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Cervical endocervicosis
Last reviewed: 07.06.2024
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Endocervicosis is a rare pathological condition characterized by the presence of mucous membrane (endocervical tissue) outside its usual location in the cervix (cervix) or other areas of the female reproductive tract. Normally, endocervical tissue is located within the cervical canal, but in endocervicosis it can spread into neighboring structures.
This condition may be asymptomatic and discovered by chance during a gynecological exam or other medical procedures. However, sometimes endocervicosis can cause symptoms such as lower abdominal pain or unusual discharge.
If endocervicosis is suspected or abnormalities are found in the female reproductive tract, it is important to see a physician or gynecologist for further testing and clarification of the diagnosis. Treatment for endocervicosis may include surgical removal of the abnormal tissue, especially if it is causing symptoms or concern. [1]
Causes of the endocervicosis
The causes of endocervicosis (endocervicosis) are not entirely clear, as it is a rare condition and there has been limited research on the subject. However, there are several hypotheses and factors that may be associated with the development of this condition:
- Embryonic development: One hypothesis is that endocervicosis may be the result of abnormal development of embryonic cells that normally form the endocervical tissue within the cervical canal. Abnormal migration or differentiation of these cells may lead to their appearance in other areas.
- Trauma or surgical procedures: It is possible that some cases of endocervicosis may be associated with prior trauma or surgical procedures such as abortions or cesarean sections.
- Idiopathic nature: In some cases, the cause of endocervicosis remains unknown and may be idiopathic, meaning it has no clear understood risk factors.
Endocervicosis is usually diagnosed during a gynecologic exam or other medical procedures such as colposcopy or ultrasound.
Pathogenesis
The pathogenesis of this disease involves the following major steps:
- Infection: Endocervicosis is usually caused by an infection caused by bacteria, viruses or fungi. Infection occurs as a result of these microorganisms coming into contact with the endocervical canal.
- Penetration and adhesion: Microorganisms penetrating the endocervical canal can adhere (attach) to the mucosa. This facilitates their long-term residence and replication in this area.
- Replication and spread: Infectious agents begin to actively multiply in the endocervical canal, leading to an increase in their numbers and the spread of infection within the canal.
- Inflammation: The multiplication of microorganisms and their metabolic products can cause an inflammatory reaction in the endocervical mucosa. This is accompanied by symptoms of inflammation such as swelling, hyperemia (redness), pain and discomfort.
- Discharge and symptoms: Inflammation can lead to increased vaginal discharge, changes in its consistency and color. Patients may experience symptoms such as itching, burning, lower abdominal pain and dysuria (pain and difficulty urinating).
- Complications: More serious complications of endocervicosis can include the spread of infection to other parts of the female reproductive organs, which can lead to inflammation of the ovaries and fallopian tubes, as well as more serious conditions such as pelvic inflammatory disease (PID).
Symptoms of the endocervicosis
Symptoms of this condition can vary from woman to woman, and some may be asymptomatic. However, when symptoms are present, they may include:
- Vaginal discharge: Women with endocervicosis may experience an increased amount of vaginal discharge, which may be yellow-green in color and have a distinctive odor. The discharge may be thick or mucousy.
- Pain or burning when urinating: An infection in the endocervix can cause irritation and inflammation of the urinary tract, which can manifest as pain or burning when urinating.
- Lower abdominal pain: Some women may feel pain in the lower abdomen or pelvic area, especially if the infection has spread to nearby tissues.
- Intermenstrual bleeding: Infection can cause menstrual irregularities and intermenstrual bleeding.
- Pain during intercourse: Intercourse can become painful due to inflammation of the endocervix.
Forms
Here are some of the types of endocervicosis:
- Simple: This is the form in which abnormal glandular tissue is found in the cervix or cervical canal area. Simple endocervicosis is usually not malignant.
- Stationary: This type is characterized by the presence of abnormal tissue that tends to grow stationary and does not undergo active proliferation. It is also considered benign and is not associated with cancer.
- Glandular: This type is associated with abnormal growth of glandular tissue inside the cervix. Glandular endocervicosis is also usually benign.
- Cystic: The cystic type is characterized by cysts in the endocervical glands or ducts. The cysts may contain fluid and may vary in size. This type is also considered a benign condition.
- Glandular-cystic: This type combines characteristics of both glandular and cystic endocervicosis, and may include both abnormalities of glandular tissue and cysts.
- Epidermizing endocervicosis: This term may refer to a condition where the endocervical tissue begins to show epidermal (skin) characteristics such as keratinization (keratin formation) or other changes associated with the epithelium.
- Healingendocervicosis: Healing refers to the process of tissue repair and regeneration after damage or inflammation. In the context of endocervicosis, it can refer to a condition where the inflammation in the endocervical canal begins to decrease and the tissue begins to heal.
- Endocervicosis with inflammation: This condition is characterized by inflammatory changes in the endocervix, which may include swelling, hyperemia (redness), pain, and discharge. Inflammation can be caused by a variety of factors, including infections or other irritants.
- Progressive: This term indicates that changes in the endocervical canal become more severe or continue to develop over time. Progression may be due to chronic inflammation, infections, or other factors.
- Proliferating: Proliferation refers to the active multiplication or growth of cells. Proliferative endocervicosis can refer to a condition where the cells of the endocervical canal begin to actively divide and increase in number. This may be due to various pathologic processes.
Complications and consequences
Complications and consequences of endocervicosis are usually rare, but may include the following:
- Pain and discomfort: In some cases, endocervicosis may cause pain or discomfort in the pelvic area or lower abdomen. This may be due to abnormal spread of endocervical tissue into neighboring structures.
- Non-functional changes: Abnormal endocervical tissues usually do not perform functions characteristic of normal cervical tissue. This can lead to functional abnormalities related to the tissues affected by endocervical tissue.
- Difficulties inpregnancy: In some cases, endocervicosis can lead to difficulties in pregnancy, such as infertility or an increased risk of pregnancy complications.
- Infections and Inflammation: Abnormal tissue can become a site for infections or inflammation, which can cause additional medical problems.
It is important to note that endocervicosis is not usually a malignant condition and is not associated with cervical cancer.
Diagnostics of the endocervicosis
Diagnosing endocervicosis involves several methods and procedures to detect infection in the endocervical canal. Here are some of them:
- Gynecologic examination: The doctor performs a visual examination of the vagina and cervix using special gynecologic mirrors. This allows you to identify signs of inflammation such as swelling, hyperemia (redness) and discharge.
- Swabbing: Your doctor may take swabs from the endocervical canal for laboratory testing. These swabs can be used to identify microorganisms that cause infection, such as bacteria, viruses, or fungi. These swabs may also be sent for culture or PCR testing.
- Colposcopy: Colposcopy is a procedure in which the doctor uses a special device called a colposcope to take a closer look at the cervix and endocervical canal. This can help detect changes associated with infection.
- Ultrasound (ultrasound examination): Ultrasound can be used to visualize internal organs and determine if there are inflammatory changes in the uterus and ovaries.
- Additional tests: Depending on the clinical symptoms and initial findings, your doctor may order additional tests, such as blood tests to determine levels of inflammatory markers or a cervical biopsy.
Differential diagnosis
The differential diagnosis of endocervicosis involves identifying and distinguishing this infection from other conditions and infections that may cause similar symptoms. Some of the most common conditions and infections to consider in the differential diagnosis include:
- Chlamydia: This is another common sex infection caused by the bacterium Chlamydia trachomatis. Chlamydia and gonorrhea can have similar symptoms such as pain during urination and vaginal discharge. Laboratory testing is required to diagnose both diseases.
- Bacterial vaginosis: This is a condition caused by an imbalance of bacteria in the vagina and can cause changes in discharge and odor, which can be similar to the symptoms of gonorrhea.
- Candidiasis: A fungal infection caused by Candida can mimic some of the symptoms of gonorrhea, such as itching and vaginal discharge.
- Cervical Irrigation: Sometimes procedures, such as cervical irrigation to treat other conditions or examinations, can cause a temporary increase in discharge, which can be similar to the symptoms of endocervicosis.
- Allergic reaction: Allergies to condoms, spermicides, or other hygiene products can cause symptoms similar to an infection.
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Treatment of the endocervicosis
Treatment for endocervicosis usually involves surgical removal of the abnormal tissue (endocervical tissue that is outside of its normal location). It is important to have surgical removal to prevent possible complications and symptoms associated with this condition. Here are some details about the treatment of endocervicosis:
- Treatment for symptoms: If endocervicosis causes symptoms such as pain or discomfort, your doctor may decide that surgical removal of the abnormal tissue is urgently needed.
- Surgicalremoval: Surgical removal of abnormal tissue can be performed using colposcopy and laser therapy or electrocoagulation. In some cases, more extensive surgery may be required, especially if the abnormal tissue has spread to large areas. The procedure should be performed in a medical facility under the guidance of a qualified professional.
- Monitoring after surgery: After surgical removal of tissue, it is important to monitor your condition and have regular checkups with your gynecologist to make sure there is no recurrence or complications.
- Following your doctor's advice: Your doctor can give you advice on care after surgery and advice on contraception (if necessary).
Prevention
Prevention of endocervicosis and other vaginal infections includes a number of measures and practices that help reduce the risk of infection. Here are some recommendations for prevention:
- Condom use: Using male or female condoms with every sexual encounter can reduce the risk of transmitting infections, including trichomoniasis (endocervicosis).
- Monogamy: Maintaining a monogamous relationship, that is, having sex with one partner, can reduce your risk of getting sexually transmitted infections. It is important to discuss sexual history and infection status with your partner.
- Regular medical check-ups: Regular visits to a gynecologist for examinations and screening for sexually transmitted infections can help detect infection early and start treatment.
- Personal hygiene: Maintaining good personal hygiene is important for vaginal health. Avoid excessive showers and use gentle, non-parfumed soaps.
- Avoid rolling tampons: Rolling tampons can upset the natural balance of bacteria in the vagina, which can promote infection. Use tampons according to the instructions.
- Beware of sexual intercourse during infections: If you have signs of infection, including discharge, itching or pain, it is best to refrain from sexual intercourse until diagnosis and treatment.
- Avoid alcohol and drugs: Alcohol anddrug use can decrease alertness and lead to more risky sexual behaviors. It can increase the risk of getting infections.
- Treatment and partners: If you have been diagnosed with an infection, it is important to warn your sexual partner and both start treatment at the same time to avoid reinfection.
Forecast
The prognosis for patients with endocervicosis is usually good, provided that the infection has been correctly diagnosed and adequate antibiotic treatment is initiated in a timely manner. Effective treatment can lead to complete recovery and elimination of the infection.
It is important to consider the following points:
- Proper treatment: Following your doctor's recommendations and completing a full course of antibiotics are key factors in the successful treatment of endocervicosis.
- Partner treatment: To prevent re-infection and spread of the infection, it is also important to make sure that all sexual partners are treated.
- Prevention: After recovery, it is important to follow preventive measures such as the use of condoms during sexual intercourse to prevent re-infection.
- Monitoring and follow-up: Patients who have had endocervicosis may be examined regularly by a physician to monitor the condition and rule out possible complications or recurrences.
- Complications: In some cases, if left undiagnosed and untreated, endocervicosis can lead to complications such as pelvic inflammatory disease (PID) or infertility. However, with proper diagnosis and treatment, the risks of such complications are minimized.