therapy is the elimination, if possible, of the original source of pathological manifestations. Treatment of true erosion of the cervix also responds to this postulate. That is, if the disease was caused by damage to the mucous membrane by invasive negative microflora, the task of therapy is to destroy the infection and anti-inflammatory therapy.
In this situation, antibiotics and antiviral drugs are introduced into the treatment protocol, for example, such as:
Antibiotics, macrolides: pefloxacin, roxithromycin Lek, rovamycin, abactal, doxycycline and others.
Roxithromycin Lek appointed by the attending physician for oral administration. Adult patients and children who are already 12 years old and their body weight is more than 40 kg, the daily dosage of the drug is determined to be 0.3 g twice during the day (0.15 g every 12 hours) or once a day with dosage 0, 3 years
If the patient also suffers from severe liver and kidney dysfunction (creatine clearance below the level of 15 ml / min), then the dose of the drug administered is reduced twice and is 0.15 g once a day (every 24 hours). The duration of the therapeutic course is determined by the doctor depending on the severity of the lesion. On average, it takes from one to two weeks.
Contraindications to Roxithromycin Lek include individual intolerance to the components of the drug, porphyria (a hereditary disorder of the pigment metabolism with an elevated content of porphyrins in the blood and other tissues of the patient's body) or the first trimester of pregnancy.
Pefloxacin must be taken with meals. The tablet is swallowed whole. Adolescents after 15 years and adult patients are prescribed a dosage of 0.8 g per diem divided into two doses. In the case of therapeutic need, the amount of drug administered can be doubled to 1.6 g per day. During the period of pefloxacin therapy, one should avoid exposure to ultraviolet rays (reduce exposure to direct sunlight).
You should not prescribe the drug if the patient has a history of lack of glucose-6-phosphate dehydrogenase, liver dysfunction, hypersensitivity to the drug's component components, as well as if the woman is pregnant or breastfeeds the newborn, children under 15 years old.
Used in the treatment of true cervical erosion antiseptics and antimicrobials: Candida, acylact, clindacin, metagin, nystatin, clotrimazole, trihopol, dellacine and many others. The purpose of a particular drug depends on the recognition of a specific pathogen of pathology.
Candide vaginal tablets are used topically and are introduced deeply intravaginally. The drug is introduced into the vagina, lying on his back and bending his knees. A single injection of 0.5 g of the drug is recommended, which corresponds to one tablet. Candide is placed in the cervical canal in the evening, just before bedtime.
Contraindications to the use of this drug include hypersensitivity to clotrimazole or other components of candida, the time of the menstrual cycle, as well as the first trimester of pregnancy and with particular caution during lactation.
Oral acylact tablets take two to three times throughout the day. To improve the effectiveness of treatment, the drug is better to enter 30 - 40 minutes before meals. Adolescents and adult patients (with acutely developing pathology) are prescribed five pills. Reception duration - seven - eight days. Возможен ввод данного лекарственного средства и в форме суппозиторий.Contraindication of this drug is the individual intolerance to the components of the drug or vulvovaginal candidiasis.
After completion of anti-inflammatory and anti-infective therapy, an obstetrician-gynecologist is determined with cautery method of erosion. The selection of the stopping process takes place, based on the patient's age, the need for her to give birth in the future, the size of the lesion and many other factors are taken into account.
Not so long ago, if a young girl subsequently wanted to bear and give birth to a child, this procedure was postponed indefinitely.
Modern methods of cauterization:
- Electrocoagulation - relief of electric shock. The effectiveness of the procedure is about 92%. With deep tissue damage by erosion during electrocoagulation, the doctor has to resort to local or general anesthesia. Quite a traumatic method, after which colloidal scars remain on the cervix. They can be a problem at childbirth. It is used quite often due to availability and cheapness.
- Cryogenic or cryolysis. This method of treatment is used with a sufficiently large lesion. Its area should be at least 3 cm. If the affected surface is deformed, this method is not recommended, as it is difficult to achieve the necessary contact of the tube with liquid nitrogen and the affected mucosa. After the procedure, rough scars are not formed, which removes the reason that prevents the passage of the fetus through the birth canal. This technique is absolutely painless, just a little unpleasant. After cryodestruction it is very rare to observe any complications, for example, bleeding, but watery leucorrhoea can be observed within a month after the procedure.
- Radio wave coagulation - This is the least traumatic method of treating the mucous of the cervix. Painless procedure that does not require anesthesia. After its application there are practically no complications, and colloidal scars are not formed. But because of the high cost of the procedure, it is used quite rarely.
- Laser coagulation It makes it possible to affect only the affected areas of the mucous membrane of the cervix, without damaging the neighboring tissues. Processing takes place with a laser beam. This is a non-contact method of exposure to the affected area. When carrying out using local anesthesia. The lesion should be greater than 3 cm. It is often enough to observe such a complication as uterine bleeding. The effectiveness of this technique - more than 98% of full recovery. On the cervix after this procedure, the formation of the scar is not observed. When processing under the action of the laser beam falls and a small area of healthy tissue.
Any of these procedures is carried out immediately after the end of menstruation - in the first phase of the menstrual cycle. Before its implementation, the woman must undergo some training: the affected area is first treated with acetic acid. This is done in order to get a spasm of blood vessels - this will allow in some way to prevent the occurrence of bleeding. After that, the surface is treated with iodine solution - this treatment makes it possible to contrast the contours of erosion.
After the treatment (no matter what method is used), it is necessary to follow a number of rules:
- It is not recommended to have sexual intercourse until complete healing of wounds. This result can be achieved on average six weeks after cauterization.
- Reduce physical loads for this period, limit the weight of the lifted load.
- It should not be in the healing period to visit the pool, public beaches, sauna or bath, swim in open ponds.
- Water treatments should be limited to a shower (you should wait while taking a bath).
After cauterization, the doctor prescribes medicinal ointments or suppositories for his patient that have a wound-healing effect. This may be sea buckthorn oil or levomekol. These drugs provide an opportunity to soften the scab, which prevents severe scarring and reduces the likelihood of bleeding at the time of tearing the scab tissue.
Should know that traditional medicine methods in this case are not used. Recipes of alternative medicine can only be used as an additional therapy to increase the body's immune forces necessary to combat the disease.
It is worth emphasizing that sea buckthorn oil does not cure true cervical erosion. If you try to treat the pathology with oil, this will not solve the problem; on the contrary, it will only contribute to the proliferation of the epithelium (proliferation), therefore, the focus of erosive damage will expand. The use of sea buckthorn oil after cauterization will allow the “postoperative” wound to drag on much faster.
Candles with sea buckthorn oil are inserted into the vagina once a day, in the evening, just before bedtime and left there until morning. Most of the suppository will dissolve during this time, having been absorbed into the layers of the body, and only a small amount will come out in the morning. The duration of the treatment course is ten days. These candles have a tinting effect, so it is advisable to use daily pads during treatment - this will save a woman's underwear from pollution.
After going through all the stages of treatment of true cervical erosion, the patient may well begin to plan the pregnancy. In any case, if a woman plans to become a mother, preferably before the onset of conception, undergo a complete examination of the body and treat the pathology, especially for the organs of the reproductive system, including arresting the foci of infection and the affected mucosa, if any.
To treat this disease is necessary. Indeed, although insignificantly (in 3% of women with this pathology), there is a possibility of its transformation into malignant neoplasms.
If true erosion of the cervix was diagnosed during pregnancy, then the obstetrician-gynecologist takes all medical measures for a time after obstetric aid. As if cauterization is carried out during the gestational period, it will be somewhat more difficult to give birth to a woman. After cauterization, the elasticity of the cervical tissue will be impaired (reduced), which can lead to problems when opening the cervix and stretching the tissues in the process of passing the baby through the birth canal.