True erosion of the cervix

True erosion of the cervix is a benign pathology of the vaginal endocervix, accompanied by a significant change on the surface of the cervix in the form of obvious bright red or pink spots.

This disease today is one of the first places among women with gynecological diseases.

Causes of the true erosion of the cervix

The causes of true erosion of the cervix are somewhat diverse, and in order to prescribe effective therapy, the specialist must present a complete clinical picture of the disease, only in this way can one determine the "provoker" of the disease. Physicians differentiate the acquired and congenital erosion of the cervix. As is clear from the title, congenital pathology is a disease with which a person has already been born. But on the pages of this article, we will try to understand in more detail the life-time (true) erosion of the cervix.

So what can lead to true erosion of the cervix?

• A consequence of inflammation caused by such invasive microorganisms as streptococci, gonococci, herpes virus, chlamydia, ureaplasma, yeast fungi, human papilloma, staphylococci, Trichomonas.
• Cervical injury (cervix uteri, cervix), obtained during obstetrics, abortion or surgical intervention, can also provoke this pathology. Trauma can also be caused by too young or late births. Other factors can trigger the trauma.
• Endocrine diseases.
• The cause of the disease can be a transferred colpitis (inflammation of the mucous walls of the vagina, of various origins).
• Early or, conversely, rather late onset of sexual activity.
• Irregular sexual relations.
• Multiple, often changing, partners.
• Dysbacteriosis of the vagina.
• Hormonal failure in the body of a woman: dysfunction of the ovaries, the failure of the menstrual cycle and so on.
• Immune disorders.
• Endocervicitis - inflammation of the mucous membrane of the cervical canal of the uterus, accompanied by increased functioning of the secretions of glands of the cervical epithelium.
• Endometritis is an inflammation of the inner layer of the uterus. As a consequence, discharge begins from the cervical canal. If this process takes a long time, the outer layer of the epithelial lining begins to soften and peel off. This process has a specific name - desquamation. During these changes, after the exfoliated site of the epithelium, the wound remains on the mucosa.
• Destroying polyps. The process of erosion formation is similar to the previous one. Destroying, the dead cells leave the uterine cavity in the form of pathological excretions. Erosion - this is essentially an "open gate", enabling pathogenic microorganisms to freely enter the body.
• Nodes of fibroid.

[1], [2], [3], [4], [5], [6], [7]

Symptoms of the true erosion of the cervix

The true or, as it is also called, acquired pathology is visually defined as a reddened point, which is clearly differentiated on the pink surface of the healthy mucosa of the vaginal part of the cervix. When palpation of the affected area from erosive wounds, a bloody discharge begins.

Mainly (about 90%), the symptoms of true erosion of the cervix are extremely rare (latent). Therefore, in the overwhelming majority of cases, it is possible to diagnose the disease only during a preventive examination.

But pathological manifestations can still appear. And then the woman herself hurries to the reception to the gynecologist. Her complaints are often voiced by such symptoms:

• Discomfort and heaviness in the lower abdomen.
• The appearance of bloody discharge irrespective of the phase of the menstrual cycle. Especially they can appear or intensify after coition.
• During coition, a woman can feel pain in the genitals.
• If the disease progresses and with the development of the inflammatory process, it is possible to observe muco-purulent leucorrhoea. Sometimes this symptomatology is incorrectly attributed to thrush, and if a woman is pregnant, they can be confused with the threat of termination of pregnancy.

Diagnostics of the true erosion of the cervix

The primary diagnosis of true erosion of the cervix is a qualified obstetrician - a gynecologist is able to deliver a visual examination of the woman after using a gynecological mirror. But, in order to be completely sure of the correctness of the established disease, one inspection is not enough. To ascertain the suspicion of a specialist, a more thorough diagnosis of true erosion of the cervix is needed.

After a visual examination, the gynecologist puts a preliminary diagnosis - cervix pseudo-erosion. To confirm or refute his suspicions, the doctor usually prescribes:

A smear is used to differentiate the microflora of the vaginal mucosa.

• Smear examination for the presence of atypical cells (cancerous growths). As a result of this analysis, the level of cell proliferation is determined, the construction of a cytogram of the inflammatory process, the detection of signs of dysplasia (structural change in the structure of the mucous cervix, attributable to precancerous diseases) or leukoplakia (of different levels of severity of the corneum epithelium).
• Blood test to exclude HIV infection (determined by the presence of these antibodies) and syphilis.
• If necessary, a blood test for hormones.
• Polymerase chain reaction (PCR diagnostics) is a high-precision examination technique that allows to identify a pathogenic infection affecting the female genital organs. Primarily it is a human papilloma virus.
• Colposcopy. Thanks to this procedure, with the help of a special biocular with a built-in microscope, an obstetrician-gynecologist has the opportunity to perform a thorough examination of the mucous membrane of the cervix. In the process of calposcopy, a number of tests are performed: mucosal treatment with 3% acetic acid (the blood vessels in the normal area under the influence of acid taper), treatment of the luciferous mucosa (the healthy epithelium acquires a brownish hue, while the erosive blotches are not stained). This technique is informative and has no contraindications.
• The removal of biomaterial for biopsy to exclude malignant neoplasm.
• Ultrasonic examination of pelvic organs. Allows to identify the presence of diseases based on hormonal failure, and / or inflammation.

By the color of the leucorrhoea, the gynecologist is able to reasonably reasonably suppose the cause of the pathology:

• If a woman has brownish-colored whites - this may indicate a traumatizing of the mucous by mechanical means. An inflammatory process affecting the endometrium is also expressed, which often happens as a consequence of progressive true erosion of the cervix.
• The appearance of yellowish discharge in case of violation of the integrity of the mucosa signals an infection to the inflammation (various genesis - streptococci, staphylococcus, ureaplasmosis and others).
• The release of a whitish liquid may indicate the presence of a disease such as candidiasis (thrush), provoked by a fungus belonging to the genus Candida.

Only after confirmation of the alleged diagnosis, the doctor makes a diagnosis. The disease is established - you can start therapy, designed to stop this problem.

[8], [9], [10], [11]

Treatment of the true erosion of the cervix

The principle of any therapy is the elimination, if possible, of the primary source of pathological manifestations. Treatment of true erosion of the cervix also meets this postulate. That is, if the disease was caused by a lesion of mucous invasive negative microflora, the task of therapy is the destruction of infection and anti-inflammatory therapy.

In such a situation, antibiotics and antiviral drugs are introduced into the treatment protocol, for example:

Antibiotics, macrolides: pefloxacin, roxithromycin Lek, rovamycin, abaktal, doxycycline and others.

Roxithromycin Lek is appointed by the attending physician for oral administration. Adult patients and children who are already 12 years old and weighing more than 40 kg, the daily dosage of the drug is determined by the figure 0.3 g twice during the day (0.15 g after 12 hours) or once a day with a dosage of 0, 3 g.

If the patient in parallel suffers severe liver and kidney dysfunction (creatinine clearance below the level of 15 ml / min), the dose of the injected drug is halved and is 0.15 g once a day (every 24 hours). The duration of the therapeutic course is determined by the doctor, depending on the severity of the lesion. On average, it takes from one to two weeks.

To the contra-indications, roksithromycin Lek refers to the individual intolerance of the constituents of the medicinal product, porphyria (hereditary impairment of pigment metabolism with an increased content of porphyrins in the blood and other tissues of the patient's body) or the first trimester of pregnancy.

Pefloxacin must be taken with food. The tablet is swallowed whole. To adolescents after 15 years and adults, the drug is prescribed in a dosage of 0.8 g daily, divided into two doses. In the case of therapeutic necessity, the amount of the drug administered can be doubled - 1.6 g per day. During pefloxacin therapy, you should avoid exposure to ultraviolet rays (reduce exposure to direct sunlight).

Do not prescribe a medicine if the patient has a history of glucose-6-phosphate dehydrogenase deficiency, liver dysfunction, hypersensitivity to the component components of the drug, as well as if the woman is pregnant or nursing a newborn, children under 15 years.

Antiseptics and antimicrobials used in the treatment of true erosion of the cervix : candida, acylactate, clindacin, metrogarine, nystatin, clotrimazole, trichopolum, delacin and many others. The purpose of a particular drug is largely dependent on the recognition of a specific causative agent of pathology.

Vandal Candida tablets are used topically and are administered intravaginally. The drug is inserted into the vagina on the back and bent legs in the knees. It is recommended to take a single injection of 0.5 g of the drug, which corresponds to one tablet. Candide is injected into the cervical canal in the evening, just before bedtime.

Contraindications to the use of this medicine include increased sensitivity to clotrimazole or other components of candida, the time of the menstrual cycle, as well as the first trimester of pregnancy and with extreme caution in the lactation period.

Oral pill Acilact take two to three times throughout the day. To improve the effectiveness of treatment, the drug should be administered 30 to 40 minutes before meals. Adolescents and adults (with an acutely developing pathology) are assigned five tablets. Duration of admission is seven to eight days. This medication can also be administered in the form of a suppository. Contraindication of this drug is the individual intolerance of the constituents of the drug or vulvovaginal candidiasis.

After completion of anti-inflammatory and anti-infective therapy, the obstetrician-gynecologist is determined with the method of cauterization of erosion. Selection of the arresting process is based on the patient's age, the need to continue giving birth, the size of the lesion, and many other factors are taken into account.

Not so long ago, if a young girl subsequently wanted to endure and give birth to a child, this procedure was postponed indefinitely.

Modern methods of cauterization:

• Electrocoagulation - arresting an electric shock. The effectiveness of the procedure is about 92%. In case of deep tissue damage by erosion during electrocoagulation, the doctor must resort to local or general anesthesia. A traumatic method is sufficient, after which colloid scars remain on the cervix. They can become a problem at delivery. It is used quite often due to availability and cheapness.
• Cryoprigation or cryodestruction. This method of treatment is used for a sufficiently large lesion. Its area should be at least 3 cm. If the affected surface is deformed, this method should not be used, since it is difficult to achieve the necessary contact of the tube with liquid nitrogen and the affected mucosa. After the procedure, rough scars are not formed, which removes the cause that prevents the passage of the fetus along the generic pathways. This technique is absolutely painless, just a little unpleasant. After cryodestruction, it is very rare to see any complications, for example, bleeding, but watery leucorrhoea can be observed within a month after the procedure.
• Radio wave coagulation is the least traumatic method for treating the mucous membrane of the cervix. A painless procedure that does not require the connection of anesthesia. After its application, there are almost no complications, and colloid scars are not formed. But because of the high cost of the procedure is used rarely.
• Laser coagulation makes it possible to affect only the affected areas of the mucous cervix without damaging adjacent tissues. The treatment is carried out with a laser beam. This is a non-contact method of affecting the affected area. Local anesthesia is used. The lesion focus should be more than 3 cm. Quite often it is possible to observe such complication as uterine bleeding. The effectiveness of this technique is more than 98% of the total cure. On the cervix after this procedure, scar formation is not observed. When processing under the action of a laser beam, a small area of healthy tissue also enters.

Any of these procedures is performed immediately after the end of the menstrual period - in the first phase of the menstrual cycle. Before it is carried out, a woman must undergo certain training: the affected area is first treated with acetic acid. This is done in order to get a spasm of blood vessels - this will in some way prevent the occurrence of bleeding. After that, the surface is treated with iodine solution - this treatment makes it possible to contrast the contours of erosion.

After the therapy (whatever technique is used in this case, it is necessary to adhere to a number of rules:

• It is not recommended to have sexual contact until the wound is completely healed. This result can be achieved on average six weeks after cauterization.
• Reduce for this period physical activity, limit the weight of the lifted cargo.
• It should not be during the healing period to visit the pool, public beaches, sauna or bath, swim in open water.
• Water procedures should be limited to the shower (with the bath should be allowed to wait).

After the cauterization, the doctor appoints his patient medicinal ointments or suppositories that have a healing effect. It can be sea buckthorn oil or levomekol. These drugs make it possible to soften the scab, which prevents coarse scarring and reduces the likelihood of bleeding at the time of rejection of the stripped tissue.

You should know that alternative medicine methods are not used in this case. Recipes of alternative medicine can be used only as an additional therapy to increase the body's immune forces needed to fight the disease.

It is worthy of special attention to the fact that sea buckthorn oil does not cure true erosion of the cervix. If oil is trying to treat the pathology - it does not solve the problem, on the contrary, it will only promote the growth of the epithelium (proliferation), hence the focus of erosive lesion. The use of sea buckthorn oil after cauterization, will allow the "postoperative" wound to drag on much faster.

Candles with sea buckthorn oil are injected into the vagina once a day, in the evening, just before bedtime and left there until the morning. Most of the suppository will dissolve during this time, having absorbed into the body layers, and only a small amount will come out in the morning outside. The duration of the treatment course is ten days. These suppositories have a tinting effect, so it is advisable to use daily pads during the treatment period - this will protect the woman's underwear from contamination.

After passing through all the stages of treatment of true erosion of the cervix, the patient may well start planning a pregnancy. In any case, if a woman plans to become a mother, it is desirable, before the onset of conception, to undergo a complete examination of the body and treat pathology, especially with regard to the organs of the reproductive system, including to kill the foci of infection and the affected mucosa, if any.

To treat this disease is necessary. After all, although insignificant (in 3% of women with this pathology), but there is a possibility of its degeneration into malignant neoplasms.

If the true erosion of the cervix was diagnosed during pregnancy, then the obstetrician - gynecologist transfers all medical measures for a time after delivery. Since if the moxibustion is carried out during the gestational period, giving birth to a woman will be somewhat more difficult. After the cauterization, the elasticity of the cervical tissue will be impaired (reduced), which can lead to problems with the opening of the cervix and stretching of the tissues during the passage of the baby through the birth canal.

Prevention

It is always better to prevent pathology than to fight it later. Prevention of true erosion of the cervix includes a number of simple recommendations that will not complicate, but will protect the life and health of women:

• Preventive examination at a gynecologist a woman should be held once in six months.
• If any disease is detected, therapy should be performed immediately.
• Do not stop halfway, healing the disease completely, and not just until the disappearance of obvious symptoms.
• Prevent early sex life and childbirth at a young age.
• The rules of personal hygiene should be carefully observed. In this case, it is mainly concerned with caring for the sex organs. For a woman, a shower is desirable twice a day: after waking up and before going to bed. Especially it concerns the period of menstruation.
• A woman will have to correct her sex life:
  • The sexual partner should be one.
  • A woman should be sure of his sexual health (lack of a sexually transmitted infection).
  • Provide reliable safe sexual intercourse with the use of condoms.
• Before sexual intercourse, it is desirable that the hygienic shower is taken and the woman's partner.
• Reduce the risk of abortion by using modern, effective methods of nontraumatic contraception.
• Mom of teenage girls should not miss the moment of their first month with their daughter and follow the establishment of a normal menstrual cycle. This will make it possible not to miss a hormonal failure in the child.
• Minimize the trauma of cervix, which can occur, both during abortion and as a result of surgical intervention affecting the pelvic organs, including the genitals. And as for childbirth.
• You should give up bad habits.
• It is advisable to go through colposcopy once a year.

Only the right way of life and the fulfillment of all the requirements of prevention will allow to save ourselves from this not very pleasant, but in the long term, degeneration into cancer, and dangerous pathology.

[12], [13], [14]

Forecast

If the pathology is detected in time and effective treatment is carried out, the prognosis of true erosion of the cervix is favorable. There is only a small percentage of the probability of a pathology transition due to untimely detection and neglect of adequate therapy in a malignant tumor. But even in this case, if the process is captured at an early stage and adequate therapy is carried out, a woman can live a fairly high-quality life.

Even minor discomfort in the genital area, pulling the pain in the lower abdomen is an occasion to come for a consultative examination to the doctor - gynecologist. Indeed, true erosion of the cervix is most effectively treated at the initial stage of the disease.

[15], [16], [17], [18], [19], [20]