Contents
What is cervical erosion?
Cervical erosion is an ulceration of the mucous membrane of the uterine os. Pathology is widespread and occurs in a third of women who come to see a gynecologist. However, true erosion should be distinguished from pseudo-erosion, since these are two different diseases, which means that their treatment will also differ.
Cervical erosion – is it dangerous?
Every woman who has been diagnosed with such a diagnosis wonders how dangerous this disease is. To assess the degree of threat to the body, you need to check with the doctor what exactly he means by the word “erosion”.
If a woman has pseudo-erosion, then this condition is not dangerous for the body. When true erosion is detected, it is necessary to find out the reasons that led to its development. If it is a vaginal infection, then there is a risk of its ascending spread to the uterus and appendages, which can lead to serious diseases, including infertility.
In any case, when a doctor prescribes treatment, you should not ignore it. Most common gynecological pathologies, such as vaginitis, endometritis and cervicitis, are associated with erosion – they either provoke its development or occur against its background. The most dangerous erosion of the cervix during pregnancy, as the risk of miscarriage increases, there is the possibility of fetal sepsis and death. Therefore, do not underestimate the danger of erosion and treat treatment lightly.
Causes of cervical erosion
There are several possible causes or theories for the occurrence of this pathology.
Among the most common of them:
Inflammation of the female genital organs. According to doctors, endocervicitis plays a particularly significant role. This is due to the fact that during such processes there is an increase in the excretory function of the glands located in the epithelium of the cervix, which becomes the cause of its damage;
Pathological discharge from the uterus, for example, destroyed polyps, endometrium, myomatous nodes. Such substances contribute to the desquamation and maceration of the epithelial tissue of the cervix. This does not happen immediately, but as a result of the long-term influence of secretions on the surface of the neck. As a result, a woman develops true erosion, and her surface is populated by pathogenic microorganisms that cause infectious inflammation. Among the possible dangerous inhabitants of the vagina: Trichomonas, gonococci, ureaplasmas, chlamydia, papillomaviruses, etc.;
Injuries. Mechanical damage to the cervix often occurs during operations, during childbirth, during abortions, the installation of intrauterine devices and other gynecological procedures. All this becomes the cause of eversion of the neck and the development of erosion;
Hormonal failures. Among the most dangerous conditions in terms of cervical erosion are late or, on the contrary, too early puberty of a girl, menstrual irregularities or ovarian functioning, their inflammation, pregnancy at an early and too late age;
immune disordersleading to various failures in the body, including erosion. In this case, diseases of a non-gynecological nature play a role;
Special development of the fetus during pregnancy. Sometimes a zone of cylindrical cells is formed outside the cervical os. However, such a defect is not considered a disease, does not require treatment and resolves on its own.
In addition, in nulliparous women, erosion occurs more often in the presence of the following predisposing factors:
Irregular sex life with rare sexual intercourse;
Early sexual debut;
Weak immune defense;
Frequent change of sexual partners and promiscuity.
There is also a connection between the development of the pathological process and the following reasons:
A woman’s addiction to smoking;
Hereditary predisposition to the formation of erosion;
It is possible that the use of hormonal drugs for contraception has an effect, but this relationship is still being established.
Sometimes in absolutely healthy women who did not give birth and did not have abortions, erosion occurs for no apparent reason. Most often, it passes on its own, and doctors associate it with the physiological processes occurring in the body. As for frequent stresses and the influence of other psycho-emotional causes on the development of the disease, the connection between them and cervical erosion has not been proven.
Symptoms of cervical erosion
The latent course of the erosive process is observed in 90% of cases. If there are symptoms, then it is extremely scarce and does not force a woman to see a doctor. Therefore, the pathology is mainly detected quite by accident, when a woman comes to the gynecologist for a preventive examination.
Possible rare manifestations of the disease may include:
With uncomplicated erosion, a woman’s natural vaginal discharge may increase. This factor is due to the fact that the increased area of the cylindrical epithelium produces more mucus;
Sometimes a woman is forced to go to an appointment by pain in the lower abdomen, menstrual irregularities, the appearance of whites that have an unpleasant odor. However, these clinical manifestations are explained by concomitant diseases of the genital area, and not by an erosive process;
Erosion itself in rare cases can cause a feeling of heaviness in the lower abdomen, the appearance of discomfort. Especially these sensations are intensified after intimacy. In addition, after intercourse, a woman may detect the appearance of minor spotting.
With an advanced form of the disease, the leucorrhoea becomes thick and mucous, blood or purulent contents can be observed in them.
Types of cervical erosion
Doctors distinguish several types of erosion, each of which has its own characteristics:
Erosion truethat resemble an abrasion. The surface of the stratified squamous epithelium is inflamed and damaged. After 1-2 weeks, this type of erosion either eliminates itself or transforms into ectopia when the stratified squamous epithelium is replaced by cylindrical cells;
pseudo-erosion, or actually ectopia. The cylindrical epithelium, as it were, creeps onto the neck area, which is normally lined with stratified squamous epithelium. On examination, the doctor sees a red surface with small villi. Ectopia can be acquired and congenital. As for the acquired variety of erosion, it occurs as a result of either a hormonal imbalance, or becomes the result of any diseases of a woman;
Erosion is congenital. At the same time, the border between the flat multilayered and cylindrical epithelium is displaced and is located on the vaginal part of the cervix. Such a defect is not large and by about 23 years passes on its own and without treatment. This type of erosion is very typical for nulliparous women under the age of 25 and for those who take oral contraceptives.
In turn, true erosion is of several types. It is classified depending on what caused the development of pathology:
True inflammatory – becomes the result of any infection of the genital organs (it can be trichomoniasis, chlamydia, etc.);
True traumatic – appears as a result of injuries during rough sexual intercourse, childbirth, diagnostic curettage, abortion, etc .;
True chemical – is formed as a result of damage to the cervix by aggressive substances used for douching with independent unskilled treatment;
True burn – is formed as a result of cauterization of the site of the throat of the cervix;
True trophic – occurs as a result of a violation of the blood supply to the neck or due to irradiation of the genital organs;
True specific – becomes the result of infection with syphilis or tuberculosis;
True cancer – is one of the forms of malignant tumors.
If the cause of true erosion was established correctly, then when the pathology is eliminated, the mucous membrane will recover on its own in half a month.
Perhaps women are wondering why such different conditions are united by one common term – erosion. The fact is that they all have one common symptom – damaged cervical mucosa.
Diagnosis of cervical erosion
After examining the cervix, the doctor makes a preliminary diagnosis. It sounds like “pseudo-erosion”, after which a number of additional examinations must be carried out.
For this, methods such as:
Determination of the microflora of the vagina by taking a smear;
Blood tests for HIV infection, possibly hepatitis and syphilis;
PCR is a method aimed at detecting sexually transmitted infections, and, first of all, at detecting HPV;
Colposcopy, when the cervix is carefully examined by a doctor under a microscope, special solutions can be used to clarify the diagnosis (this method does not cause the woman any discomfort or pain and allows you to distinguish pseudo-erosion from true);
A smear aimed at identifying atypical cells, which shows the following results: inflammatory cytogram, cytogram of endocervicosis, without features, with signs of dysplasia and leukoplakia, or proliferation of stratified squamous epithelium;
A biopsy of the cervix, which boils down to taking a small piece of tissue for examination. The procedure is carried out under the control of a microscope during a colposcopy (performed when there is a suspicion of a malignant formation);
If necessary, the doctor sends the woman to take blood tests for hormonal status;
To identify inflammatory and endocrine diseases, a woman is sent for an ultrasound scan of the genital organs.
Cervical biopsy
A biopsy is a procedure that is ordered by a gynecologist after a visual examination and colposcopy if cancer cells are suspected.
There are two types of this diagnostic technique:
At first, this is a trepanobiopsy, when tissue is taken from several damaged areas of the cervix. If a simple biopsy is supposed to be performed, then the doctor chooses the method of taking the puncture. If an endocervical biopsy is necessary, tissue is scraped from the cervical canal. Loop trepanobiopsy can also be performed, when tissue is taken using a special loop through which an electric current passes;
Secondly, this is conization. In this case, a wedge-shaped tissue fragment is taken. The procedure is performed using a scalpel or laser.
If the biopsy requires anesthesia, then the woman must refrain from eating for up to 12 hours before the procedure. Local anesthesia: a woman either treats the surface of the cervix with a spray with lidocaine, or injects it. The optimal time for diagnosis is the 7th or 8th day of the cycle.
If the biopsy is performed in a laboratory, then the woman is entitled to two sick days. The results of the study will be received within two weeks. Of the possible complications of the procedure, slight bleeding and pain are isolated, which are stopped by antispasmodics.
Over the next two weeks, a woman should not have sexual intercourse, bathe in the bath and lift weights. Inflammatory processes of the genital organs and blood clotting disorders act as contraindications for cervical biopsy.
Popular questions and answers:
Can cervical erosion go away on its own? Independently, without any treatment, erosion may well pass. But this applies only to a certain age category of women and a certain type of pathology. Congenital ectopia of the columnar epithelium can self-eliminate, it disappears up to 23-26 years without any outside interference. Also, without treatment, gestational erosion in pregnant women, which arose as a result of increased production of progesterone, can pass. Another possible option for self-elimination of erosion is observed when the defect was caused by taking hormonal contraceptives. There are frequent cases of self-healing from true erosion caused by traumatic factors (for example, when douching or as a result of careless intimacy). However, when a defect is formed as a result of a disease or inflammation in the body, it requires treatment and threatens with serious complications.
Is it possible to get pregnant with cervical erosion? This kind of defect does not affect a woman’s ability to reproduce in any way, so it is possible to become pregnant with erosion. Sometimes patients believe that they could not conceive a child precisely because of ectopia, but in reality this is not the case. Pathology is only a consequence of any disease. It is the disease that caused erosion that can lead to problems with conception, for example, if a woman has inflammation of the uterus, ovaries, appendages, etc. After the cause of erosion is eliminated, conception will occur, and the cervical defect often resolves itself when the child appears into the world. In the event that a woman has erosion, but no infectious and inflammatory processes are diagnosed, then she is able to conceive a child at any time.
How quickly can you get pregnant after cauterization of erosion? Cauterization does not affect the reproductive function.
Is it possible to give birth with cervical erosion? You can give birth with cervical erosion only if it is congenital. When there is an acquired pseudo-erosion, before planning a pregnancy, it is necessary to get rid of all diseases of the genital organs, normalize the hormonal background, etc. In addition, the damaged surface of the cervix is a potential threat to the fetus, as it becomes an ideal environment for colonization and reproduction of bacteria. That is why doctors recommend eliminating all types of erosion, except for congenital, and only then plan conception. However, if it turns out that there is erosion, and the woman is already pregnant, then this is not an indication for interruption (except for third-degree dysplasia).
Can cervical erosion develop into cancer? Erosion can lead to oncology only in the presence of HPV-oncogenic types, or the presence of HIV infection. Therefore, it is imperative that during erosion, PCR is taken for the human papillomavirus and colposcopy is done.
Does it hurt the erosion of the cervix? The procedure is painless, but a few days after it is carried out, a woman may begin to experience discomfort. They are localized in the lower abdomen and are similar to aching and pulling sensations that often occur on the first day of the menstrual cycle.
I was cauterized by erosion, but after 2 years it reappeared. What to do? You will need re-treatment. Perhaps more radical. Of the existing methods, laser therapy gives the smallest percentage of relapses.
I have watery discharge mixed with blood after cauterization of cervical erosion. This is fine? Yes. They can last a month after cauterization.
How long can you not have sex after cauterization of cervical erosion? Approximately 4 weeks until the complete disappearance of spotting.
Is it possible to have sex with erosion? Yes, you can.
The doctor suggested cauterizing the erosion with liquid nitrogen. Will I have a scar on my cervix after the procedure? No, it will not, this method does not leave scars, it can be recommended to nulliparous women planning a pregnancy in the next year.
How to treat cervical erosion?
In order to determine the therapeutic regimen, it is necessary to take into account many factors, the main among which is the cause that caused erosion.
It is important to eliminate it first of all:
If a woman has sexually transmitted infections, then they should be treated depending on which pathogen caused the disease. For this, either antibiotics or antiviral agents are used;
When the course of therapy aimed at eliminating inflammation is completed, the doctor will decide what is the best way to get rid of pseudo-erosion. This is also affected by the area of the throat of the neck, which is involved in the pathological process, and at what age the patient is, and whether she plans to have children, etc.;
Modern methods of eliminating erosion allow even nulliparous women to get rid of the pathological process. While in the past, erosion was recommended to be treated only after childbirth, and the process itself dragged on for several years;
Eliminate the defect in the first phase of the next menstrual cycle, as soon as the bleeding ends. However, there are exceptions, in particular, the method of diathermocoagulation.
It is worth knowing that the so-called cauterization is not always an impact with the help of any toolkit. In some cases, the defect can be removed using special preparations.
Chemical coagulation
This method of ridding a woman of cervical erosion comes down to the fact that the area with the defect is treated with a chemical preparation. As such, Solkovagin can be used. It contains zinc nitrate, nitric, oxalic and acetic acid. The use of chemical coagulation is possible with small erosions.
In the recent past, doctors used another drug, Vagotil, to eliminate the defect. It was applied to a tampon and inserted deep into the vagina for a week. However, modern doctors do not use it, since it acts on the surface layers without penetrating inside, which leads to a low effectiveness of the drug. While after treatment with Solkovagin, a scab is formed, which is rejected after a few days. After two months, complete tissue regeneration occurs, and the healing process is completed.
Among the positive aspects of chemical coagulation:
No pain during the procedure;
Ease of use of the method (cauterize the erosion twice with a break of several minutes);
Low cost of the drug (the price of two ampoules of Solkovagin does not exceed 1200 rubles).
If we consider the negative sides, then the only negative is the ability to process only slight erosion.
Diathermocoagulation
This method of getting rid of pathology refers to outdated methods, and it has many disadvantages. The essence of diathermocoagulation is that erosion is cauterized with high-frequency current, and a black scab is formed on the treated area, looking like a burn. In this regard, this method of treatment is currently used extremely rarely.
Other cons of this method include:
During treatment, the woman experiences pain;
Both during and after cauterization, there is a risk of bleeding;
The cervix is deformed as a result of scarring, so it is not possible to use this method in women who are going to give birth, as well as in women who have not given birth.
Recovery occurs after 1,5 months, and the cauterization itself is performed immediately before menstruation, so that the scab is rejected faster and more painlessly. Among the advantages of diathermocoagulation are the possibility to perform conization of the neck before this, as well as the low cost of the method and its simplicity.
Laser vaporization
This method is one of the most common. It boils down to the fact that the affected area is treated with a beam of laser beams. Before irradiation, the cervix is wiped with a solution of acetic acid and iodine solution. This allows you to achieve vasospasm, and also makes it possible to “outline” the boundaries of erosion. When a laser beam hits the pathological tissues, moisture evaporates from the damaged cells and as a result they are destroyed.
Among the positive aspects of this technique can be noted:
No pain during the procedure;
High efficiency, while the guarantee of recovery is 98%;
Scars do not form on the cervix.
Among the main disadvantages of this method, the relatively high cost of the procedure is distinguished, and the decay zone of healthy tissue is quite large compared to radio wave erosion therapy.
Cryodestruction
This relatively new method is based on the fact that the affected area is treated with liquid nitrogen, its temperature can reach 150 ° C with a minus sign. Nitrous oxide is sprayed using a special apparatus. In this case, the area of the treated tissue acquires a light color and becomes insensitive. The fluid in the affected cells turns into ice crystals, which leads to the destruction of pathological tissues. The procedure takes an average of 15 minutes, and full recovery occurs after 1,5 months. After the treatment, the woman has abundant discharge, which mainly consists of water.
Among the positive aspects of this method of treatment:
High efficiency, which reaches 97%;
Ease of implementation;
No pain during treatment;
No deformity of the cervix.
Among the shortcomings of cryocoagulation, doctors highlight the possible risk of incomplete treatment of the damaged area, as well as the appearance of copious discharge (possibly with blood impurities) after the procedure.
Radio wave method
This method of treatment is one of the most popular in modern medicine. He is preferred by the majority of oncogynecologists, calling the treatment with radio waves the most effective. The method is non-contact, while the electric current, passing through the special apparatus Surgitron, is transformed and converted into radio waves. With the help of an electrode, they are directed exactly to the affected area.
During the procedure, there is no contact between the tissues and the electrode, the cervix is not exposed to high temperatures and does not heat up, which does not lead to burns. In this case, the liquid from the pathological cells evaporates, and the diseased cells themselves are destroyed. The immediate affected area is small, healthy tissue does not suffer from radio waves, which is an undoubted advantage of this method.
It is worth knowing that the procedure can cause pain, so local anesthesia is necessary.
Among the positives:
100% cure for erosion is guaranteed;
The risk of bleeding is reduced to zero;
The neck does not form a scar, it is not deformed.
After a maximum of three weeks, tissue is completely restored, and the woman recovers. In addition, the procedure can be carried out on any day of the menstrual cycle. As for the shortcomings, there is only one – not every clinic has equipment for radio wave treatment, and it is not cheap.
Surgitron in the treatment of cervical erosion is a recognized leader in terms of effectiveness. This is a special apparatus that is used to eliminate erosion using radio waves. Damaged tissues are simply evaporated under the influence of microwave vibrations. The patient experiences almost no pain during such treatment. At the same time, the vessels are instantly sealed or coagulated, which prevents the development of such a complication as bleeding. After the treatment is completed, a special protective film is applied to the damaged surface, which makes it possible to protect the uterus from various infections.
Treatment with this modern device is suitable for most women, even those who have not had pregnancies and have not gone through childbirth. This is due to the fact that scars will not form on the surface of the cervix, as with other methods of exposure. It is the scars that often cause violations of labor activity in the subsequent time. Also, treatment with Surgitron is suitable for women who have recently given birth, who have just completed lochia, while lactation is not a contraindication to the procedure.
However, despite the fact that the method is minimally traumatic, before undergoing treatment, a woman needs to carefully prepare.
These activities boil down to:
Identification of infections of the genital tract, including hidden ones. Any inflammatory process must be excluded: vagina, uterus, ovaries, tubes;
The procedure is not done during menstruation;
Treatment with Surgitron should be carried out with extreme caution if a woman has poor blood clotting;
Before starting treatment using radio waves, a woman must undergo a complete diagnosis.
When the session is completed, for two weeks you should not lift weights, bathe in the bath and live an intimate life. When the doctor confirms that the recovery process has come to an end, you can start planning a pregnancy.
Candles for cervical erosion
Erosion can be treated not only with cauterization, but also using various candles.
This method is the most gentle, among the indications for candle therapy:
An erosive process caused by an imbalance in the microflora of the vagina;
Pain during the menstrual cycle with localization in the sacrum;
Erosion caused by venereal diseases;
Injuries received after abortion or difficult childbirth;
Erosion, formed as a result of hormonal failure.
However, it is worth knowing that candle therapy is possible only with small areas that have undergone a pathological process. Erosions of a larger size, as a rule, do not respond well to conservative treatment. Candles can also be prescribed as an adjuvant therapy after cauterization. You should not prescribe the drug yourself and use it to eliminate erosion, as this can be detrimental to health. It should be taken into account that sea buckthorn oil is not used to treat ectopia, as it promotes the growth of epithelial tissue, which means it stimulates the growth of erosion. It is possible to treat ectopia with sea buckthorn candles only after it is cauterized.
The recommended therapeutic course is 2 weeks. In addition, the following may be assigned:
Candles Depantol. They are administered intravaginally twice a day. The maximum duration of a course of treatment is 3 weeks. During therapy, it is forbidden to use toilet soap for washing, since the components included in its composition neutralize the effect of candles;
Candles Hexicon. They are able to relieve inflammation, normalize the microflora, have no contraindications. They are also used twice a day, the duration of the course can be a maximum of 20 days;
Candles Livarol. The advantage of this remedy is that it is enough to administer it once, and the therapeutic effect can be achieved after five days. However, they cannot be used during childbearing, during lactation and in the presence of hypersensitivity to the components that make up the candles;
Fitor candles. This remedy is made on a natural basis, more often used after cauterization of erosion;
Candles Clotrimazole. The therapeutic course is 6 days, a candle is inserted once a day;
Candles Suporon. Based on therapeutic mud, application is possible only after consulting a doctor.
Should erosion be treated at all?
Cervical erosion does not always require treatment. The need for therapy is determined by the doctor and depends on a number of factors. It is important to establish the type of erosion, the degree of its progression and the cause of the occurrence.
According to etiology, it is customary to distinguish the following types of cervical erosion:
Ectropion;
Ectopic columnar epithelium;
Erosion true;
Erosion is inflammatory or the so-called cervicitis.
As a rule, the doctor informs the patient about the problem, but does not name the type of erosion during the announcement of the diagnosis. Although this moment is one of the key in the question of the need for therapy. Therefore, after making such a diagnosis, a woman must independently clarify it.
To determine whether erosion should be treated, the patient is referred for a colposcopy. In parallel, tests are performed for hidden sexual infections (syphilis, trichomoniasis, chlamydia, etc.). Only after receiving the results of all studies, you can decide on the tactics of further treatment.
If there are no latent sexual infections, and inflammation of a non-specific nature (candidiasis, vaginal dysbacteriosis) is not detected, then it is not necessary to treat the mucosal defect. It does not matter what type of erosion a woman has.
The next diagnostic step is to take a smear to identify atypical cells. If it is negative, then you should take a wait-and-see attitude. This is due to the fact that any erosion against the background of the full health of the reproductive system can resolve itself. Even if there is no cure, surgery will not be required until undesirable changes are detected in the cytology smear, or other signs appear that indicate the presence of severe cervical dysplasia.
Erosion treatment is required if it is covered with ulcers, or if there is an inflammatory process in the vagina. Therapy is reduced to taking medications (antibiotics, antifungal and anti-inflammatory drugs), which should act directly on the cause of the pathology. The success of medical correction is achieved in 90% of cases. Therapy can last up to 3-4 months. Only after this time is it possible to make a decision to perform a surgical intervention using one method or another (radio wave surgery, laser or chemical coagulation, diathermocoagulation, etc.).
The operation is indicated for severe dysplasia, which is detected by the results of a cytological examination of a smear. It does not matter whether there is an inflammatory process in the vagina or not. Affected tissues are unambiguously removed.
Prevention of cervical erosion
All doctors are unanimous in one opinion – erosion, like any other disease, is easier to prevent than for a long time, and, at times, it is painful to get rid of it. Therefore, the prevention of this cervical pathology is a rather urgent issue:
Regardless of whether a woman is healthy or not, she needs to undergo regular examinations by a gynecologist. Both visual inspection and smear sampling are important;
It is important for a woman to adhere to elementary hygiene rules, not to forget about the need to wear underwear made from quality materials;
A permanent sexual partner is a guarantee of protection against most sexually transmitted diseases, which, in turn, can provoke erosion. Do not ignore such an elementary method of contraception as a condom. It will protect a woman not only from diseases, but also from unwanted pregnancy, which can lead to abortion, injury and erosion;
It is important to monitor the state of the immune system and eliminate any diseases in time. For this purpose, it is worth taking vitamin and mineral complexes, which are especially relevant in the autumn and spring. In this regard, physical activity, a balanced diet, yoga classes, etc., perfectly “work” on the immune system.
These measures are quite enough to avoid such an unpleasant pathology as cervical erosion, especially for nulliparous women. Naturally, before planning pregnancy, it is best to get rid of erosion, if it is not congenital. This will help preserve the health of the woman and the unborn child.