Cervical erosion: what it is, causes, symptoms, diagnosis, treatment and prevention. What is cervical erosion and what causes it? What does advanced cervical erosion look like?

Content:

Visiting a gynecologist should be periodic, not occasionally. A routine inspection should be carried out on average once a year (six months). An appointment with a gynecologist is made when complaints arise, before a planned pregnancy, or when pregnancy occurs.

This often happens because a woman cannot find “her” doctor, during whose appointment she experiences a minimum of discomfort and receives competent advice and treatment.

Periodic examinations with a gynecologist are very important. Many diseases occur without pronounced clinical manifestations, so only a specialist can identify them.

Diseases of the cervix are diseases that occur hidden: there is no disruption of the menstrual cycle, unpleasant heavy discharge, or pain.

Important! Cervical erosion is most often asymptomatic.

Every second woman hears this diagnosis at an appointment with an obstetrician-gynecologist, but it needs immediate clarification. By calling two types of erosion (true and background) in one phrase, the gynecologist usually means background erosion (ectopia).

True erosion of the cervix is ​​rare and does not last long, because, like a wound, it either heals quickly or turns into a background wound, which is a wound on the cervix, which can be seen without difficulty when examined with mirrors. Erosion looks like a bright red spot on the intact pink mucous membrane of the cervix. Such cervical erosion usually lasts no more than two weeks.

True erosion is a violation of the integrity of the epithelium of the cervix, which can bleed during and after sexual intercourse. With true erosion, a defect in the lining of the cervical epithelium is accompanied by rejection and desquamation of epithelial cells, which leads to damage to the blood vessels.

In most cases, cervical erosion is asymptomatic and can only be noticeable by pathological secretion, bloody discharge, and leucorrhoea after sexual intercourse.

Background erosion of the cervix, ectopia, is caused by the proliferation of velvety epithelium lining the cavity of the cervical canal into the vaginal cavity. The velvety epithelium is not adapted to the acidic environment of the vagina, so it begins to heal itself and over time a flat protective epithelium appears, which can lead to the development of tumors.

How to clarify the diagnosis

To find out what is actually hidden behind the change in the epithelium of the cervix, the specialist has various methods. The main one is colposcopy, which is used to diagnose the general condition of the cervix and is an examination of the mucous membrane using a colposcope under optical magnification with additional lighting.

The procedure is painless and allows you to detail changes in the area of ​​the cervix, which appear the same when examined with the naked eye.

When performing an extended colposcopy, the obstetrician-gynecologist stains the area of ​​the cervix, which makes it possible to distinguish pathological changes in tissue against the background of healthy ones.

To determine the degree of change in the epithelium that lines the cervix, during colposcopy (before staining the area of ​​the cervix), the doctor takes a smear to conduct a cytological examination (oncocytological smear) - the study of cells exfoliated from the surface of the cervix.

The study is carried out to identify malignant diseases at an early stage. If necessary, the doctor may also do a biopsy (taken from suspicious areas for analysis).

A full range of examinations includes testing for sexually transmitted infections, studying the condition of the ovaries, and the functioning of the patient’s immune system. Only an integrated approach to examination can ensure success in the treatment of cervical erosion.

Causes of cervical erosion

The main predisposing factors are:

• Hormonal disorders.
• Reduced immunity.
• Onset of sexual activity at an early age.
• First pregnancy and early first birth (before 16 years).
• Poor intimate hygiene, frequent change of sexual partners (leads to changes in the vaginal microflora).
• Injury during abortion, difficult childbirth, medical procedures or due to improper use of intravaginal contraceptives, due to inept douching.
• Viral, bacterial, inflammatory diseases of the cervix.
• Diseases of the genitourinary system.
• Sexual infections (chlamydia, gonococci, trichomonas, candida), a special role belongs to the human papillomavirus.
• Unfavorable heredity. Congenital erosions are the most common. It is important for such women to see a gynecologist regularly.
• Dysfunction of the thyroid gland, adrenal glands, ovaries.

Cervical erosion: symptoms

The disease does not have pronounced symptoms, so women most often find out that they have cervical erosion at an appointment with a specialist.

Sometimes patients complain of white or yellowish discharge from the genital tract, which is accompanied by painful sensations. Such symptoms are associated with an infection present in the body.

Other symptoms of ectopia include:

• menstrual irregularities;
• bleeding during sexual intercourse or after exercise;
• discomfort during sexual intercourse;
• heaviness in the lower abdomen.

The appearance of obvious symptoms is delayed in relation to the development of the underlying disease, so it is impossible to rely on the patient’s absence of complaints and refuse to treat cervical erosion. Changes occurring in the epithelium of the cervix provide a favorable background for the development of malignant processes.

The results of numerous annual studies have shown that malignant neoplasms on the cervix rarely occur against the background of unchanged tissue, and timely, competent treatment of background processes reduces the risk of developing malignant diseases.

With pseudo-erosion (ectopia), there may be no symptoms, so experts recommend doing colposcopy twice a year to check. The procedure takes no more than 20 minutes.

If the process has been running for a long time, purulent or bloody discharge may begin, which is accompanied by pain. Particularly threatening symptoms are bleeding during or after sexual intercourse.

Treatment of cervical erosion

Treatment of cervical erosion is carried out using conservative and surgical methods.

Drug therapy is carried out using:

• nonspecific anti-inflammatory therapy;
• antifungal and antiviral drugs;
• physiotherapeutic techniques - therapeutic mud, iontophoresis, microcurrent and ozone therapy.

According to indications, erosion is cauterized with Solkovagin, which penetrates the damaged tissue by 2.5 mm and gives a positive effect after 1-2 times of application.

Surgical methods include:

• Laser removal is an effective and modern method that provides high precision cutting and preserves healthy tissue, which promotes rapid healing without scars. Gynecologists recommend this method to nulliparous women, although specialists have differing opinions on this issue. Healing time is 4-6 weeks.
• Diathermocoagulation - cauterization of cervical erosion with electric current. This is the most common treatment method in antenatal clinics. Electrical burning is a painful method that leaves scars, so it is recommended only for women who no longer plan to give birth. Healing time is 8-10 weeks.
• Cryodestruction is freezing of the cervix with liquid nitrogen. When cold nitrogen interacts, it crystallizes the water contained in the cells and, as a result, destroys the cellular structure of the affected area of ​​the cervix. This method requires mandatory follow-up, as complications are possible due to the destruction of the surface layer of cells. Healing time is 8-10 weeks.
• Chemical coagulation - cervical erosion is treated with drugs whose action is aimed at corroding atypical cells. This method does not leave scars and is therefore recommended for nulliparous women. Healing time is 6-10 weeks.
• Electroexcision - cutting out the affected area on the cervix.
• Radio wave treatment is the use of high energy radio waves. Without pressure on the tissue, the area with erosion is treated, which minimizes damage to the cervix. Electrical burns are also completely eliminated, due to the fact that the method is not based on thermal action, but on the process of “evaporation” of water molecules from damaged epithelial cells. The technique used is non-traumatic, does not leave scabs (crusts covering the surface of the wound; burns; abrasions formed by coagulated blood, pus and dead tissue) and scars, which allows to halve the healing time, and also preserves, thanks to the shape of the conizer (a surgical instrument used in gynecology), structure of the cervix). Patients do not experience discomfort, and adjacent tissues are not damaged. Healing time is 3-5 weeks.

Treatment of cervical erosion is necessary. Lack of therapy will cause the development of neoplasms not only of a benign, but also of a malignant nature; glandular-cystic erosion of the cervix may develop.

Mandatory preventive visits to the gynecologist must be taken responsibly. Timely diagnosis and prescribed comprehensive treatment will have a positive effect on health and relieve problems.

Treatment of cervical erosion in nulliparous women

Background erosion of the cervix (ectopia) of small size can also be observed in young nulliparous women as a physiological norm. The disease requires observation and in most cases goes away without additional intervention due to hormonal changes in the body (taking oral contraceptives, pregnancy).

But background erosion of the cervix is ​​an “entry gate” and a place for infection to attach, and can also serve, if not a direct, then an indirect cause of the development of diseases of the reproductive system. Infections that are sexually transmitted, inflammation of the mucous membrane of the cervical canal (cervicitis) and background erosion of the cervix (ectopia) act as concomitant diseases.

Previously existing methods of treating ectopia led to cervical rigidity (the cervix became less elastic in order to give birth independently in the future without a cesarean section).

Now there are methods for treating cervical erosion in nulliparous women without serious consequences. Lack of timely treatment for erosion can lead to dangerous complications. First of all, this is a malignant degeneration of cells in the damaged area of ​​the cervix.

Specialists periodically encounter patients who put off examination for a long time due to lack of complaints, and when they arrived, it turned out that the time had already been lost. When signs of malignancy appear, more radical treatment methods must be used; such patients are referred to oncologists.

Quite often, after the next preventive examination by a gynecologist, a woman hears the phrase: “You have cervical erosion!” And this is perhaps the most common diagnosis in women of childbearing age.

However, in fact, it turns out that in our time the concept of “erosion” is absent in professional medicine throughout the world, except for Russia. In our country, for some unknown reason, this term has taken root firmly, although today it has been precisely proven that it is absolutely incorrect and does not reflect the essence of the processes occurring on the mucous membrane of the cervix.

Is there actually erosion?

Translated from Latin, “erosio” means “corrosion.” For many years, it was believed that erosion was a defect in the cervical tissue (ulcer) that could develop into cervical cancer if not treated. And cauterization was carried out on all women in a row. This is how it was in the time of our grandmothers and mothers.

As time passed, gynecology developed progressively, and the following became clear:

• There is virtually no cervical cancer without infection with the human papillomavirus;
• The presence of erosion in itself does not increase or decrease the likelihood of developing cancer;
• Often erosion is not erosion at all, but ectopia;
• Ectopia is the migration of cervical epithelial cells from the inner part of the cervix to the outer surface;
• Ectopia is not a disease, but a physiological condition of the cervix that does not need to be treated: over time it goes away on its own.

This is what large cervical erosion on the anterior and posterior lips looks like during colposcopy.

On a note

Cervical erosion is not a female disease that needs to be treated. This is the norm. In other words, cells turn from the inside out (in medical parlance, this condition may be called ectropion). No matter how paradoxical it may sound, if you do nothing about such erosion, it will go away on its own.

Therefore, if you are informed that you have been diagnosed with erosion, do not panic, do not rush to remove it and spend money on treatment, the cost of which is often quite high.

We repeat once again that the concept of erosion is outdated, and it would be more correct to say ectopia (false erosion or). But this term has become so firmly established in our everyday life that it continues to be used not only by patients, but, oddly enough, even by doctors. This is probably due to a lack of information among women. If the patient is told that she has “erosion,” then no additional questions arise, because she heard this name from her friends, mother or grandmother. But if you tell a woman that she has ectopia or ectropion, then she is unlikely to immediately understand what the doctor is talking about; she will also decide that something terrible and dangerous has been discovered in her.

This is what a large cervical ectopia looks like during colposcopy.

Therefore, doctors still have a long way to go to eliminate illiteracy among the female population.

On a note

The term “erosion” is currently used exclusively for true erosions that arise as a result of an infectious process, trauma or radiation.

How is the cervix structured?

To clearly understand what we are talking about, you need to have minimal knowledge of anatomy and know how the organ we are talking about works.

So, that part of the cervix that is located in the vagina and which the doctor sees during a gynecological examination in the speculum is quite logically called the vaginal part of the cervix. Inside the cervix is ​​the cervical, or cervical, canal, which opens into the uterine cavity. There are two physiological narrowings in the cervical canal - the external and internal pharynx. The external os opens into the vagina. In nulliparous women, it is round in shape, and after childbirth it takes on the appearance of a transverse slit. The internal os opens into the uterine cavity. The cervical canal contains mucus, the main function of which is to prevent infection from entering the uterine cavity from the vagina.

The structure of the cervix.

The outside of the vaginal part of the cervix is ​​covered by stratified squamous epithelium. The word “multilayered” itself suggests that it consists of several layers of cells. Thus, it has a significant (of course, by microscopic standards) thickness and performs a protective function. The mucous membrane of the cervix, covered with stratified epithelium, has a pale pink color.

Inside the cervical canal there is a cylindrical, or glandular, epithelium. It is thinner and more delicate, consists of a single row of cells, and the blood vessels shining through it give it a red color.

The columnar epithelium has a completely different function - to produce mucus. Columnar epithelium is hormone-dependent: when there are a lot of female sex hormones, it produces liquid mucus, when there is little, thick mucus. This invention was invented by nature for conception: through liquid mucus, sperm very easily penetrate the uterine cavity, meet the egg, and fertilization occurs. This quality of mucus is observed during the period of ovulation. The rest of the time, cervical mucus is thick, viscous, its function is protective - no infectious agent can penetrate the uterine cavity and cause inflammation.

The zone where two types of epithelium meet is called the transition zone, or transformation zone. At different age periods of a woman, this zone is located at different levels, which depends on the stage of development of the female reproductive system.

Thus, in newborn girls and virgins, the junction zone is located on the outer cervical surface. In this case, they talk about congenital erosion.

Histological structure of different types of cervical epithelium (in women of reproductive age and during menopause).

During puberty or during pregnancy, when a high level of sex hormones is noted in the female body, the cylindrical epithelium begins to quickly “crawl” out of the cervical canal and is located around the external pharynx, resulting in the formation of a red spot in this place. The same can happen if a woman takes hormonal contraceptives.

As a girl grows up, the level of sex hormones decreases, the stratified squamous epithelium begins to displace the cylindrical epithelium into its place - into the cervical canal, and the junction zone moves closer to the external pharynx.

With age, the border of the two epithelia completely hides deep into the cervical canal, which is why it becomes invisible. Therefore, ectopia no longer occurs in women of the older age group.

What does erosion (ectopia) look like?

Below in the picture, made based on the photo, you can see what a healthy cervix looks like and a cervix with erosion, or ectopia.

Ectopia of the cervix (schematically).

Let's take a look at the medical history...

So, we have already mentioned that ectopia (we will get used to speaking correctly) is a common condition in which a gynecologist sees a red spot around the external os of the cervix. Previously, due to imperfect research methods, it was believed that this was a defect in the cervical tissue, which could turn into cancer if left untreated. Therefore, in order to prevent cervical cancer, they tried to eliminate this defect by cauterization. Moreover, cauterization was performed on almost all women in 100% of cases.

But science moved forward. It became clear that the doctor’s eye cannot examine the cervix and its defect in detail: after all, it is necessary to evaluate the quality and structure of the cells. But it is almost impossible to do this with the naked eye. And in the daily practice of gynecologists, colposcopes began to appear - microscopes for a detailed study of the condition of the cervix.

The procedure of colposcopy, examination of the cervix in mirrors under microscope magnification, allows you to assess the condition of the epithelium and the presence of pathological changes.

Diagnostics have become more advanced. It was established that “erosion” is not an area devoid of epithelium at all, but a displacement of the intracervical columnar epithelium onto the vaginal part of the cervix. It is the columnar epithelium on the surface of the cervix that looks like a red spot.

Types of erosion

Experts distinguish the following types of cervical erosion:

• Ectopia, or pseudo-erosion (sometimes in the scientific literature you can find the name “false erosion”). It occurs when the internal epithelium of the cervical canal shifts to the surface of the cervix (this was discussed above);
• True erosion. We can talk about it when a defect appears on the outer part of the cervix and the stratified squamous epithelium is completely absent. The reason for this may be an inflammatory process, trauma to the cervix with gynecological instruments, or constant trauma to it due to uterine prolapse.

On a note

In young women, true erosion is extremely rare, while ectopia is quite common. On the contrary, in women over 40 years of age, ectopia is an extremely rare phenomenon. For this age, true erosions are more typical.

This is what pseudo-erosion and true erosion of the cervix look like during colposcopy.

How is ectopia diagnosed?

There is no diagnosis of cervical erosion worldwide. However, although today most practitioners do not consider cervical erosion a disease and claim that there is no such diagnosis, in the international classification of diseases of the 10th revision (ICD-10) under the heading “Non-inflammatory diseases of the female genital organs” it is assigned code N86. Allow me a small clarification: this section refers only to a case of ectopia with complications, that is, a pathology variant that requires treatment.

Ectopia is a condition that has no symptoms. And only a gynecologist can detect it during an examination. Very rarely (when ectopia reaches a large size) there may be complaints of spotting after intimacy or appear. There is never pain during erosion. And it cannot be seen on an ultrasound.

So, what does a doctor do if he discovers an unclear red spot on the patient’s cervix during a gynecological examination?

Firstly, the doctor will definitely take smears from the cervix for atypical cells. A smear for cancer cells in gynecology is called a Pap test. This is a very important analysis. Even if a woman is gynecologically healthy, she must undergo it without fail once a year.

The process of collecting material for a Pap test.

On a note

Cervical Papanicolaou smear examination (PAP test) is the main method for identifying precancerous conditions of the cervix. Material for cytology is collected from three areas: from the outer part of the cervix, from the junction of stratified squamous and columnar epithelium, and from the lower third of the cervical canal. To take material for examination, special brushes are used.

Interpretation of the results of cytological examination

Secondly, he will take a vaginal smear for flora. The smear may contain elevated leukocytes and pathogenic microflora, which indicates inflammation of the vagina. The inflammatory process in the vagina makes it difficult to identify atypical cells, therefore, if one is detected, then it is necessary to treat it, and then repeat the cytological examination.

For sanitation of vaginal inflammation, topical preparations in suppositories or vaginal tablets are used: Terzhinan, Hexicon and others. In some cases, it may be necessary to prescribe antibiotics, and to treat thrush - antifungal agents. The doctor will select all medications taking into account the causative agent of the disease.

To speed up the healing of erosion, all existing inflammatory diseases in the vagina should be cured, as they can affect the development of the focus of an existing pathological area.

It's important to understand

All of these medications are not used to treat erosion. The purpose of their purpose is to sanitize the vagina so that microbial agents do not provoke the transition of an uncomplicated form of erosion, which does not need to be treated, into a complicated one. Complicated erosion has a less favorable prognosis and always requires therapy.

Thirdly, if a cervical defect is detected, the gynecologist will suggest taking an HPV (human papillomavirus) test. Cervical pathology is usually caused by two oncogenic types of HPV - 16 and 18.

And finally, a colposcopic examination. The doctor will examine the cervix in detail under a microscope and evaluate the structure of the cells of the spot seen, the nature of the surface, color, edges of the affected area, and vascular pattern. Colposcopy complements cytological examination and makes it possible to identify a group of healthy women - those who do not require treatment for ectopia. The purpose of this study is to identify the lesion and substantiate the indications for targeted biopsy of the cervix. There is no need to be afraid of this procedure - it is absolutely painless.

A cytology smear allows you to determine the presence of cervical diseases and identify the risk of neoplasms.

Ectopia – is it dangerous or not?

Today, medicine has firmly established that ectopia, especially small ones, is a natural stage in the development of the female reproductive system. The spot of columnar epithelium at different periods of life against the background of hormonal surges can either appear or disappear, sometimes be very small, sometimes more extensive. And with age, the body completely eliminates this area, moving the transformation zone deeper into the cervical canal.

Often , and is a physiological condition that does not require treatment and does not pose a health hazard.

Need to know

If you have been diagnosed with ectopia of the cervix, but a cytological examination does not reveal pathological cells and there is no human papillomavirus, then your erosion is not dangerous, nothing needs to be done about it, it will go away on its own over time. The only thing that should not be ignored is annual gynecological examinations.

If HPV is still detected, and there are no atypical cells in the Pap test, then nothing needs to be done about your erosion. Just see a gynecologist twice as often (every six months).

When should erosion be treated?

In most cases, erosion does not need to be treated. But for this there are two conditions that should be remembered:

• There should be no inflammatory process;
• There should be no atypical or cancer cells in the smear for oncocytology.

When we talk about ectopia, we mean that the cylindrical epithelium of the cervical canal is not in its place, that is, not inside the cervix, but outside - on its vaginal part. The columnar epithelium is very thin and easily injured. The vaginal environment is not entirely natural for him. In addition, microbes can enter the vagina during sexual intercourse or from the rectum and harm the delicate epithelium.

Therefore, to prevent ectopia from developing into a complicated form, you need to keep the vagina clean, follow the rules of intimate hygiene and use condoms or spermicides during sex. This is especially true for women who are in sexual search and do not have a permanent sexual partner.

Chronic cervicitis during colposcopy (presence of hyperemia and discharge from the cervical canal).

Who is at risk for complicated erosion?

Complicated erosion can occur in any woman, but most often it occurs in representatives of the following groups:

• Women who begin sexual activity early;
• Women who often change partners. They are more susceptible to sexually transmitted infections, which adversely affects erosion, and the latter takes a complicated course;
• Patients who have had abortions in the past, since mechanical trauma to the cervix can also cause complications of erosion.

What should I do if my Pap test reveals cancer cells?

If cancer cells are found in a cytological study, then this condition will no longer be called erosion. This is dysplasia (precancer) or even cervical cancer. In this case, you need to take a targeted biopsy from the suspicious area under the control of a colposcope.

The biopsy results are sent to the laboratory for histological examination, and only a histologist can make a final verdict, based on which the following actions are taken:

• If, according to the results of the biopsy, there is no cervical cancer, but a precancerous process is confirmed, then in this case treatment is indicated (most often by);
• If cancer is confirmed, then the method of choice is wide conization - excision of the cervix, in which the focus of the affected tissue is removed in the form of a cone with an apex extending deep into the cervical canal.

Which cauterization method is preferable for cervical dysplasia and cancer?

Often, mild dysplasia detected may simply be a consequence of inflammation. And after anti-inflammatory therapy at the control oncocytology, not a trace will remain of it.

But if dysplasia really needs to be treated, it is important to choose the right cauterization method. When a doctor decides on the method of surgical treatment of dysplasia, the key factors are the following:

• Severity of dysplasia;
• Woman's age;
• Does her plans include motherhood in the future?

Of course, gentle surgical methods are indicated for young women with mild to moderate dysplasia who are planning to give birth after cervical treatment. This can be done using radio waves, argon or freezing with liquid nitrogen. In case of deep lesions of the cervix in women who do not plan to give birth, diathermoelectrocoagulation or electroexcision may be justified.

Extent of spread of cervical cancer.

Frequently asked questions for women with cervical erosion (ectopia)

Is it possible to install a spiral if there is erosion?

Can. But only on the condition that there are no signs of inflammation in microflora smears, and there are no atypical cells in oncocytology smears.

It is important to know

Uncomplicated cervical erosion is not a contraindication for the installation of an intrauterine device.

Is it possible to have sex if there is erosion?

Can. But you need to remember that small erosion does not give any symptoms and does not interfere with sexual activity, but large ectopia (more than 1-1.5 cm) can cause bleeding after sexual intercourse. In this case, you will need to see a doctor for examination.

Is it possible to use tampons for cervical erosion?

Yes, you can.

Can erosion affect the conception of a child and the pregnancy in the future?

By itself, it does not cause obstetric complications. The problem is different. It happens that the tactics for managing and treating erosion are chosen incorrectly. An unjustified desire to cauterize uncomplicated ectopia can lead to narrowing of the cervical canal, which often causes infertility.

Why does menstruation delay due to erosion?

Cervical erosion does not affect the menstrual cycle, and delayed menstruation is associated with concomitant pathology.

What are the psychosomatic causes of erosion?

According to the theory of psychosomatics, erosion occurs in women who do not accept their feminine essence, are dissatisfied with their relationship with their partner, and experience certain difficulties in their sexual life. Official medicine does not focus on psychosomatics, so a practicing gynecologist is unlikely to recommend that his patient accept herself as a woman in terms of treating erosion (although this is exactly the advice that is given on numerous forums).

We think that from the above you understand: it is very important to decide whether your erosion is normal or pathological. The tactics of further management and treatment will depend on this. Knowing in which cases ectopia can be observed and in which it needs to be treated, you will not part with “your blood” in vain, because the cauterization offered in many clinics is paid, and the price for services is far from symbolic.

Useful video about cervical erosion

What is cervical erosion

Erosion of the cervix is ​​manifested by dysfunction and destruction of the upper layer of the epithelium, which can only be seen during a gynecological examination

A defect in the cervical epithelium is detected during a routine examination or after a woman contacts a gynecological consultation with complaints of other disorders. The doctor sees changes by examining the patient using mirrors.

Cervix

The vagina and the uterus, hidden inside the woman’s pelvis, are connected to each other by the cervix. From the vagina one can see her external os, which is normally covered with pink epithelium. There is a canal inside the cervix, and the wall of the organ consists of three layers:

• external;
• muscle, consisting of fibers arranged in a circle;
• inner, epithelial layer.

Each of them has its own purpose. Muscular layer - provides compression and sealing of the cervix, protecting the uterus and its contents from infection and fluids.

The inner layer lining the uterine canal consists of a single layer of cells that have a specific, cylindrical shape. They are colored in a specific red color and form a velvety surface; the purpose of such cells is to secrete mucus, which tightly clogs the cervix. The epithelium covering the cervix from the vaginal side has a different structure. Its cells:

• flat, with dense walls, a core inside;
• arranged in several layers;
• tightly closed.

In the lowest, basic row of cells, located at the border of the muscle and epithelial layers, a continuous process of division of existing cells and the birth of new cells occurs. Layers of “fresh” cells rise, squeezing out the aging ones, ensuring complete renewal of the mucous membrane over a short period of time. This process ensures the healing of large and small damage that occurs on the mucosa during life.

The period of such renewal is individual for each woman and depends on the condition of her body.

In some cases, there is a disruption in the functioning of the layer of cells, they cannot be restored as quickly as necessary to maintain their integrity, and ulcerations appear on the cervix. The base layer of epithelium becomes too thin and weak for infection. Such destruction is defined as cervical erosion.

Types of erosion

Patients whose doctor has diagnosed the disease are interested in what cervical erosion will look like (photo), erosion, what is it?

Externally, the damage takes the form of scratches or rounded wounds covering the mucous membrane of the cervix, and defects found on the mucous membranes are usually red.

True erosion

Wounds occur in varying depths and sizes. If lesions:

• observed on the upper epithelial layer;
• do not penetrate deep;
• leave the basal layer intact;
• no infection was detected on the mucous membranes and there was no pronounced inflammation;
• with a fairly strong body, they will be able to grow over themselves, the upper layer of the epithelium will be restored.

When pressing on the wound with an instrument, the doctor may observe slight bleeding - this condition is called true erosion. A doctor can rarely see such a lesion - usually defects of this kind heal within 10-14 days.

If the damage is deep, reaching the basal layer of cells or penetrating below, healing can proceed in two ways:

• a scar will form at the site of the damage, which will make the cervix more rigid and prevent it from stretching during childbirth, which may result in its rupture;
• the defect will not be overgrown with flat epithelium, characteristic of the cervix, but with cylindrical, “velvet” epithelium, which normally should not leave the internal canal of the cervix. This epithelium is located in one layer and produces thick mucus, which is not typical for the cervix.

Pure “erosions” are quite rare. The photo shows erosions of the uterus, which in most cases are accompanied by inflammatory processes or arise against their background.

Causes of the condition

Erosion is a complex condition, the exact mechanism of which is unknown.

Clinical observations made it possible to identify the causes that may provoke a defect in the cervical mucosa. These include:

• damage to the body by sexually transmitted infections that weaken the woman’s body (gonococci, HPV, trichomonas, staphylococci, yeast);
• lowering the body's immune threshold;
• traumatic injury to the cervix due to birth trauma, uterine curettage, surgical treatment or mechanical trauma;
• damage to the epithelium during too early or too late childbirth - during early labor the mucous membrane is still immature, which leads to its destruction;
• inflammatory diseases of the vagina or cervical canal, in which massive mucus secretion and mechanical irritation of the cervical epithelium occur;
• hormonal imbalance due to diseases of the thyroid gland, adrenal function, age-related changes, ovarian tumors;
• violation of the vaginal microflora, which is caused by poor hygiene, unreasonable change of sexual partners;
• discharge from the uterus caused by destruction of fibroids or endometritis, which leads to chemical damage to the cervix and the appearance of wounds.

The resulting condition provokes inflammation of the internal genital organs, weakening the body and can cause infertility.

External signs of the disease

It is believed that erosion has no symptoms and does not manifest itself in any way. But the process is usually accompanied by an infection, which gives cause for concern and consultation with a doctor. The woman begins to be bothered by:

• pain and heaviness in the lower abdomen;
• the appearance of bloody discharge after sexual intercourse;
• pain during sex;
• the appearance of a brownish leucorrhoea (indicates mechanical injury to the cervical mucosa);
• with a long process, mucous leucorrhoea with a purulent odor appears;
• the appearance of a yellowish leucorrhoea indicates the addition of an opportunistic infection;
• Milky white leucorrhoea indicates candidiasis (thrush).

All these conditions, if treated in a timely manner, are treatable and require correction, as they can become a background for malignant changes.

False erosion

False erosion or ectopia is understood as the overgrowing of a defect in the mucosa with single-row columnar epithelium. When you press on the affected area, no blood will be released. The mechanism of replacement of the true epithelium of the cervix with cylindrical epithelium is not completely known. It is believed that the main provoking factor is a hormonal imbalance, which had an impact on the body at the time of formation or in the process of life.

When talking about uterine erosion, most gynecologists mean pseudo-erosion. Women under 30 years of age are most susceptible to this disorder. False erosion can be acquired or congenital.

The doctor can observe in the mirrors what congenital cervical erosion looks like - this is a displacement of the natural pink squamous epithelium, onto which a layer of red velvet cylindrical cells creeps.

Depending on the type of growth, there are several types of pseudo-erosions that differ in appearance.

Glandular

With this lesion, erosion is characterized by greatly overgrown glands - the red epithelium penetrates into the deep layers of the cervical epithelium and “slides” to cover large surfaces. Such a lesion can develop in a woman’s body for a long time (over several years). Clinically, it is the most common type of false erosion.

Papillary

This species is externally designed as symmetrical, clearly shaped growths, reminiscent of miniature papillae, on which a layer of “velvet” epithelium is formed on top. Some doctors attribute this false erosion not to a disease, but to a pathology in the development of tissues of the internal genital organs of a woman.

With the development of such a disorder, a woman may complain of:

• weak nagging pain in the lower abdomen;
• itching and burning in the vagina;
• slight bleeding after sexual intercourse;
• profuse leucorrhoea without a strong odor, white or translucent.

If the leucorrhoea acquires a pungent odor or its color changes, this will indicate an infection.

Cystic false erosion

Such erosion on the cervix (can be seen in the photo) is characterized by the appearance of small cystic growths that form between the layers of columnar epithelium. The cysts are dense and elastic when pressed. This form of change in the integumentary epithelium of the cervix is ​​the most common.

Combined false erosion

The pure, “classic” type of erosion is not so common. In clinical practice, gynecologists most often encounter cervical erosion, which looks like a combination of two types of false erosions - glandular and cystic.

Upon visual inspection, it looks like a combination of enlarged glands and cysts between them. This combination leads to a delay in the secretion secreted by the glands and the addition of infection. The appearance of such an inflammatory process leads to an increase in painful symptoms and will be a reason for a woman to consult a doctor.

After correct identification of the underlying disease and its effective treatment, you can observe a process called healing false erosion. The process occurs in a mirror order to the process of the occurrence of false erosion - flat epithelial cells begin to displace the red columnar epithelium, eventually completely replacing it. But if a woman is diagnosed with changes in the epithelium with the appearance of cysts, then they will remain in most cases. Cystic formations enlarge the cervix and change its natural shape.

The erosions on the cervix shown in the photo are papillary growths, covered on top with a layer of columnar epithelium. They contain infiltrated and inflamed areas. The cause of the growths is the human papillomavirus.

Such a disorder can exist for quite a long time on the cervix without significantly disturbing the woman. In this case, dysplasia may develop, which is considered a precancerous condition. Overgrowth of the cervix does not allow sperm to penetrate into the organ cavity, which threatens the development of infertility.

Condition of the cervix after treatment

When carrying out conservative treatment, the condition of the mucous membrane can change - its layer is restored or a scar is formed. After removing the inflammatory processes, to accelerate the restoration of the squamous epithelium layer, cauterization of the affected area is used.

After the procedure, epithelial restoration processes are activated - leukocytes and other cells are drawn into the burn area, enhancing regeneration.

At the site of erosion, a crust forms, which falls off within 10-15 days, revealing part of the mucous membrane, which will fully recover within 45-60 days. When using the radio wave method, not a scab, but a thin film appears on the surface of the treated area.

To accurately diagnose the condition of the cervical cells, it is necessary to examine them under magnification. For this, colposcopy is used, a method that involves examining the organ under a microscope (with the possibility of additional lighting) and a mirror.

To ensure a quality examination, the doctor cleans the cervix. To do this, the vagina is treated with a cotton swab moistened with a solution of vinegar or Lugol.

This treatment makes the lesions more contrasty and allows you to better see the erosion of the uterus and what the lesion looks like.

If, when stained with Lugol, light-colored spots appear on the neck, this raises suspicions of malignant cell degeneration, which requires taking material for examination.

Prevention of the condition
For timely detection of cervical erosion, women over 25 years of age must contact a gynecologist for examination at least once every 6 months for examination by a doctor and a smear.

Important for the prevention of defects in the mucous membrane is the need to choose high-quality underwear that meets the requirements of personal hygiene.

Consistency in choosing a sexual partner will most likely protect you from sexually transmitted diseases and subsequent erosion; it is advisable to practice protected sex even with a regular partner.

In order for the immune system to be strong, you should adhere to a healthy diet, a healthy lifestyle, and treat infectious diseases in a timely manner.

According to the medical literature, cervical erosion is detected during a gynecological examination in 15% of all women. Some varieties of this pathology are diagnosed in approximately half of all patients. Such widespread prevalence explains the important medical and social significance of the problem.

Definition and types of erosion

The term erosion usually means damage or degeneration of the structure of the mucous membrane of the cervix. First of all, the part of the cervix that exits into the vagina is affected. In this place, the cervix is ​​covered with a special type of cells that form the surface of the skin and mucous membranes. These cells are called stratified squamous epithelium. The internal, or cervical canal of the cervix is ​​normally covered with columnar epithelium (the cells have the appropriate shape).

The cervix is ​​covered by stratified squamous epithelium

Classification of erosions

Depending on the location of the defect and the nature of changes in the mucosa, it is customary to distinguish the following types of cervical erosions:

1. True erosion is a pathological condition in which the stratified squamous epithelium is damaged, the integrity of the mucous membrane is disrupted and a defect in the form of a wound is formed.
2. False, or pseudo-erosion, is a change in which cylindrical cells appear on the cervix instead of stratified squamous epithelium.
3. Congenital erosion is a condition when elements of the cylindrical epithelium grow beyond the boundaries of the cervical canal. Such erosion develops in girls at the earliest stages of development.

True erosions are divided into several types depending on the cause:

• inflammatory - caused by infectious pathogens - viruses, chlamydia, etc.;
• traumatic - resulting from damage by gynecological instruments, rough intimate contact or careless administration of local contraceptives;
• chemical - developing when exposed to aggressive chemicals, for example, acidic solutions due to improper douching;
• burn - occurring after surgical treatment (diathermoelectrocoagulation);
• trophic - caused by poor blood circulation in the vessels of the cervix;
• specific - developing with tuberculosis or syphilis;
• cancerous - malignant degeneration of epithelial cells on the cervix.

Pseudo-erosion, in turn, is divided into several forms according to its structure. The following forms of pseudo-erosion have been described:

1. Glandular - distinguished by a large number of special formations - erosive glands. With this form, cylindrical cells not only line the neck on top, but also grow into the thickness of the tissue.
2. Papillary - a form in which the entire surface of the cervix is ​​covered with growths in the form of papillae.
3. Cystic - develops when layers of epithelium grow on top of each other.
4. Glandular-cystic form, characterized by an increase in erosive glands and the formation of cysts (cavities filled with mucus) between them.
5. Epiidermizing or healing - a type that occurs at the site of successfully treated diseases of the cervix - true erosion, polyp, etc.
6. Papillary - characterized by the proliferation of connective tissue formations (so-called papillary stroma).

Why does the disease occur?

Doctors have not yet been able to fully understand the exact cause of the development of this pathology. In practical gynecology, it is customary to identify several possible reasons for such a high prevalence:

1. Chronic inflammation of gynecological organs.
2. Early onset of sexual activity.
3. Mechanical injuries to the mucous membrane - previous curettage, ruptures during childbirth, gross mechanical damage during sexual intercourse.
4. Disturbances of the normal microflora in the vagina (dysbiosis) - develops with frequent changes of sexual partners, taking antibacterial drugs.
5. Hormonal disorders due to the use of corticosteroid drugs (Prednisolone, Hydrocortisone, etc.), chronic diseases, age-related changes (decrease in estrogen levels with).
6. Decreased immunity due to previous diseases, etc.
7. Features of the anatomical structure of the female genital organs - ectropion (pathological eversion of the uterine mucosa).

Factors that provoke the development of erosion include:

• frequent douching, which disrupts the normal microflora in the vagina;
• violations of the technique of placing an intrauterine device;
• excess body weight;
• undergone surgical operations on the uterus - removal of polyps, etc.;
• the use of various artificial devices during sexual intercourse.

Main symptoms

In the first days and weeks of the disease, the woman does not feel pain or discomfort and is not aware of the pathology that has arisen. Over time, the following complaints appear:

• discomfort and bleeding during intimacy or when lifting weights;
• lack of connection of such discharge with menstruation;
• when a secondary infection occurs, the discharge from the genital tract turns greenish-yellow and acquires an unpleasant odor;
• nagging pain in the lower back and lower abdomen;
• high body temperature;
• discomfort in the vagina when visiting the toilet or having sexual intercourse;
• When the inflammatory process passes to the uterus and fallopian tubes, the menstrual cycle is disrupted, the discharge becomes abundant and turns brown.

A woman will be able to independently suspect the appearance of erosion only when the process becomes advanced and is accompanied by severe discomfort.

The nature of the discharge also gradually changes. They can be:

1. Brown or bloody. Such discharge indicates an inflammatory process in the uterus or mechanical damage to the mucous membrane.
2. Curdled, white in color with a sour odor - characteristic of damage to the genus Candida ().
3. Yellow - when affected by staphylococcus or ureaplasma.
4. Green and thick - with gonorrhea or trichomoniasis.

With postpartum erosion, the patient feels a nagging pain in the vagina, but may not pay attention to it, attributing the discomfort to the recovery period after childbirth.

In nulliparous women, discharge from the genital tract during erosion is scanty; the main symptom is pain in the lower abdomen. The discharge is reddish or brown in color and occurs between menstrual periods.

If the pathology develops after cauterization of the cervix, the leading sign will be the appearance of scanty, light, transparent discharge.

Erosion and pregnancy

According to most experts, uncomplicated erosion of the cervix does not affect the process of conception and the development of the fetus.

A woman may well become pregnant, but she will need to be more carefully monitored by an obstetrician-gynecologist. The situation is different in cases where it is accompanied by infectious inflammation of the genital organs. Such complications can cause intrauterine growth retardation and even fetal death.

If erosion was cured by cauterization, doctors advise postponing conception for at least a year. During this time, the scars on the cervix will resolve, and it will regain elasticity. During pregnancy, this pathology most often develops in young women who are about to give birth for the first time. Its appearance is associated with hormonal changes in the body.

Symptoms that suggest cervical erosion in a pregnant woman may include:

• sensation of itching or burning in the external genital tract;
• aching or pulling pain in the lower abdomen;
• copious discharge mixed with mucus, blood or pus;
• bleeding from the genital tract that appears soon after sexual intercourse.

Diagnostic methods

For diagnostic purposes, the doctor examines the cervix using a special instrument - a gynecological speculum. Upon examination, a red spot may be detected. If the erosion is of inflammatory or traumatic origin, a raised area consisting of squamous epithelium is visible along the edges of the spot.

To determine the consistency of the tissue at the site of erosion, its bottom is examined with a metal probe (Krobak's test). If the probe easily enters the tissue, the test is considered positive. Using this test, you can distinguish some individual types of erosion.

Table: characteristic features of some specific erosions

To diagnose erosion, smears are taken from the cervical canal and from the surface of the ulcer. The material is sent to the laboratory, where the cellular structure of the tissue at the site of the lesion is determined (cytological examination). If an infectious nature of the pathology is suspected, a bacteriological study is carried out to determine the type of pathogen and sensitivity to antibacterial agents.

An accurate diagnosis can be established using instrumental and additional research methods. These include:

1. Colposcopy is an examination of the cervix using a complex optical instrument. The method allows you to identify a defect in the epithelial tissue and the connective tissue base underneath (stroma). The bottom of the erosion has a granular, bright red surface. In true erosion, it is always below the level of the epithelial cover and has clear contours.
2. Samples with chemical reagents. If you treat the damaged area with 3% acetic acid, the bottom of the ulcer becomes pale, and when treated with 5% silver nitrate it turns black.
3. Cervical biopsy - scraping out the mucous membrane in the damaged area and sending it for examination of the cellular structure (histology). Such a study is carried out if cancer is suspected or if altered (atypical) cells are detected in a smear. An examination can reveal an area of ​​ulcerated surface, proliferation of connective tissue, a large number of leukocytes and congestion of blood vessels in the lesion. With pseudo-erosion, altered columnar epithelial cells are detected.

Based on the results of the examinations, the attending obstetrician-gynecologist can prescribe a consultation with specialists:

• oncologist - if atypical cells are detected;
• dermatovenerologist - when identifying sexually transmitted infections;
• phthisiatrician - if a tuberculosis infection is suspected.

Principles and methods of treatment

It is necessary to develop a treatment regimen individually, taking into account the following indicators:

• forms of the disease;
• stages of development;
• size of the lesion;
• intensity of the inflammatory process;
• patient's age;
• obstetric history (information about pregnancy and childbirth).

Congenital erosion, according to obstetricians-gynecologists, does not require special active treatment, since it usually heals on its own. In this case, the woman should be under medical supervision. Therapeutic measures are carried out when infectious and inflammatory complications are detected.

Women who do not yet have children and who are planning to become pregnant are usually prescribed local and systemic treatment with medications. Active therapy for true and false erosion during pregnancy is carried out only in cases where there are concomitant infectious and inflammatory processes. In this case, local remedies are prescribed.

Do not confuse cervical erosion and so-called ectopia. The latter often occurs in nulliparous women (up to 23–25) years old and resembles erosion in appearance (this is what many gynecologists mistakenly try to treat both conservatively and surgically). However, ectopia - a congenital condition in which part of the mucous membrane of the cervical canal extends beyond its position - is not a pathology and, as a rule, goes away on its own. The doctor needs to conduct a cytological examination, which will confirm that this is not erosion, and simply observe until the patient turns 25 years old. If the ectopia increases, you will need to do a biopsy and use the most gentle surgical treatment (for example, radio wave). If it disappears or remains the same size, interventions on the cervix are not recommended.

Professor K. Bakhtiyarov, obstetrician-gynecologist, MD

http://bakhtiyarov.ru/article/6-mifov-ob-erozii-sheyki-matki

Drug therapy

Drug therapy is carried out for nulliparous women, as well as as part of complex treatment together with cauterization procedures or surgical interventions.

Table: medications for the treatment of erosions

Photo gallery: drugs to combat erosion

Amoxicillin helps cure genital infections Clotrimazole cream effectively fights pathogenic fungi Hexicon suppositories - a remedy for the local treatment of gynecological infections

Surgery

Surgical treatment involves surgical excision of the affected area or cauterization. Indications for surgical excision are:

• large area and rapid growth of the lesion;
• erosion in women who have given birth;
• the appearance of pain and bleeding;
• malignant degeneration (cancerous erosion).

This operation is carried out using the conization method - in this case, a section of tissue in the shape of a cone is removed, the top of which goes deep into the cervical canal, and the base is located outside. Removal is possible in several ways:

• classical surgical (using a scalpel);
• laser;
• radio waves.

Experts consider radio wave conization of the cervix using a device called “Surgitron” to be the most effective and least traumatic. The operation is performed outside the hospital; the use of local painkillers (anesthetics) is sufficient to carry it out. With this method, it is easy to control the depth of the intervention and the volume of tissue removed. In this case, the pathological areas are not destroyed and it is possible to send them for histological examination. Due to the coagulating effect of radio waves, bleeding is minimal.

Conventional knife conization is performed in an operating room. This intervention is performed under general or local anesthesia in an operating room in a hospital. The operation is highly traumatic and has a risk of bleeding.

Conization using a laser beam is reduced to tissue burning. With this method of treatment, it is not possible to study the removed tissue. In addition, this method does not allow determining the exact depth of excision. Laser conization can be performed only in cases of true erosions without the slightest sign of cell degeneration or malignant growth.

Methods of cauterization of the affected area are considered the most effective and modern. Their comparative characteristics are shown in the table.

Table: methods of cauterization of erosions

Video: laser treatment of erosions

The recovery period after surgical removal can last about 10 days. At this time, a woman may notice the appearance of reddish or brownish discharge from the genital tract. During this period, it is extremely important to observe the rules of personal hygiene.

After surgical treatment, the patient is strictly prohibited from:

• douche;
• visit the bathhouse, sauna, solarium, swimming pools, take a hot bath;
• sunbathe on the beaches and swim in open reservoirs;
• engage in sports or heavy physical work;
• be sexually active until your first menstruation;
• use sanitary tampons (pads are allowed).

Traditional methods of treatment

Folk remedies for getting rid of cervical erosion are most effective after the end of menstruation, when the recovery processes are faster and easier.

A popular home recipe is tampons with medicinal compounds:

1. Sea buckthorn oil is applied to a tampon and inserted into the vagina for 12–15 hours, placing a pad. The full course of treatment lasts 2 months, although noticeable improvements occur within 2–3 weeks. The oil accelerates the healing of erosion, reduces bleeding, eliminates pain and discomfort.
2. A tablespoon of linden honey is wrapped in a bandage or a piece of gauze and inserted deep into the vagina. It's best to do this before bed. The procedure needs to be done for 10–15 days. Honey stimulates regeneration processes and increases local immunity.
3. Fresh juice from aloe leaves can be used alone or mixed with an equal amount of honey. Soak a tampon in the liquid and insert it overnight. According to patients, recovery occurs after a month of regular use.

An effective method is douching:

1. A teaspoon (about 5 ml) of pharmaceutical tincture of calendula (marigold) is dissolved in 300 ml of heated water and douched. The procedure is carried out once a day, preferably at night. The course of douching lasts 21 days. Calendula relieves inflammation well and fights pathogenic microbes.
2. You can make an infusion of marigold flowers at home. To do this, take a tablespoon of flowers and pour half a glass of boiling water, then leave for 10 minutes. You should douche with this product every day for 7 days.
3. Chamomile flowers (2 tablespoons) are poured into 1 liter of fresh boiling water and left on low heat for 15 minutes, then left for half an hour. This product must be used within 2 weeks. Chamomile has an antimicrobial and anti-inflammatory effect, promotes the healing of erosion.
There are also recipes for folk remedies for oral administration:
1. Pour 1 liter of water into 7 yarrow flowers and boil for 20 minutes. The decoction is drunk throughout the day instead of regular tea, the course of treatment is 2 weeks. The product has a pronounced anti-inflammatory and wound-healing effect.
2. Grind fresh pumpkin seeds in a meat grinder and pour boiling water over them. For 1 part seeds take 2 parts water. Infuse the mixture for 10 hours and take half a glass in the morning. Pumpkin seeds contain a large amount of biologically active substances and accelerate tissue regeneration.

Pumpkin seeds accelerate the healing of erosions

Treatment prognosis, possible consequences

If cervical erosion was detected in a timely manner and the patient received the correct treatment, there is a high probability of a complete recovery. If appropriate assistance is not provided and the disease progresses, the following complications are possible:

• further growth of the lesion;
• the addition of a secondary bacterial or fungal infection and the development of the inflammatory process;
• development of bleeding from the genital tract;
• degeneration of erosion into cervical cancer;
• miscarriages during early pregnancy;
• development of female infertility.

It is also possible to develop some complications after surgical intervention on the cervix (knife conization or diathermoelectrocoagulation). As a result of such interventions, the following complications are possible:

• narrowing of the lumen of the cervical canal;
• difficulty getting pregnant;
• scar formation on the cervix;
• cervical ruptures in pregnant women or during childbirth;
• development of endometriosis - a chronic gynecological disease.

Prevention of erosion development

To prevent the formation of an erosive defect in the mucous membrane of the cervix, doctors recommend:

• avoid casual sexual contacts;
• use personal protective equipment against sexually transmitted infections;
• carefully observe the rules of hygiene;
• undergo regular preventive examinations with a gynecologist;
• promptly treat emerging diseases of the genital organs.

Cervical erosion is a benign process that leads to changes in epithelial structures. This disease ranks first among gynecological pathologies and is detected in 1/3 of patients. Is this disease dangerous, what symptoms are it accompanied by, and what should be done when the diagnosis is confirmed? Experts will tell you about all this.

In order to understand what cervical erosion is, this disease should be characterized in more detail. Small ulcers (erosions) appear on the mucous membrane of the female reproductive organ. The appearance of the occurring disorders depends on the degree of progression of the disease.

What is uterine erosion? This is damage to the mucous membrane adjacent to the vagina, which, in the absence of timely treatment, can provoke penetration of the pathological process into deeper layers.

There are several forms of ectopia, each of which differs in the course of the pathological process.

1. Ectropion. Characterized by free eversion of the cervical mucosa. Develops against the background of abortion or after the birth process.
2. Endometriosis. Accompanied by transplantation to the surface of the reproductive organ of the endometrium, located in the internal cavity.
3. Leukoplakia. A condition characterized by keratinization of stratified squamous epithelium.

Erosion may be accompanied by the appearance of polyps in the cervix and cervical canal. The development of genital warts cannot be ruled out. The defect can cause malignant degeneration.

In addition, the cervix represents an obstacle to the penetration of pathogenic organisms into the uterine cavity. It is here that the mucous membrane produces mucus, which is so acidic that it is destructive to pathogens.

As a result of erosion, damage occurs to the glands that are responsible for the synthesis of necessary substances. When disturbances occur in the body, infectious agents easily penetrate inside, which is fraught with the development of inflammation of the endometrium and ovaries. The result is infertility.

For a long time, cervical erosion does not reveal itself. The insidiousness of the disease is that it can develop at any age. This is due to the fact that the cylindrical epithelium covering the uterus does not have protective functions, and is therefore susceptible to the influence of bacteria and viruses.

After 1-2 weeks, the damaged areas of the mucous membrane begin to heal on their own. In most cases, incorrect epithelization occurs. In place of true erosions, pseudo-erosions appear - modified areas without signs of obvious damage.

Let's look at the main types of the disease.

A pathological process that forms against the background of exposure to unfavorable factors (inflammation, injury, etc.). As a result, the epithelium is exfoliated, and in its place the area of ​​inflammation begins to progress. True erosion develops below. When examined, it is bright red in color, damaged areas may bleed.

Pseudo-erosion

Epithelial cells are replaced by cylindrical ones. A false type of disease develops against the background of displacement of cells from the cervical canal beyond its boundaries. False ectopia develops in 35-40% of cases and has no characteristic symptoms.

Congenital erosion

Displacement of the internal uterine epithelium beyond the boundaries of the cervical canal can form during the process of intrauterine development. Experts have not fully studied the factors that contribute to this.

The congenital type of the disease is detected in childhood or adolescence during a routine gynecological examination.

Symptoms

With a disease such as cervical erosion, symptoms and treatment are closely related. The sooner measures are taken, the less likely it is to develop complications. The disease rarely manifests itself clinically, so the diagnosis is made mainly in advanced cases.

The photo clearly shows what cervical erosion looks like. It is not easy to imagine that in the absence of pain there could be an extensive ulcer inside. Such cases are not uncommon nowadays.

Progressive erosion of the cervix has quite characteristic symptoms.

1. Bloody discharge between menstruation and after sexual intercourse.
2. Unreasonable nagging pain in the lower abdomen and discomfort during intercourse.
3. Copious discharge of leucorrhoea in the absence of thrush.

The woman’s general well-being does not suffer. But often erosion is accompanied by an inflammatory process, which is characterized by an increase in pain and the amount of discharge. Leucorrhoea looks like a thick white liquid that does not have a pungent odor. When changing underwear, you can find peculiar marks, which can be an alarm bell, since they often accompany infectious diseases.

The appearance of complaints is due to the presence of concomitant diseases of the cervical canal (endocervicitis) or vagina (colpitis).

The listed symptoms are not specific for erosion, as they can occur against the background of other

pathological processes. If at least one sign occurs, you should consult a doctor as soon as possible. This approach eliminates the possibility of developing complications, which are characterized by the appearance of mucous or mucopurulent discharge, accompanied by severe discomfort.

It has not yet been fully studied which predisposing factors contribute to the appearance of wounds on the mucous membrane of the female reproductive organ. Before treating cervical erosion, a comprehensive examination is required to determine the probable cause of the development of the pathological process.

Among the main prerequisites are vaginitis and endocervicitis. In girls under 18 years of age, the congenital type of the disease is most often observed. In adolescents, disorders are possible against the background of the onset of sexual relations and due to hormonal changes in the body. In pregnant women, mucosal damage occurs for the same reason.

With a disease such as cervical erosion, the causes of pathological changes may be as follows.

• Mechanical damage. Among the provoking factors, prolonged and rough sexual intercourse, abortion, and childbirth should be highlighted. Physical impact on the squamous epithelium leads to the fact that its layers begin to thicken. This provokes the development of the inflammatory process.
• Infectious diseases transmitted through unprotected sex (genital herpes, human papillomavirus, etc.).
• Inflammation in the area of ​​organs located in the pelvis (endometritis, salpingitis, oophoritis, etc.).
• Untimely or illiterate treatment of gynecological diseases.
• Early or late onset of sexual activity.
• Frequent change of sexual partners or prolonged absence of sexual contact.
• Disorders of the menstrual cycle and hormonal status of the body.
• Violation of the body's protective functions.

Erosion of the physiological type, which occurs before the age of 25, should also be highlighted. In this case, there is no need for treatment, since the damage heals on its own.

Diagnostics

Already at the first visit, the gynecologist makes a preliminary diagnosis. Before treating cervical erosion, a number of laboratory tests are required:

• vaginal smear for flora and colposcopy;
• cytological examination and PCR to determine herpes, mycoplasmosis and trichomoniasis;
• blood test for syphilis, hepatitis and HIV;
• biopsy and bacteriological culture.

Treatment tactics depend on the characteristics of the patient and the degree of progression of erosion. The congenital form of the disease requires monitoring over time. In this case, self-healing is possible.

For erosion, drug or surgical therapy may be prescribed. Without fail, a specialist determines the cause of the disease and takes measures to eliminate it.

Conservative treatment is aimed at stopping the inflammatory process and combating sexually transmitted infections. The doctor may prescribe antibiotics that have a broad spectrum of action. It is recommended to use anti-inflammatory and immunomodulatory agents as auxiliary agents.

Locally, the cervix is ​​treated with drugs that are intended for chemical coagulation in the area that was affected. They do not leave scars, so they are widely prescribed to nulliparous girls. Among their disadvantages, the risks of relapse should be highlighted.

Surgery

Operating techniques are used only if there is no significant effect from medications. With an advanced degree of erosion, the doctor immediately refers the patient for surgical treatment.

Erosion is treated surgically using the following methods.

1. Cryodestruction. Treatment of the damaged area with liquid nitrogen at ultra-low temperatures. The damaged area is frozen point by point until healthy tissue is exposed.
2. Laser coagulation. With the help of a powerful beam of light, which is produced using special expensive equipment, the eroded area of ​​the mucous membrane is exposed.
3. Radio wave cauterization. To carry out the procedure, the Surgitron device is used, which is recognized by most specialists in the field of gynecology as the best method for combating erosion.
4. Diathermoconization. Removal of cervical erosion with a special loop. At the place where the eroded surface was located, a scab forms, which disappears on its own 7 days after excision of the overgrown tissue. The multilayered epithelium is restored only after 1-1.5 months.

Folk remedies

Alternative medicine should be used to increase the effectiveness of drug recovery or to increase the recovery period after surgery.

Among the most effective traditional medicines are:

• and sea buckthorn oil. Dissolve 2 tablets. in 1 tsp. and mix with 2-10 drops of sea buckthorn oil. Soak a sanitary tampon in this solution and use it for its intended purpose. It is recommended to carry out the procedure 1-2 times per day. The course of treatment is 5-7 days;
• bergenia root. Grind the plant on a grater, take 3 tbsp. l. and pour 200 ml of boiling water. Keep in a water bath for 15 minutes and drink 30 drops 2 times a day immediately half an hour before meals for 5 days.

How to cure cervical erosion with folk remedies? It is unacceptable to use medicinal herbs without consulting a doctor. Lack of timely drug therapy can lead to progression of the pathological process, which entails serious complications.

Prognosis and prevention

In advanced cases, erosion can cause the development of cervical cancer. It is better to prevent the disease or start treatment on time.

Among the most effective preventive measures are:

• regular visits to the gynecologist - at least 2 times a year;
• maintaining personal hygiene;
• desire for regular sex life and monogamy.

Conclusion

Cervical erosion is a serious disease that can cause malignant degeneration. Prevention of this disease is of great importance. If you consult a gynecologist in a timely manner, you can avoid the development of complications and be cured with the help of medications.

In advanced cases, surgical intervention is, unfortunately, indispensable.