Update: October 2018
Common gynecological pathology – erosion
cervix, which is observed in about a third – half
women who applied to receive. Although the diagnosis of cervical erosion is not
quite true when they talk about erosion, they usually have
mind pseudo cervix, respectively, methods of treatment of the
or other pathologies differ. Speech in the proposed material
talk about pseudo cervix or ectopia.
The cervix is a continuation of the main reproductive organ.
women – uterus. The neck is divided into the supravaginal part, hidden in
the pelvis and vaginal, visible to the eye in gynecological
mirrors. The vagina is reported to the uterine cavity through the cervical
a channel that is lined with a cylindrical (cubic) epithelium.
The glands of this epithelium actively produce mucus, which protects
cervical canal and uterus from infectious agents. Vaginal
part of the neck lines the stratified squamous epithelium.
A defect in the mucous membrane of the eye visible part of the neck is called
erosion. This disease refers to the background processes of the cervix, but
in any case, erosion needs treatment. As a result of this
multilayer epithelium flaw located on the vaginal part
cervix is replaced by the epithelium of the cervical canal. Three forms are known
It is a damaged area of a multilayer flat
epithelium and resembles a wound, as with abrasion (desquamation). AT
as a result of damage, the wound surface becomes inflamed. Exists
true erosion is short-lived, only 7 – 14 days, after which it either
heals itself, or goes into ectopia.
Pseudo-erosion or ectopia
Such pathology arises due to the creeping of cylindrical
epithelium on the ulcerated cervix or true erosion.
The cubic epithelium looks like velvet, so the eye is visible
plot of red with small villi – velvety.
It is an offset boundary of the multilayer flat and
of the cubic epithelium in the direction of the part of the cervix protruding into the vagina
and is outside of the external os. Its size is small.
This condition does not require treatment, usually by age 23.
erosion disappears (the cylindrical epithelium “crawls” into the cervical
Causes of erosion
Cervical erosion and the reasons for its appearance are discussed.
Doctors for quite a long time. AT настоящее время получило
Spreading several theories:
- In the first place is the theory of female genital inflammation.
organs, especially endocervicitis, which is accompanied by enhanced
secretion of cervical epithelium glands.
- Pathological secretions that expire
from the uterus (endometritis, collapsing polyps, inflamed myomatous
nodes, etc.). Such pathological secretions have a long-term effect on
epithelial lining of the vaginal part of the cervix, as a result of which
macerated and exfoliated (desquamation). AT результате возникает
true erosion, the surface of which is actively populated by pathogens
microorganisms (chlamydia, ureaplasma, herpes viruses, papillomas
human, Trichomonas, gonococci and others).
- Another, equally important, theory of erosion is
traumatic. Mechanical neck injury happens during
births, neck surgery, abortions (consequences), intrauterine devices
procedures and other things lead to the formation of ectropion (inversion of the neck)
and its eroding.
- Theory of dyshormonal origin of cervical ectopia
implies a violation of the ratio of sex hormones. So to
hormonal changes include early and late sexual
maturation, various cycle disorders, ovarian dysfunction,
chronic inflammation of the ovaries, childbirth in young and late
And predispose to the occurrence of the disease:
- early sex life
- promiscuous sex
- rare sex
- weakened immunity
The relationship between factors such as:
- hormonal contraceptives and the development of ectopia still
pore still proved.
The clinical picture of cervical erosion
In more than 90% of cases, erosion of the cervix flows latently, without
symptoms. The disease is usually detected by chance, with
routine examination when the gynecologist in the mirrors sees a defect
- Uncomplicated cervical ectopia is characterized by a single
a sign – an increase in whiter. ATыделения при эрозии объясняются
the production of mucus glands of the cylindrical epithelium, the area
which has increased.
- ATсе остальные клинические проявления эктопии (выделения с
smell, pain, disturbed menstrual cycle)
uncharacteristic and associated with other diseases that accompanies
- Some women may complain of discomfort and
heaviness in the abdomen, which increases during coitus and blood
ATрач, осмотрев шейку в зеркалах, выносит диагноз, пока еще
preliminary: “Pseudo-cervical erosion”, and then directs
patient for additional examination. Additional
research includes analyzes and instrumental examination:
- a smear on the vaginal microflora (see leukocytes in a smear);
- кровь на сифилис и антитела к ATИЧ-инфекции;
- smear on atypical cells from the vaginal part of the neck / cervical
channel (can be 4 types: without features, proliferation
cubic epithelium, cytogram of endocervicosis, inflammatory
cytogram, signs of leukoplakia or cervical dysplasia).
- ПЦР-диагностика половых инфекций (в первую очередь ATПЧ);
- colposcopy – examines the cervix under a microscope,
Absolutely safe and painless method (when
diagnostic samples revealed a plot with a velvety surface and
clear boundaries after treatment with a solution of vinegar, which
slightly stained or not stained after exposure to iodine
- fence a piece of cloth from the most suspicious area under
control colposcopy or cervical biopsy;
- Ultrasound of the internal genital organs to detect inflammatory and
- blood tests for hormones (if indicated).
How to treat
Treatment of cervical erosion is selected based on many factors.
After the examination, the doctor determines the cause, which
caused the disease. If possible, eliminate the cause.
- That is, if hidden genital infections were discovered,
appropriate therapy is recommended, depending on the highlighted
pathogen (antiviral drugs or antibiotics).
- After completing the course of anti-inflammatory treatment gynecologist
selects the best way to remove pseudo-erosion, given
area of the nidus, age of the woman, her attitude to
future birth and other factors.
- Virtually all methods of cervical ectopia removal are currently
time can be used in women who have not passed through childbirth (this
importantly, not so long ago, erosion treatment was postponed for a period
after the birth of a child, which could be delayed both for a year and for
- Removal of cervical pseudo-erosion should be carried out in the first
phase of the cycle, immediately after the end of menstruation, but the method
diathermocoagulation is an exception.
�”Cauterization of cervical erosion” is carried out by pharmacological
method and non-drug methods.
This method of cervical ectopia removal is to process
pathological site chemical solutions for example
drug Solkovagin. Its components are
organic acids (oxalic and acetic) and zinc nitrate with
nitric acid. Chemical destruction is used only when
treatment of small areas of ectopia.
Не так давно популярностью пользовался ATаготил, тампоны с
which for 7-10 days were applied to erosion. Today
treatment with vagillo does not apply, since the depth of its penetration
in the modified tissue is small, and therefore, the effectiveness of therapy
is low. After cauterization of erosion by solkovagin on its surface
scab is formed, rejected in a few days. Complete
regeneration occurs after 6 to 8 weeks.
The advantages include:
- almost complete painlessness;
- ease of processing (twice at intervals of several
- relatively inexpensive (the cost of solkovagin varies from 750
up to 1200 rubles: 2 ampoules in 0.5 ml packages;
The disadvantages include low efficiency, processing
only small cervical ectopias are produced.
A rather old method with a lot of flaws. The essence
diathermocoagulation consists of cauterizing the ectopia with a high current
frequency, that is, at the site of erosion, a black scab is formed as after
burns AT настоящее время практически не используется.
- the risk of bleeding occurring during cauterization and
- altered by cervical scarring, and this makes it impossible
apply the method in non-giving girls and women planning
Complete healing occurs at 4–6 weeks. Moxibustion
carried out in the second phase of the cycle, on the eve of menstruation, in order to
menstruation “washed” the scab, which contributes to its more “gentle”
Positive aspects of DTC: the possibility of conizability
cervix, if necessary, the simplicity and low cost method.
The widespread method of processing
pathological site by a laser beam (contactless method).
Before manipulation, the cervix is wiped with acetic acid solution.
in order to spasm blood vessels and iodine solution to determine
boundaries of ectopia. Under the action of laser beams liquid from
pathologically altered cells evaporate and they are destroyed.
Advantages of the procedure:
- the method is practically painless;
- high efficiency (98% recovery);
- Do not form scars on the neck.
The disadvantages are the high cost and the need for special
instrumentation, which makes the accessibility of the method relative and large
the decay zone of healthy tissue (1.2 mm) than with radio wave treatment
Cryocoagulation is based on the treatment of the pathological focus
cooled to 100 – 150 degrees with liquid nitrogen (replacement – nitrous
nitrogen), which is sprayed apparatus. Plot area
whitens and loses sensitivity. Fluid in the cells
crystallizes, so that they are destroyed. Duration
manipulation is 15 minutes. After processing appear
significant watery discharge most of the recovery
ectopia begins by day 7, and complete healing occurs by
after 4-6 weeks.
Advantages of the method:
- quite effective (85 – 97%);
- практически полная безsoreness;
- does not violate the structure of the neck.
The disadvantages include the possibility of blood discharge
after treatment and the risk of incomplete treatment of pathological
Radio wave method
This method of treatment of ectopia and not only, enjoys a wide
popular lately. Gynecologic treatment of diseases
radio waves are considered the best method among all
used by The method refers to contactless and is based on
converting electric current into radio waves (apparatus
Surgitron), which with the help of the electrode are sent to the affected
AT процессе манипуляции электрод не контачит с тканями и не
heated, that is, the risk of burns is completely excluded.
Under the influence of radio waves, the liquid from the cells evaporates and they
break apart. The zone of altered epithelium at the border of healthy and
pathological tissue is 0.04 mm, that is, we can say that
radio waves stop in the affected area without affecting
healthy cells. The method is relatively painful, but only requires
Advantages of the method:
- cicatricial deformity of the neck after the manipulation does not occur;
- efficiency reaches 100%;
- the risk of bleeding is almost zero.
Healing comes by 2 – 3 week. The procedure can be carried out.
on any day of the cycle.
The disadvantages can be attributed only to the fact that not all women
consultations have special equipment.
After treatment of cervical erosion
What method would not be carried out ectopia removal, it is necessary
follow certain guidelines:
- sexual rest for a period of 6 weeks, sex is permitted by a doctor after
examination of the cervix;
- limiting weight lifting and debilitating physical
- postpone visits to the bath / sauna, refusal to take baths.
AT послеоперационном периоде показана местная терапия в виде
tampons with medicinal ointments (levomekol, sea buckthorn oil),
which helps to soften the scab and prevents bleeding during
time of its rejection. Folk remedies to eliminate ectopia
are used, they can only be used as a supplement to
major postoperative recommendations and after consultation with
Note! Beloved sea buckthorn oil beloved by women
used to get rid of erosion (in the form of tampons), this
вызывает пролиферацию (разрастание) эпителия, а значит и erosion.
This appointment is possible only after its cauterization.
After successfully treated cervical erosion, the patient can safely
планировать pregnancy. AT любом случае, перед тем как решиться на
pregnancy, all chronic pathologies should be treated and
get rid of foci of infection.
Although the described pathology and refers to background diseases
cervix, cervical cancer is among the consequences of erosion,
every patient must remember. Certainly, cervical ectopia is not
means 100% rebirth in a malignant process, but is
the first bell. Thus, in 3% of women with erosion in cytological
smears detected atypical cells indicating
dysplasia, which is a direct road to cervical cancer.