Erosion at an early stage. Cervical erosion: causes and symptoms

Cervical erosion is any disorder normal condition its mucous membranes. Such disorders may include both mechanical or chemical damage and abnormal development of the mucosal epithelium. Protect your health and warn serious consequence A woman's illness will be helped by regular visits to a gynecologist.

What kind of disease is this, the causes of erosion, symptoms, treatment methods, and is it dangerous for women's health and how to protect yourself in the future - we will consider further.

What is cervical erosion?

Cervical erosion is an ulcerative defect of the vaginal mucosa of the cervix. Its insidiousness lies in the fact that for a long time the disease has no manifestations. Pathology occupies one of the leading places in the structure gynecological diseases and is often diagnosed in women of different age groups.

Cervical erosion does not turn into cancer but she prepares the ground for tissue regeneration.

Chronic inflammatory processes lead to the appearance of scars, the formation of cystic cavities, and polyps. Erosion is a defective change in the mucous membrane of the cervix. Very rarely does a true form occur that heals quickly; most often it becomes permanent.

When factors affect the uterine surface of the cervix, epithelial cells cannot normally perceive the acidic environment, harmful microorganisms, which live in the vagina for a long time.

The cylindrical epithelium does not have a protective function, therefore, when it is affected by viruses and bacteria, it does not protect itself.

As a rule, after one (less often two) weeks, the damaged mucous membrane begins to heal. More often, epithelization occurs incorrectly, and pseudo-erosion of the cervix appears in place of the true one - also a modified area of cervical epithelium, but without signs of damage.

To avoid confusion, patients should know that erosion is a wound (ulcer) on the cervix, and pseudo-erosion is the process of its improper healing, literally what remains on the cervix after the wound heals.

Species

It should be understood that the term “erosion” is quite broad and includes several manifestations of the disease. Therefore, it is necessary to distinguish between types.

Congenital erosion	Congenital variety of this disease consists of displacement of the cervical columnar epithelium. There is congenital erosion in childhood or in adolescence, while the symptoms of the disease mostly do not manifest themselves in any way. Detection occurs during colposcopy, where the presence of a bright red area that cannot be stained using Lugol’s solution is determined.
True cervical erosion	The true form is a defect in the stratified squamous epithelium of the cervix. When examined with the help of mirrors, a bright red spot with a diameter of up to 1 cm around the external os of the uterus with clearly demarcated edges is visible. After some time, bloody streaks appear in the mucous secretions during erosion of the cervix.
Pseudo-erosion (false)	What is it? The most common type of gynecological disease, occurring in every second patient. Externally similar to the real one too bright red spot, which arises on the mucous membrane of the cervix, of various sizes. Small erosion is measured in millimeters, while large erosion can grow up to several centimeters. The differences from the truth are that the surface of the uterus with pseudo-erosion is smooth and does not bleed. There are big risks infection, which is accompanied by pain in the lower abdomen, leucorrhoea and contact bloody discharge(after sexual intercourse or gynecological examination).

Development options

Doctors identify several options for the development of erosion, including:

Ectropion. The pathological process is characterized by eversion of the mucous membrane of the cervical canal due to surgical termination pregnancy or childbirth.
parts of the uterus. With this disease, endometrial cells reflux and grow on the mucous membrane of the cervix.
Leukoplakia. Pathology involves keratinization of the cervical epithelium.
Polyps diagnosed in the cervical canal area, as well as polyps of the cervical part of the uterus and condylomas.

Reasons for appearance

The causes of cervical erosion, unfortunately, are not fully understood, but modern medicine It is generally accepted that the main prerequisites for the development of this female disease are such inflammatory processes of the genital organs as endocervicitis and vaginitis.

In girls and young women under 18 years of age, erosion can be congenital and detected after the start of sexual relations. Many specialists have ectopia in everyone nulliparous women classified as congenital. In girls under 21 years of age and women during pregnancy, as well as during the period of involution, erosion is considered the result of hormonal changes.

In these cases, it is often changes happen on their own and require only examination and observation.

When a patient develops cervical erosion, the reasons for its development may be different. However, most often the surface epithelial cells begin to be rejected due to a previously developed inflammatory process.

The main causes of erosion in modern medicine are considered to be:

inflammation of the genital organs – cervicitis;
hormonal imbalances;
decreased local or general immunity;
genital infections and inflammatory diseases of the female genital area (HPV, chlamydia, ureaplasmosis, trichomoniasis, gonorrhea, vaginal dysbiosis, etc.); traumatic effects (abortion, mechanical damage, surgical interventions, childbirth, etc.);

Symptoms of cervical erosion + photo

In the vast majority of cases, cervical erosion rarely manifests itself clinically and most often such a diagnosis is a finding in gynecological examination. But it happens that patients themselves turn to the gynecologist with complaints of bleeding not associated with menstruation, especially after sexual intercourse.

Possible symptoms of cervical erosion:

any bleeding, especially after sexual intercourse;
nagging pain in the lower abdomen
pain during intercourse
copious whitish discharge
There is no change in general well-being. Often inflammation is associated with erosion. Then the symptoms will appear more clearly: the pain will intensify, the discharge will become more abundant.
Discharge during cervical erosion is otherwise called “leucorrhoea” and is a thick white liquid without strong smell, which often leaves marks on underwear. Such discharge usually indicates the presence of inflammation or hidden infection, which often accompanies this disease.

All symptoms are not specific to erosion and their manifestation can sometimes indicate the development of a completely different gynecological disease. In any case, the appearance of even one symptom is a reason to contact a gynecologist for an examination.

What does erosion look like in the photo?

Complaints from patients with erosion are due to concomitant inflammatory diseases vagina () and cervical canal (endocervicitis). When erosion is complicated by inflammation, mucous or mucopurulent leucorrhoea and a feeling of discomfort appear.

Complications: how dangerous is the disease?

The fact that the symptoms of cervical erosion in a woman do not appear particularly pronounced does not at all indicate that there is no need to treat the disease. When pseudo-erosion occurs around the cervical canal, epithelium appears that does not have the ability to protect against infection from the vagina into the uterus.

In certain cases, it is also possible to develop spontaneous epithelization of cervical erosion, as a result of which the formation of defective epithelium is possible.

The answer to the question " Why is erosion dangerous?“depends on what changes the doctor discovered during the examination:

if this is pseudo-erosion (ectopia, congenital erosion), then there is no threat to health, and no consequences can arise;
if it is true erosion caused by infectious diseases, then the main danger is that the infection can penetrate the uterus and uterine appendages, and in the future cause infertility;
If this is the case, then without appropriate attention there is a real danger of developing cervical cancer within a few years.

The common belief about the malignant degeneration of erosion is incorrect. The only dangerous ones are those cervical erosions in which atypical changes are present. They are easily detected during standard colposcopic and laboratory examination, and their presence only means that the pathological area should be eliminated.

Effect on pregnancy

The presence of cervical erosion does not mean that a woman will not become a mother. Naturally, like any damage to organs included in the genitourinary system, erosion is an object of close observation by a gynecologist. Depending on the type of erosion, its size and location, treatment can be prescribed both before and after pregnancy.

If erosion is detected in a pregnant woman, then treatment is also carried out after childbirth, since the disease does not affect the course of pregnancy and the condition of the fetus. Symptoms of erosion in a pregnant woman may include blood in the discharge, as well as burning and itching during sexual intercourse.

Diagnostics

The diagnosis can be established already at the first visit to the doctor. Meanwhile, in many cases visual inspection– this is only half the battle in diagnosing the disease.

Therefore, patients will need to undergo the following tests:

Visual inspection with a mirror to identify changes in the mucosa. True erosion: the epithelial layer is bright red, bleeding is visible. False erosion: squamous epithelium is replaced by columnar epithelium. Simple erosion: the epithelial layer is smooth. Papillary: nipple outgrowths form on the mucosa.
a regular smear on the flora;
PCR diagnostics, aimed at identifying the main types of infections (genital herpes, trichomoniasis, mycoplasmosis, etc.);
blood test for,;
biopsy (if there is a suspicion of a malignant formation, a piece is taken from the affected area of the cervix for histological examination).

Only after all the data has been collected, the doctor will be able to make a final conclusion, make a diagnosis, determine whether there are complications, and only then treat the patient.

Treatment of cervical erosion

If this state requires the use of therapy, the doctor assesses how extensive the affected area is and the advanced course of the disease. Based on this analysis, he decides how to treat cervical erosion by choosing one of the following methods:

Medicinal - a medicine is used that affects the infection that causes irritation of the mucous membrane. Local - the patient is treated with healing suppositories and tampons. This method may involve chemical cauterization of the wound. special drugs with further rehabilitation therapy.
Surgical operation - cauterization.

Conservative treatment of cervical erosion consists of:

carrying out nonspecific anti-inflammatory therapy;
treatment with drugs that suppress the growth and development of fungal bacteria and viral infection sexually transmitted (if detected);
correction of hormonal and immune disorders;
the use of physiotherapeutic techniques (rarely) - vaginal tampons with therapeutic mud, irrigation mineral waters, iontophoresis with drugs, ultraviolet and short wave ultraviolet therapy, microcurrent and ozone therapy, helium-neon laser.

Gentle methods of treatment include the use of suppositories. Suppositories for cervical erosion are prescribed in the following situations:

erosion is caused by a violation of the vaginal microflora;
pain during menstruation, localized in the sacral area;
appeared as a result of sexually transmitted diseases;
arising against the background of hormonal disorders;
injury as a result of abortion or difficult childbirth.

Causes of repeated cervical erosion

The causes of cervical erosion in recurrent manifestations are almost the same as those in the primary occurrence of the pathology:

infectious and inflammatory processes,
promiscuous sexual relations,
hormonal disorders,
immune disorders.

Surgical treatment: cauterization of erosion

Cauterization of cervical erosion is carried out to influence pathological changes in the epithelium to remove damaged cellular structures on the cervix. There are several basic methods of performing the procedure, which last no more than half an hour:

Diathermocoagulation. The most outdated and traumatic method is cauterization of erosion using current. Because of high efficiency method, its implementation has not yet been abandoned. The procedure is carried out without anesthesia for 20 - 30 minutes in the second period menstrual cycle. After the procedure, the patient is monitored in the ward and if all is well, she is sent home.
Cryotherapy - cauterization liquid nitrogen(“freezing” of tissues). A more gentle method than diathermocoagulation. Minus this method– possible relapses (re-appearance);
Laser coagulation– use of laser in treatment. After the procedure, there are no adhesions or scars left on the neck, healing and recovery occur quickly (in 4-6 weeks).
With chemical coagulation the cervix is treated with drugs that are harmful to the resulting columnar epithelium. Flat epithelium, growing, covers the area that was previously affected by erosion. This method is not without its drawbacks. It is not used for erosion that occupies a large area.
Diathermoconization– excision of overgrown tissues with a special loop. A scab forms on the surface of the cauterized erosion, which comes off a week after the procedure. Overgrowth of the zone with multilayered epithelium is usually completed after a month and a half.

Folk remedies for cervical erosion

Before using folk remedies, be sure to consult a gynecologist.

Thoroughly dissolve 2 mummy tablets in 1 tsp. warm water, add sea buckthorn oil. Place a tampon soaked in this solution according to the scheme described above.
Bergenia root extract: 3 tbsp of crushed plant root is poured into 1 tbsp of boiling water, simmer over low heat until the liquid has completely evaporated. Drink 30 drops three times a day half an hour before meals.
Calendula infusion used for vaginal douching in cases of congenital erosion and mechanical damage to the mucous membrane. The product serves as a preventive measure for many STDs.
2 tablespoons pharmaceutical chamomile pour a liter of boiling water into a saucepan. Place a saucepan with a lid on water bath for 15 – 20 minutes. Turn off the heat, leave the solution for 40 minutes, then cool to room temperature.
Treatment with honey, for this you need to wrap one teaspoon of honey in a bandage or gauze, make a tampon from it, tie it with thread, insert it inside the vagina as deeply as possible. This should be done at night, in the morning you will notice a little blood, this is normal.
Ointment "Levomekol". A miraculous ointment that has proven itself excellent for wounds. Squeeze the ointment onto a tampon and insert it into the vagina at night. In the morning, remove the tampon and douche. Carry out daily for two weeks.
For cervical erosion, it is recommended to inject aloe juice into the vagina every day, and then lie down for 20 minutes.
Douching. St. John's wort infusion: 4 tbsp. l. St. John's wort herb pour 2 liters hot water, simmer over low heat for 10 minutes and leave for 30 minutes.
A decoction of boron uterus is used for treatment.(the decoction is used both for douching and in the form of tampons soaked in the decoction). To prepare a decoction, 2 tablespoons of raw materials are mixed with half a liter of water. The mixture is brought to a boil, filtered and cooled. Douching should be done once a day, at night. The course of treatment is about a week (5-7 days on average).

Prevention

As you know, it is better to prevent pathology than to treat it. To protect yourself, you should follow a number of recommendations:

Visit your doctor regularly (at least twice a year).
Observe hygiene rules. In particular, you should shower at least twice a day, especially during menstruation.
Use condoms when having sex with casual partners to prevent the spread of infections.
Strive for monogamy and regular sex life.
Use protection in cases where pregnancy is not planned. It should be remembered that any abortion complicates the course of the pathology and injures the cervix.

From the material you learned what cervical erosion is, why it is important to start treatment on time and how to protect yourself from this disease. Be healthy, get examined by a gynecologist on time and take care of your health!

To the most common reasons The occurrence of erosion includes mechanical damage to the cervix, decreased immunity, sexually transmitted infections (genital herpes, human papillomavirus and others).

True cervical erosion may occur after difficult childbirth, abortion and other gynecological intrauterine interventions. And also due to the resulting gaps. The cervix can, as it were, turn out, the cylindrical epithelium of the cervical canal appears on the vaginal part of the cervix and ectopia is formed.

Symptoms of cervical erosion

Symptoms are few. As a rule, cervical erosion does not lead to significant changes in a woman’s well-being.

Women with this disease do not have discomfort in the lower abdomen. And it does not appear during sexual intercourse, because... There are no sensory receptors on the cervix. However, after intimacy Some women experience minor bloody or bloody discharge, which is a good reason to visit a gynecologist.

In most cases, cervical erosion is an incidental finding during examination by a gynecologist. The doctor sees it as a small bright red area on the cervix. However, to clarify the diagnosis, it is important to do an additional examination - the so-called colposcopy.

Colposcopy is an examination of the cervix using a special optical device with a magnification of 25-30 times. The device helps the doctor to better see the changed areas. After colposcopy, the gynecologist makes a more accurate diagnosis. The fact is that the term “cervical erosion” refers to several diseases that differ in their origin and prognosis. The examination lasts at least 20 minutes, but it is practically painless for the patient.

During colposcopy, the gynecologist has the opportunity to perform a biopsy of the changed area of the cervix. This study is not carried out if the patient complains of any symptoms, but only if the doctor sees a suspicious area during colposcopy.

A biopsy is usually performed on days 5-7 of the cycle, immediately after the cessation of menstruation. It is also important that at the time of taking the material there is no inflammation in the vagina. Therefore, if you are bothered by itching or discharge, it is advisable to see a gynecologist in advance and get treatment. And then go for a cervical examination.

The doctor excises a small area of cervical tissue to then send it for histological examination. A detailed study of the cells in the area of cervical erosion and the depth of the lesion allows the doctor to develop the correct treatment tactics for the patient.

If erosion exists for a long time, and there is no proper treatment, the cells of the cervix can change irreversibly. As a result, the risk increases malignant tumors cervix. Therefore, a medical examination by a gynecologist twice a year is mandatory for every woman.

Despite the fact that the symptoms of erosion are not always pronounced, this disease must be treated. Pseudo-erosion of the cervix is characterized by the presence of epithelium around the cervical canal that does not have protective function and cannot prevent the penetration of infection (if any) from the vagina into the uterine cavity.

In addition, in some cases, a process of spontaneous epithelization of erosion occurs, which can lead to the formation of defective epithelium.

Diagnosis of cervical erosion

Erosion of the cervix may show virtually no symptoms. Only occasionally is minor bleeding possible during sexual intercourse. Therefore for early detection And timely treatment erosion even healthy woman should visit a gynecologist at least twice a year.

If the doctor sees that there are any defects on the cervix, it is necessary to conduct a colposcopy - an examination using a special device with optical system. This procedure is painless and does not require special preparation.

If during the examination the doctor sees an area that requires a more careful examination, he will take a small piece from it with special tweezers. This is called a biopsy. It is necessary to then examine the cells of the cervix in detail under a microscope.

In addition to colposcopy and biopsy, before treating erosion, you need to undergo a series of additional examinations. This is a smear for flora, cytological examination, blood tests for HIV, syphilis, viral hepatitis. Tests for the presence of sexually transmitted infections will also be required: chlamydia, gardnerella, myco- and ureaplasmas, trichomonas, herpes, human papillomavirus.

Complications

A patient with cervical erosion must be under the supervision of a gynecologist. Only with erosions that occur in adolescence, you don’t have to rush into treatment. Such erosions most often do not cause much harm and disappear on their own. But even in this situation, you need to regularly see a doctor.

In other cases, in the absence of proper treatment, cervical erosion can lead to complications. Due to prolonged inflammation, the structure of cells in the area of erosion may change. The appearance of so-called atypical cells, precancer and even cervical cancer is possible. Sexually transmitted infections, especially papillomaviruses and their combination with genital herpes viruses, can play a negative role in this process.

Treatment of cervical erosion

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The treatment method is determined after a complete examination. The issue of choosing a specialist and the method of influence should be approached with caution, especially if a woman plans to have children in the future.

Cauterization with electric current (diathermoelectrocoagulation - DEC) has been used for quite a long time. But this procedure is not without its drawbacks. Healing after it takes a long time, and sometimes cauterization leads to complications, and rough scars may occur. It is possible, for example, a narrowing of the external opening (or pharynx) of the cervical canal. This can lead to problems during next pregnancy and childbirth. Therefore, diathermoelectrocoagulation is now used much less frequently. Currently, preference is given to other methods, in particular, freezing with liquid nitrogen - cryodestruction, radio wave method and laser coagulation.

However, with cryodestruction, there is a shortening of the cervix and, just like with DEC, a narrowing of the external os is possible. Therefore, the selection methods in recent years become radio waves using the Surgitron apparatus or laser coagulation.

Surgical laser treatment used in our clinic is the most preferred treatment method. It simultaneously affects the affected area and stops bleeding. After laser coagulation, complications are rare; a scar does not form, because The operation is carried out under close supervision and under the direction of a doctor. The depth of exposure can be minimal (up to 1-2 mm) and can be adjusted during the coagulation process. The recovery process takes less time than using other methods.

Sometimes, with cervical erosion, a minor operation is necessary - conization of the cervix. It is carried out if, based on the results of a biopsy, doctors find significantly changed, that is, atypical cells. If erosion occurs after a difficult birth, cervical plastic surgery is sometimes required. Remember that cervical erosion is a disease for which consultation with a doctor is required. Self-medication for folk recipes can bring more harm than good.

Cervical erosion, ectropion, leukoplakia

Content

Pathological signs are essential for timely diagnosis any gynecological disease. They facilitate early referral of the patient to the doctor, thereby increasing the effectiveness of treatment. Many manifestations of gynecological diseases are similar. In this case only thorough examination allows for differential diagnosis.

Some pathological conditions occur without characteristic features. It is known that the absence of signs leads to late detection of the disease and development possible complications. In this connection, experts pay attention to preventive examinations that can detect early manifestations diseases.

One of pathological conditions, which progresses without obvious symptoms, is cervical erosion. This is a background benign process, which does not in every case imply pathology.

Erosion implies the appearance of signs of a defect in the visible area of the cervix. This term includes:

true erosion;
congenital ectopia;
acquired ectopia or pseudo-erosion.

Due to the prevalence of erosion in the form of ectopia, experts often use this term to refer to a cervical defect. Erosion is located in a small vaginal area of the cervix, which is lined with flat cells of a multilayer epithelial tissue. The defect is a spot that can be characterized by various visual signs.

If there is damage to the covering epithelium, an ulcer or wound forms on the vaginal part of the cervix. Violation of the integrity of the cervical area occurs due to various factors that have a damaging effect.

The ulcer lasts a short time, healing on its own within two weeks. However, this process does not always occur correctly. In this case, replacement of flat cells occurs stratified epithelium, which normally cover the area of the cervix adjacent to the vagina. The wound heals, becoming covered with columnar cells of single-layer epithelium.

This replacement process leads to the appearance of characteristic signs, which involve the appearance of a reddish spot on the cervix against a background of pale pink mucosa. Flat and cylindrical cells differ in color and texture, covering certain areas of the internal genital organs.

Cylindrical cellular elements otherwise called cubic. They line the surface of the narrow cervical canal, which connects the uterine cavity and vagina. Glands also function inside the cervical canal, producing mucus that protects against infections.

Sometimes the appearance of cylindrical cells in the vaginal area is observed when there is a violation intrauterine development genitals. The vaginal part of the cervix is covered with cylindrical cells, which over time move into the area of the cervical canal. Signs of the stain disappear.

If a defect in the form of a wound is diagnosed due to damage to the epithelium, gynecologists speak of true erosion. The result of replacing one type of epithelium with another is called ectopia. If the ectopia is intrauterine in nature, a diagnosis of congenital erosion is made. Improper healing of true erosion is considered acquired ectopia or pseudo-erosion.

Clinical picture

As a rule, when erosion develops, a woman does not observe characteristic signs. Sometimes there may be spotting that accompanies sexual intercourse or a gynecological examination. These bloody discharges are associated with trauma to the cylindrical cells located on the surface of the ectopia.

In addition, the cylindrical pseudoerosion cells contain glands. It is known that the glands actively produce protective mucus. Therefore, with ectopia, an increase in mucous secretions is usually observed.

Many women wonder whether erosion may cause other symptoms, such as pain or menstrual irregularities. Erosion cannot have these signs. However, the disease is often combined with infections and other diseases that may have various signs. So, when erosion occurs against the background of an STI, the woman notes the presence of various nature discharge - from mucous to purulent. Often during sexual intercourse there are painful sensations. Therefore, if unusual symptoms appear, you should visit a doctor and undergo an examination.

With cervical erosion, there are no specific symptoms. However, signs of cervical erosion are obvious during a cervical examination by a gynecologist.

The true type of erosion is an ulcer or wound that occurs when the integrity of the vaginal tissue of the cervix is damaged. The surface of the wound is often contaminated with opportunistic or pathogenic flora. In contact with a gynecological instrument, true erosion may bleed.
Congenital ectopia looks like a regularly shaped spot. Usually there are no signs of inflammation of such a formation. In the case of a congenital variant of the defect, the gynecologist visualizes the transformation zone, which is a junction of squamous and columnar epithelium. Normally, the transformation zone is hidden and cannot be detected upon examination.
Pseudo-erosion is characterized by the formation of a spot that can take any shape. The size of the defect also varies. Pseudo-erosion is often complicated by symptoms of the inflammatory process.

In order to accurately classify a spot on the vaginal part of the cervix as erosion, an examination is necessary. In some cases malignant tumor has external manifestations of erosion, which without special research it is impossible to differentiate.

Signs of erosion occur for the following reasons.

Hormonal fluctuations. On the condition of the epithelium uterine cervix influenced by estrogens. During pregnancy, menopause, and puberty, the concentration of this hormone changes.
Early sexual life. To of a certain age the epithelium of the uterine cervix is immature. This explains the increased susceptibility of the cervix to infections and traumatic factors.
Inadequate contraception. Chemical spermicides used on on an ongoing basis, may cause signs of erosion.
Infections. In most cases, symptoms of erosion develop due to infectious lesion. HPV is considered especially dangerous, often causing dysplasia.
Traumatization of the epithelium of the uterine cervix. Abortions and other interventions lead to ectropion, which is then complicated by erosion.

The effectiveness of the treatment depends on the elimination of provoking factors. Before appointment adequate therapy The woman is recommended to undergo examination and treat the symptoms of concomitant diseases.

Examination and treatment

Symptoms of cervical erosion should be differentiated in time from others dangerous diseases. In order to exclude manifestations of dysplasia, it is necessary to regularly visit a gynecologist and perform the necessary studies.

Identification of symptoms of erosion often occurs as part of preventive examinations. However, visual assessment of the condition of the uterine cervix alone is not enough.

In order to confirm the diagnosis and exclude manifestations of concomitant diseases, the patient is recommended to undergo the following examination:

smear for oncocytology;
bacterial sowing;
flora smear;
colposcopy in simple and advanced versions;
detection of sexually transmitted infections using PCR.

Treatment depends on the results of the examination. If there are symptoms of inflammation, it is recommended drug therapy in accordance with the identified pathogen:

antibiotics;
anti-inflammatory drugs;
antiviral drugs;
antifungal agents;
antiseptics.

If manifestations of ectopia are detected, in most cases it is recommended to eliminate it through cauterization. In modern gynecology, several techniques are used, which are selected depending on the size of the pathological focus, the age of the patient and her reproductive status. The desire of a woman to carry out childbearing is essential.

Gynecologists call following methods cauterization if signs of cervical erosion, in particular ectopia, are detected.

Diathermocoagulation. One of the simplest and effective ways Cauterization - exposure to the lesion with electric current. However, this technique involves an aggressive impact, which often results in the appearance of scar tissue. IN rehabilitation period Symptoms of infection may appear. Therefore, diathermocoagulation is contraindicated if the patient has no history of childbirth.
Chemical coagulation. During the cauterization process, the cervix is treated chemical solutions. This tactic effective if pseudo-erosion is small. In general, chemical coagulation is considered a gentle method and can be recommended for nulliparous women.
Laser vaporization. This is a non-contact method, during which pathological elements erosions of the uterine cervix are evaporated. Cauterization may affect healthy tissue. Some gynecologists note that after this intervention, large erosions often develop symptoms of relapse.
Radio wave treatment. This optimal method cauterization, which can be used for symptoms of pseudo-erosion even in nulliparous women. The effect of the Surgitron apparatus affects only the altered tissue of the uterine cervix. Recovery of the affected area occurs quite quickly.
Cryodestruction. Cauterization with liquid nitrogen is effective if the erosion of the uterine cervix is insignificant. As a disadvantage of this technique, one can note such a symptom after the intervention as copious watery discharge.

There is no treatment for congenital erosion. During pregnancy, dynamic monitoring of pseudo-erosion of the uterine cervix is recommended, and after childbirth the issue of its surgical treatment is decided.

Probably every woman has heard about such a disease as cervical erosion - the most common gynecological disease.

In reality, it is a violation of the external structure of the cervix, which was caused by mechanical or other damage. In its true form, erosion is quite a rare occurrence, and the healing process occurs naturally within a couple of weeks. How to correctly diagnose this disease, what symptoms it has.

More often, cervical erosion refers to a slightly different disease. The cervix covers two tissue zones - vaginal and multilayer flat epithelium(MPE) and channel with one layer of columnar epithelium (CE). Accordingly, the environment in these zones is significantly different. The junction of two zones can sometimes shift under the influence of certain factors.

What is erosion

The vaginal epithelium is constantly in an acidic environment, and the cells have developed protection against the destructive effects of such an aggressive environment. Channel epithelial cells are in more comfortable conditions and do not have additional protective properties.

If the junction shifts and the CE cells find themselves in an acidic environment, then they are exposed to the acidic environment and microorganisms that support the vaginal microflora. As a result, the process of inflammation begins. In medical circles, this process is called pseudoerosion or ectopia. But for convenience, a simpler name is used - erosion.

For mechanical damage to the cellular structure to occur, several other reasons are necessary. For example, rough sexual contact, low level immunity or the presence of sexually transmitted infections. In its true form, erosion is the result of difficult childbirth or surgical intervention in the intrauterine space.

Symptoms of the disease and diagnostic methods

Internal damage to the cervix does not have any effect on a woman’s well-being. There is no feeling of discomfort, there are no pain symptoms lower abdomen. During sexual contact there are no strange sensations, because the cervix does not have its own receptors. But minor discharge with ichor after sex is possible.

You can diagnose the presence of cervical erosion only by visiting a gynecologist. Upon examination, small bright red spots will be visible on the cervical membrane. If they are detected, the gynecologist will refer you for an examination to clarify your diagnosis. To do this, you will have to undergo a colposcopy.

During colposcopy, a special optical device is used to examine the cervix, which has a 25-30x magnification. Thanks to this, it will be possible to more carefully examine the damaged area of tissue and make a more accurate diagnosis. The examination is absolutely painless and takes no more than 20 minutes.

During a colposcopy, the doctor may perform a biopsy - that is, take a tissue sample from the damaged area. Microscopic examination damaged tissue makes it possible to prescribe a more precise course of treatment.

Is it necessary to treat erosion with medications?

Like any disease that carries inflammatory nature, cervical erosion needs proper treatment. If the problem is left untreated, over time the structure of the uterus will begin to change irreversibly.

New epithelium will begin to form on top of the damaged tissue, changing the shape of the cervix. The new layer of cells will work less productively and will not have the necessary protective properties. Accordingly, there is a risk, and considerable one, of more serious inflammatory processes which can lead to malignant formations.

Any woman who values her health and leads a healthy life sex life, should visit a gynecologist at least twice a year. In the early stages, any disease can be treated complete cure. But an neglected problem will have to be treated for a long time and at a high cost. Also, do not forget that self-medication or the use of methods traditional medicine without accurate diagnosis rarely leads to a positive result.

Cervical erosion symptoms- this is a set of signs indicating the presence of a limited epithelial defect covering the vaginal surface of the cervix.

The part of the cervix accessible to normal external examination, similar to the surface of the vagina itself, is covered with several layers epithelial cells flat shape, and the inside of the cervical canal is lined with one row of columnar epithelial cells. The junction of the stratified epithelium of the cervix with the single-layer columnar epithelium of its canal is called the “transformation zone” or “transformation zone”. As a rule, it is not normally visualized, since it is located inside the external pharynx - a physiological narrowing of the cervical canal, accessible to external inspection.

Erosion is understood as the presence of a wound surface (ulcer) on the neck of a traumatic or inflammatory origin. However, the same term is often used to refer to false erosion - ectopia of the cervix. This confusion of terms is not a mistake, since both states represent different stages of the development of one process.

With the participation of traumatic factors (abortion, incorrect instrumental gynecological manipulations) or pronounced local infectious inflammation, a section of the integumentary epithelium on the neck is destroyed, exposing the underlying layers, that is, a open wound– true erosion. Like all other wound surfaces, it exists for a short time (no longer than 2 weeks), and then gradually begins to epithelialize.

Epithelization of the eroded surface is carried out from the reserve cells of the multilayered epithelium surrounding the erosion zone. However, sometimes restoration of the integrity of the epithelium covering the uterus occurs incorrectly - with the participation of columnar epithelium. It literally “slides out of the cervical canal and covers the resulting ulcer. Thus, a pathological area appears on the neck, but no longer a wound one, but formed by “wrong” cells - false erosion, or ectopia.

Since the cause of ectopia is true erosion, they are sometimes simply called “erosions.” True erosions heal quickly and are rarely diagnosed (2%). can exist on the cervix for years, they are found in every fifth patient with gynecological pathology.

The causes of erosions are not all known, but analysis of existing cases allows us to reliably confirm the impact of infection, mechanical damage and hormonal dysfunction.

Ectopia also includes congenital erosion. It appears in girls in utero and can go away on its own after puberty.

Uncomplicated erosions are rarely diagnosed, since most heal without external involvement and do not manifest clinically. More often (80%) doctors have to deal with complicated erosions (more precisely, ectopia).

Any erosion is clearly visualized during a simple examination; it looks like a spot of various sizes and shapes on the neck around the external pharynx, differing in color from the surrounding tissues. However, the presence of a modified area on the cervix may indicate many pathologies. For a detailed study of all the features pathological process additional examination is required.

Symptoms of inflammation during cervical erosion correspond to the infection that caused them. Complicated erosion is necessarily accompanied by pathological discharge.

There is a misconception among patients about the mandatory connection between the appearance of erosion and childbirth. Symptoms of cervical erosion in nulliparous women are not associated with birth injuries cervix, but not always different from those in patients who have given birth. Cervical erosion, the symptoms of which appeared in the first days after childbirth, is always true, that is, it superficial wound or ulcer.

Any origin can recur. More often, cervical erosion recurs, the symptoms of which were eliminated incorrectly, regardless of the method. When, during the destruction of a pathologically altered area of the mucosa, an “untreated” edge of erosion is left, the “irregular” cells remaining there become a source of re-formation of ectopia.

Cervical erosion (any) is not a disease, but a condition of the cervical mucous membranes. It occurs in little girls, pregnant women, women in labor and elderly women. Its cause determines what symptoms of cervical erosion are present in the patient.

Cervical erosion symptoms of discharge

Infrequently, true cervical erosion is found in diagnoses, the symptoms of which do not manifest clinically without the presence of concomitant infection. It is present on the cervix for a short time and does not manifest itself until complete healing, and the first signs often appear when an “incorrectly healed” area forms in its place - false erosion of the cervix. Symptoms of false erosion also do not appear clinically and may go unnoticed or be diagnosed accidentally.

The first subjective complaints with any erosion appear after it becomes infected. The patient develops pathological mucous membranes purulent discharge(). Infection on the surface of the cervix comes from the vaginal epithelium when and of various origins, or “descends” from the overlying cervical canal in case of endocervicitis. The amount of leucorrhoea depends on the severity of infectious inflammation in the surrounding tissues. The erosion itself is not so large in area as to provoke significant leucorrhoea, but if the vagina and/or cervical canal are involved in the process, they become abundant.

Often, the presence of erosion on the cervix is associated with the appearance of bloody contact discharge. The erosion zone during infectious inflammation becomes swollen, loose, and blood vessels damaged by the infection are exposed. Such erosion bleeds easily during sexual intercourse, douching, contact with gynecological instruments or vaginal tampons.

Often, with abnormal bleeding of any origin, patients believe that they are provoked by cervical erosion. Symptoms of significant bleeding are not typical for erosions.

Symptoms of cervical erosion during pregnancy

Erosion found in a pregnant woman can be:

- Innate. Uncomplicated congenital ectopia is asymptomatic and, if the patient has not been examined outside of pregnancy, is not diagnosed.

— Acquired ectopia of columnar epithelium. Before pregnancy, the patient could have had a true erosion, which subsequently epithelialized on its own and transformed into ectopia. Symptoms of cervical erosion in nulliparous women in the absence of complications do not manifest themselves clinically, so it can be located on the cervix long time, but appear after pregnancy.

As a rule, when planning, patients come for examination. In this case, any cervical erosion detected in time, the symptoms of which are absent, is treated in advance. Otherwise, the diagnosis is made during pregnancy.

— Physiological, that is, caused natural causes: estrogen deficiency and weakening of immune defense mechanisms.

The cause of its appearance does not affect what symptoms of cervical erosion are observed in pregnant women. As a rule, subjective signs are pathological, sometimes mixed with a small amount of blood after intimacy.

It is the presence of contact bleeding against the background of ectopia during pregnancy that is associated in patients with the likelihood of early termination of pregnancy, but the presence of erosion on the cervix in a pregnant woman does not pose any threat. Uncomplicated erosion in a pregnant woman is under observation, but special therapy does not need it, but returns to the issue of treatment after childbirth. Much more harm to the fetus can be caused by an infection in the vagina, which complicates the course of erosion. Many pathogenic microbes (especially pathogens of sexually transmitted infections) are able to overcome protective barriers on the way to the fetus, so it must be eliminated in a timely manner. In this case, during pregnancy, any erosion of the cervix, the symptoms of which indicate infectious inflammation, should not be left without treatment.

Symptoms of cervical erosion after childbirth

Postpartum true erosion of the cervix is formed against the background of mechanical trauma, when passing through birth canal the fetus tears or tears the cervical tissue. In conditions of sharply reduced immunity, an acute infectious-inflammatory process begins on the damaged surface.

The first signs of true erosion after childbirth are found in women in labor at the site of damage to the cervix. Four days later, women in labor with good immunity a small ulcerated surface begins to epithelialize on its own, and heals completely after 10-12 days. Extensive ulcers are closed with stitches.

Also, at the site of rupture or damage to the cervical mucosa during childbirth, complicated true erosion of the cervix is formed, its symptoms correspond to the signs of infectious inflammation: severe hyperemia, edema, dense layer purulent plaque on a damaged surface, fragility of blood vessels and bleeding.

Severe inflammation in the erosion zone provokes copious purulent discharge. Bloody or bloody discharge from an eroded surface, as a rule, is not noticed by women in labor against the background of physiological postpartum discharge. In the first few days postpartum period In the uterine cavity, processes of healing of the wound surface remaining after separation of the placenta from the uterine wall occur; this process is accompanied by bloody or dark spotting discharge - lochia. They “mask” bloody discharge from erosion.

The presence of postpartum erosion is often accompanied by deterioration in health, moderate fever, and vaginal pain.

Complicated true erosions that formed in the first days after childbirth heal poorly on their own, therefore, in conditions postpartum ward Local wound healing and anti-inflammatory therapy is carried out. After preliminary cleansing of the wound with disinfectant solutions (Furacillin, Chlorhexidine), it is treated antibacterial ointments(Sintomycin, Levomekol, Vishnevsky ointment). When the wound is completely free of infection, its epithelization begins.

When wound surface true postpartum erosion heals incorrectly; instead of the proper stratified squamous epithelium, columnar epithelium grows, which normally should remain in the cervical canal. Thus, after childbirth, false erosion of the cervix is formed. The symptoms of postpartum ectopia, as well as methods of its treatment, do not have any distinctive features.

Symptoms after cauterization of erosion

“Cauterization” of cervical erosion (diathermocoagulation) is one of the “old” therapeutic methods, but is not inferior in efficiency (93-98%) and ease of implementation to more modern techniques. It is based on ability electric current coagulate biological tissues.

The procedure is practically painless (there is no nerve endings), is carried out once. The purpose of diathermocoagulation is complete destruction (destruction) of the surface layer of ectopia.

During the procedure, the electrode moves pointwise along the surface of the erosion. After each touch to the neck, a small burn zone remains; as the electrode moves, the burn zones merge together, and after the end of the procedure, at the site of the ectopia on the neck, a scab of equal size remains - a dark crust consisting of burnt columnar epithelial cells. The scab is rejected after two weeks when the wound heals. Process full recovery healthy tissue takes about three months. When epithelialization ends, in place former erosion a healthy surface of the cervix remains, evenly covered with stratified epithelium.

Like all other methods, diathermocoagulation is possible when the symptoms of inflammation during cervical erosion are eliminated.

Correctly carried out “cauterization” of erosion is usually not accompanied by serious complications. A small amount of serous or serous-bloody discharge after the procedure is not considered a complication. Sometimes such vaginal discharge may be present until the normal mucous layer is completely restored. If such discharge becomes abundant, before the scab is rejected, the cervix is treated with a disinfectant solution, and after rejection - with wound healing agents.

During diathermocoagulation, a small “rim” of healthy tissue around the erosion is sometimes affected. This leads to minor and short-term (no longer than three days) bleeding.

Diathermocoagulation is not indicated for nulliparous patients. After the procedure, dense scars form on the cervix, and the cervix loses its ability to stretch well during childbirth. Also, complicated cervical erosion is not “cauterized.” Symptoms of infection are previously eliminated.