Contents
What is cervical erosion
Cervical erosion is damage to the upper layer (epithelium) of the cervix. True erosion should be distinguished from ectopia – the movement of the cylindrical epithelium from the cervix to its vaginal part. By the way, a few years ago, gynecologists did not distinguish between ectopia and erosion, but these are completely different things.
Most often, true erosion can occur after the appearance of human papillomavirus infection in a woman’s body. Violation of the integrity of the epithelium of the cervix can be the cause of many gynecological diseases, as well as go into dysplasia (precancerous condition), and subsequently cervical cancer.
– The main difference between true cervical erosion and ectopia is that ectopia is the physiological state of the cervix. Ectopia is the movement of the cylindrical epithelium of the cervical canal to the surface of the cervix, a congenital condition, occurs in almost every second girl and, as a rule, epidermizes independently by the age of 25-26.
True erosion of the cervix is a pathological condition characterized by desquamation of the epithelium due to inflammatory diseases, injuries, age-related changes in the mucous membranes (atrophy), explains obstetrician-gynecologist of the highest qualification category Natalya Belyaeva.
What you need to know about cervical erosion
| Synonyms | True erosion, ulcer |
| ICD 10 code | N86 Erosion and ectropion of the cervix |
| How often does it occur | In 15-20% of women of childbearing age |
| Methods of diagnosis | Cytological examination, colposcopy, PCR diagnostics, biopsy. |
| Complications | Endometritis, cervicitis, infertility, cancer. |
Causes of cervical erosion
The causes of true erosion of the cervix include:
- sexually transmitted diseases,
- inflammatory diseases of the genitourinary system,
- hormonal disorders,
- mechanical trauma to the epithelium of the cervix – abortion (especially instrumental, vacuum),
- gynecological operations and manipulations,
- complicated childbirth,
- chemical effects on the cervix (frequent douching, spermicides, abuse or misuse of medicinal suppositories or vaginal tablets).
Also, many experts call the human papillomavirus the main cause of true cervical erosion.
Symptoms of cervical erosion
Most often, true erosion of the cervix occurs in women completely asymptomatically, and only on examination by a gynecologist does the patient find out about her problem. However, in some cases, for example, with concomitant inflammatory processes in the cervical canal or vagina or infections, the following symptoms may be observed:
- copious mucous or purulent discharge,
- spotting (often after intercourse, when the epithelium of the cervix is mechanically injured, and the true erosion is quite extensive),
- pain or discomfort during intercourse.
Treatment of cervical erosion
Diagnostics
A gynecologist can make a diagnosis of true erosion of the cervix during an examination. A colposcopy is mandatory: a study using a special device-colposcope of the cervix, cervical canal and vaginal mucosa. With the help of a colposcope, the doctor can see suspicious areas of tissue, assess their condition, how deep the lesion is, and also distinguish benign from malignant tumors.
The doctor also prescribes a gynecological smear for oncocytology (a study under a microscope that allows you to determine the presence of atypical – precancerous or cancerous cells in a smear), and, if necessary, a biopsy.
A biopsy of the cervix is considered a minor gynecological operation, but is performed on an outpatient basis and without the use of anesthesia, but only local anesthesia. A small piece of tissue is plucked from the affected area of tissue and sent for histology to determine if there is a development of a malignant process.
Modern treatments
Treatment of true cervical erosion involves several treatment options. Treatment is prescribed by a gynecologist, based on the results of the examination. For young nulliparous girls, the most sparing method of treatment is chosen so as not to cause complications during childbirth.
- Local drug treatment (for example, suppositories with panthenol, which promote the healing of erosion. So cervical erosion can be treated at home, but it works very early in the disease. With extensive lesions, of course, no suppositories will help). In the event of a bacterial infection, antibiotic therapy is prescribed.
- Cryodestruction. This is the “freezing” of erosion with the help of liquid nitrogen, while only affected tissues are affected, and healthy ones are not damaged. The main advantages of this procedure are: accessibility, painlessness, no bleeding, a quick recovery period, no scarring on the cervix after treatment. True, there are also disadvantages: often, after cryodestruction, erosion can return.
- Laser coagulation. During this procedure, the affected areas are exposed to a laser, which seems to evaporate the defective tissue, while healthy cells are not affected. It is carried out on the 5-8th day of the menstrual cycle. After laser coagulation, there are also no scars on the cervix, the procedure is fast, effective, painless, and recovery after it is very fast. Also, due to the effect of the laser, blood supply to the tissues improves, which leads to their rapid regeneration.
Contraindications to laser coagulation include pregnancy, inflammatory processes in the small pelvis, cervical dysplasia II and III degree, malignant tumors in the small pelvis.
- Diathermocoagulation. Previously, cauterization with electric current was the most popular (and probably the only) method of treating cervical erosion. At the same time, the method itself has many disadvantages: soreness, bleeding during the recovery period, and most importantly, scars remained on the cervix, so during childbirth there was often a risk of complications, ruptures, and premature disclosure. Now this method is practically not used by gynecologists.
- Radio wave treatment. FROMIt is read as one of the most modern and effective methods of treating not only cervical erosion, but also other gynecological diseases. For radio wave treatment, modern devices “Surgitron” or “Fotek” are used. The radio wave painlessly affects the affected areas without affecting healthy tissues. The procedure lasts only 15-20 minutes, while the woman practically does not experience any discomfort, since the radio wave “solders” the nerve endings. Radio wave treatment has many advantages: the postoperative period passes quickly, tissues recover quickly, scars do not form.
- Argon plasma coagulation. One of the most modern and sparing ways to treat cervical erosion. With this method, radio wave treatment is enhanced by an inert gas – argon. The procedure is practically painless, does not leave scars on the tissue, while full recovery occurs within 1,5-2 months, and the postoperative period itself proceeds without any discomfort.
Prevention of cervical erosion at home
Prevention of true cervical erosion includes the following items: personal hygiene, exclusion of casual sex and frequent change of sexual partners, use of barrier contraception (for example, condoms) during sex, timely treatment of inflammatory diseases and sexually transmitted infections.
Since often erosion may not manifest itself in any way, make it a rule to regularly (2 times a year) be examined by a gynecologist, and immediately seek advice if there are any complaints. Also, at least once a year, you need to undergo a colposcopy to notice any change in the tissues of the cervix, cervical canal and vaginal walls.
Popular questions and answers
The most common questions regarding cervical erosion, we asked obstetrician-gynecologist of the highest qualification category Natalya Belyaeva.