Cervical Erosion Symptoms
Mar 05, 2018
Cervical erosion is one of the most common diseases of the female genital area. More often, erosion does not reveal itself, but reveals its gynecologist with gynecological examination. But sometimes it can be manifested by the appearance of pathological bloody discharge from the vagina, especially after sexual intercourse. Erosion can occur at any age: both in very young girls, and in elderly women. There are a lot of reasons for erosion, but most often they are inflammatory diseases of female genital organs, traumas and micro-traumas arising from careless gynecological manipulations and even during sexual intercourse. The current cause is now allergic reactions to contraceptives and sperm. How to treat folk remedies look here.
There are two types of cervical erosion. The first - true erosion of - is rarely found in clinical practice. This is a defect in the epithelium of the vaginal part of the cervix, when the surface of the mucosa is disturbed. Emerging wounds bleed. Through them, as well as through any other wounds, the infection easily penetrates. The causes of true erosion can be trauma, imprudent syringing, inflammatory diseases of the cervix.
Another species, the so-called ectopia , is most common. In this case, the cylindrical epithelium of the cervical canal is shifted towards the multilayered flat epithelium of the vaginal part of the cervix. Ectopia is also often found in young girls, virgins, and with the onset of sexual activity, it can be complicated by inflammation. As doctors say, ectopia is a benign, or background, condition. But, as they say, smoke without fire does not happen. So with ectopia: it is dangerous for its complications.
Infections such as chlamydia, gonococci, herpes simplex virus easily enter the cervix and thereby cause disease. The fact is that when the epithelium is shifted, protection is lost, and pathogenic bacteria do not interfere with penetration and start "poisoning life" for a woman. After the epithelial shift of the cervix, the secretory epithelium remains in its place, and it can not exist for long in the acidic environment of the vagina. And here the organism independently starts the healing mechanism. That epithelium, which remained after the displacement of the true, turns into a multi-layered flat. It seems to be all right, but there is a danger. It is at the moment when the epithelium heals, this surface can become fertile soil for the reproduction of the human papilloma virus. This virus is sexually transmitted and causes diseases of the cervix of varying severity: flat warts, cancer.
That's why gynecologists are always cautious about ectopia. In some cases, they can trust the body to cope with the disease itself - provided that the woman did not give birth and the ectopia is not complicated by anything.
Ectopion is an eversion of the mucous cervical canal that occurs after childbirth, traumatic enlargement of the cervix with abortion and diagnostic curettage. As a rule, the patient does not make specific complaints.
Leukoplakia is the appearance on the epithelium of the cervix of the areas similar to the usual skin. The causes are diverse: infection, trauma, hormonal imbalance and immunity. This pathology does not manifest itself, but in most cases leads to a malignant tumor.
Erythroplasty - thinning of the mucous membrane of the cervix. When viewed in the mirrors is a bright red spot on the cervix. The causes of the appearance of this disease are still unknown.
How are tumors formed? With prolonged inflammation, the body includes a self-healing function. The properties of epithelial cells change, they begin to rapidly divide, and this, as a rule, leads to the formation of a tumor - first benign, and then malignant. It has also been proven that tumors can occur against the background of infections caused by certain types of the virus of genital herpes and human papilloma that are transmitted sexually.
As a result, a woman is diagnosed with cervical cancer. Basically, this disease affects women at the age of about 40 years. But recently the following trend has been observed: these women are beginning to visit a gynecologist more often, and the doctor diagnoses pathology in the early stages. In time, the prescribed treatment reduces the number of patients. But women under the age of 35 are much less likely to attend a women's consultation. And in this age group the number of cancer patients began to increase. The reason is also that patients who hear a diagnosis are afraid to be treated, thinking that they have been sentenced to death. You know, this is not true: medicine has progressed very much in the treatment of cancer recently, and in the initial stage the cancer is treated quite successfully.
If you come to the doctor and he diagnoses you with "cervical erosion", he prescribes treatment with tampons with oils, which means that you have a slight reddening and the body needs to just help cope with the inflammation. Here the most important thing is not to launch this "small scratch", so that on the next visit to the gynecologist he does not prescribe a moxibustion. Such a doctor's recommendation means that a small wound has begun to increase. If you continue not to pay attention to it, then at the most inopportune moment it will give you a far from pleasant surprise.
The danger of erosion of the cervix does not depend on its size. In addition, there are situations that it is still not visible even with the "armed" eye, and here experts will help you on the pathology of the cervix, the uterus - they will precisely diagnose it.
It is worth noting this fact. There are cases that, due to incompetent cauterization of erosion, scars form on the surface of the uterus. As an indicative
So before you start treatment, you need to choose a good clinic or a highly qualified gynecologist who has been practicing in this direction for years.
Cervical examination is performed on a gynecological chair. Many women are very negative about this, probably because the examination procedure is not very pleasant. After examining the genitals, the doctor proceeds to examine the cervix. To do this, he inserts metal mirrors into the vagina;as a rule, they seem cold to a woman, because of this, and it becomes unpleasant, because the muscles contract and the tools are tight. When using plastic mirrors, this problem is often solved. After the introduction of the mirror, the cervix is guided by the light and examined by the "naked eye".In this case, only gross violations are visible, they can not be distinguished from each other, they look the same as the site of redness, - but this is erosion of the cervix. The doctor takes swabs on the flora and cytology. To make an accurate diagnosis, you need to perform an advanced colposcopy.
So, in order to correctly diagnose erosion of the cervix, the doctor should conduct an examination of the cervix and bacteriological examination. If necessary, for a more accurate result, do an advanced colposcopy. In this case, the doctor will examine the surface of the cervix under a special microscope. After that he will determine both the degree of danger, and the ways of treatment.
It is also necessary to conduct a cytological and histological study. To spend the last, it is necessary to lay down in hospital for 2-3 days. A woman cuts out a tiny piece of damaged epithelium and examines to find out if a malignant degeneration has occurred. The results of the biopsy allow us to finally clarify the diagnosis and determine the choice of the method of treatment.
Bacteriological study is a study of a smear from the vagina and cervix under a microscope. It is done in all gynecological institutions, but its quality depends on the qualification of a person looking in a microscope. In the smear, the number of white blood cells is counted( more than 10-20 in the field of vision indicates the presence of infection) and are looking for pathogens of this infection. As the gynecologists say, you can learn everything by brushstroke. This, of course, is an exaggeration, but the doctor actually receives the bulk of the information after this analysis. Smear is determined by such diseases as thrush, or candidiasis, bacterial vaginosis, trichomoniasis, gonorrhea. If the smear shows infection, but does not identify the pathogen, seeding and PCR diagnostics are shown.
Why do I have to give a smear to a woman if she has erosion? Some are mistaken, thinking that erosion is also an infectious disease that caused inflammation on the surface of the cervix. And if you burn it, then all micro-organisms and bacteria will die. This opinion is mistaken!
Treatment of infection must necessarily precede the treatment of erosion. First, it can lead to the self-elimination of erosion;secondly, surgical treatment of any organ, including the cervix, is impossible in conditions of "contamination" of its microbes, as it is fraught with the development of complications. When treating you need to combine the common drugs used in tablets, and local - candles, douches, gels. Local drugs help antibiotics penetrate directly into the affected cells, including erosion cells. After using antibiotics, thrush often develops;to prevent it, the course of antibiotics should end with the use of drugs containing milk bacteria, normally living in the vagina( for example, candles "Acilact").The only exception is the initial thrush( candidiasis).In its treatment, "Acilact" is not necessary to use, since in the presence of a large number of milk bacteria, Candidiasis is aggravated.
In addition to bacteriological research, as already mentioned, the doctor can perform advanced colposcopy. A colposcope is a special microscope that allows you to study the appearance of the cervix, and the procedure of using it is colposcopy. In principle, any gynecologist is required to own this technique. To date, almost every women's consultation has such a device. The gynecologist uses it to accurately determine the presence of erosion, and also not to miss phenomena similar to a malignant tumor.
Before starting to examine the cervix with a colposcope, it is treated with a substance containing acetic acid and then with iodine. The procedure itself takes quite a long time, about 20-25 minutes. Stock up with patience and do not distract the doctor with your questions: doing advanced colposcopy, the doctor should be extremely attentive. So, first the gynecologist inserts a mirror into the vagina and processes the cervix, as already said, with a solution of acetic acid. The fact is that this substance leads to spasm of blood vessels, which allows the doctor to examine the cervix itself, and not its vasculature. Before coloring with acetic acid, the neck looks like a large pink spot, after all the available pathology is clearly distinguished. Then the doctor pushes a large instrument with eyepieces to the chair, turns on the bulb and looks. Colposcope itself remains outside, its increase allows you to see the cervix from afar.
After the doctor has examined the surface of the cervix, he has determined the place of the pathology, he passes to the next stage of the procedure - a clearer definition of the erosion size. For this, Lugol's solution is used. Unlike an alcohol solution of iodine, iodine is dissolved in water, so you should not feel anything. When the surface of the cervix is processed, normal, healthy cells will be stained with Lugol's solution, and pathologically changed - no. But if you still feel a burning sensation, it means that in addition to erosion, there is also an inflammatory process: the solutions that are used in this procedure are designed only for coloring the surface of the cervix, and not for antiseptic treatment.
Having performed an advanced colposcopy, you can put an accurate diagnosis of cervical disease and determine its malignancy. If it is not done, then erosion will be just a red unexplored spot, in which anything can be hidden.
In addition to advanced colposcopy, a mandatory stage in the diagnosis of cervical pathology is a cytological study. It should be noted that cytological scraping from the cervix should be performed before the treatment, even if the woman does not care and the uterus at first sight looks without pathologies.
Cytology is the science of the cell. In the cytological study, the features of the structure of the cells of the cervical surface are studied. The result of the study largely depends on the qualifications of the person who looks at the microscope, and the correctness of the material sampling.
To take the material for a cytological examination, gynecologists use a special tool - a spatula. It has a curved surface, corresponding to the shape of the cervix. This spatula removes a layer of cells from the surface of the cervix. But do not worry, this is a completely painless procedure. If it is not done correctly, an accurate diagnosis will not be made. Scratch the layer of cells due to the fact that the malignant process begins with the lower layers of the epithelium( integumentary tissue) of the cervix and progresses upward, to the surface. Therefore, if only the surface layer enters the smear, the diagnosis will be comforting, but incorrect. As a result, precious time will be lost and the woman will find out about the illness only at the last stage. Scraping the cells from a specific area of the cervix - the junction of the outer covering epithelium, located outside, and the cylindrical epithelium lining the cervical canal from the inside - they are distributed on the glass.
The cytologist gives one of two possible answers: "Atypical cells are not found" - this means that everything is in order, or "Discovered" - hence, there is a pathology. Atypical cells - changed in shape, size, structure of nuclei. Such changes can be caused by a malignant process or inflammation. Therefore, in the case of an affirmative response, anti-inflammatory treatment is mandatory, and cytology data is complemented by biopsy under colposcopy control.
One of the causes of the pathology of the cervix can be viruses. If you have suffered genital herpes, the doctor can conduct a study to determine the type of the virus in order to find out whether it is highly coexisting or not, that is, what is the probability that this virus can subsequently cause cervical cancer. Therefore, with a minor lesion, you need to determine the type of the virus. In severe pathology, neoplasm, as a rule, is removed regardless of the type of virus, in which case it can not be determined. To identify the virus, a special brush is inserted into the vagina and a smear is taken from the cervix.
Biopsy( histological examination) can be taken on the 5th-7th day of the menstrual cycle, immediately after the termination of menstruation. In other words, almost at its very beginning.
Before performing a biopsy, the doctor must make sure that you do not have an infection. If the smears on the flora show poor results, the doctor will first prescribe the treatment of the infection, and after the stroke will take a biopsy. A biopsy requires cleanliness: it is a small, but still an operation.
To see the changed area more clearly, it is stained with Lugol's solution, after which the procedure is performed under the control of the colposcope. To do this, use special tools - such as biopsy forceps, radio knife( apparatus "Surgitron"), electro-loop or scalpel.
No need to worry: a biopsy is a painless and very fast procedure, doing it literally in a matter of minutes. It does not require anesthesia, but if you are still afraid that it will hurt, the doctor can treat the cervix with lidocaine. However, your fears are in vain: there are few nerve endings on the surface of the cervix, and local anesthesia practically does not work. If you are tense, your muscles will contract and the doctor will be uncomfortable inserting tools inwards. To make the procedure easy and quick, a strong breath should be made on the team, and after a few seconds a piece of tissue will be taken for analysis.
Once a biopsy is taken from the cervical surface, this site can bleed. As a rule, the gynecologist cauterizes this point, and then presses it with a gauze pad. Cauterization lasts a few seconds, while you will feel a sip in the lower abdomen, as during menstruation.
After a biopsy within a week, you should not live a sexual life, douche, lift weights. In other words, it is necessary to protect the cervix.
The main plus of the histological study is that it allows you to make a final diagnosis. The answer of histologists can be one of the following: endocervicosis, that is banal pseudo-erosion of the cervix, various types of dyskeratosis, endometriosis of the cervix - also absolutely benign disease, varying degrees of dysplasia or cervical cancer. Dysplasias are of three degrees. Dysplasia of the 1 st degree, that is, a disruption in the structure of the tissue, can be both the onset of the tumor process and the result of inflammation. If it turns out that the cause of its appearance is an infection, it is treated, after which the biopsy is repeated. But the violations of the structure of tissue of 2 nd and 3 rd degree( dysplasia of 2-3 degrees) suggest that the condition is precancerous and requires surgical treatment. Also, according to the results of the biopsy, the method of treatment of for cervical erosion is chosen.
Before you start talking about methods of treating erosion, you need to find out what it is in size and how dangerous, you need to undergo a survey. After all the tests are done, the doctor prescribes appropriate treatment according to their results.
There are many methods for diagnosing erosion of the cervix;the methods of its treatment are also diverse. If erosion is not complicated by infection and is not large in size, then the prescriptions of traditional medicine are quite suitable and you can not resort to drug therapy. When erosion heals, we simply help the body cope with the disease. If, in addition to the pathology of the cervix, you still have an infection, then first you need to cure it. It is always necessary to take medication and control the treatment process with the results of the tests. If erosion of medium size or can not for a long time heal itself, then resort to such methods of treatment as cauterization( diathermocoagulation, or cauterization by electric current), laser removal( is considered the most successful method of treatment, since it has no complications), chemical coagulation(when the patient is cauterized with liquid nitrogen).If a woman has eroded into a more serious form - cancer or other neoplasms, the treatment becomes more complex. In such cases, surgical intervention is necessary( completely removing the uterus or part of it).
Let's look now in the "assortment" of ways to heal cervical erosion. Let's start with the treatment of the most insignificant manifestations of this disease and we will move from simple to complex.
In the normal state of the cervix, its vaginal part is covered with a multi-layered flat nonkeratinizing epithelium( to make it clearer, I will say that this layer is very similar to the oral mucosa), and the cervical canal is lined with single-rowed cylindrical epithelium. The joint of two layers of the epithelium is in different parts of the cervix - depending on the age. As a rule, in girls before the beginning of the period of puberty this joint is located on the vaginal part of the cervix, in other words, outside the cervical canal. In women of reproductive age, the junction of the epithelium is in the region of the external pharynx of the cervix;After 50 years, he is displaced into the cervical canal. Displacement of one of the epithelium and the creeping of one layer on the other causes erosion. Everything begins, as a rule, with true erosion.
True erosion is a defect of multilayer flat epithelium on the vaginal part of the cervix. In other words, it is a wound or a scratch that can exist for 2-3 days or up to 2 weeks. As a rule, such erosion does not manifest itself in any way, does not require specific treatment, it can heal independently. But it is worth considering that if at that moment an infection gets into the vagina, then favorable conditions have been created for it.
Anti-inflammatory drugs are good for diseased tissue, but erosion of the cervix is a healthy tissue, only it is not in its place. However, if it is accompanied by an infection, then, of course, anti-inflammatory therapy is necessary.
Unfortunately, often in cases where surgical intervention is required, women, fearing this, continue to use locally rose hips oil or sea-buckthorn, honey, which are potent biological stimulants. This provokes an increased growth of the multilayered plane epithelium, which creeps into erosion and closes it. In this case, some of its parts break through the layer of the epithelium, forming tubercles, clogged ducts glands. The surface of the neck becomes uneven and very vulnerable. Under the cover of the epithelium in the glands, the process of transformation of normal tissues into malignant ones can occur. The problem is that the process is invisible - the swabs taken from the surface will not be pathological even in the case of an initial cancer!
That's why every woman should know: if the results of the tests showed the presence of erosion, then it must be treated. The exception is the nulliparous girls under the age of 22 years. They should regularly visit a gynecologist who will monitor the condition of the uterus before giving birth. In some cases, doctors recommend the use of oral contraceptives: they help not only to avoid unwanted pregnancy, but also, eliminating hormonal imbalance, get rid of pseudo-erosion. We will talk about this later. And now - about modern methods of treatment.
If you characterize it figuratively, you can say this: burn with a hot iron. Cauterization has been used since ancient times. This is a radical way to treat erosion. He remains today in the arsenal of doctors.
However, over time, treatment methods have become less painful for a woman.
The instrument of the pre-electric era was replaced by an electrocoagulant, which destroys the tissue by exposure to high temperatures. On the burn wound immediately there is a scab. This effective method( diathermocoagulation) has brought over a lot of women for many years of existence. As a result of cauterization, the epithelium is removed, which is not in its place, and instead of pseudo-erosion, a wound appears, that is, real erosion, which is covered with a healthy multilayered epithelium.
After this procedure for a month you can not live a sexual life, lift weights, douche, use tampons during menstruation, so that the wound heals without inflammation and suppuration. If these rules are observed, in the vast majority of cases the process goes without complications.
It is worth noting the drawbacks of this method of treatment: it does not allow controlling the depth of current penetration, as a result of which rough scars can form on the cervix, which can lead to complications in future births. Despite this, almost every gynecologist owns the method of cauterization, and the device for electrocoagulation is in any women's consultation.
But the problem is that modern methods of treatment should be safe, do not have negative consequences, be accessible and promote cure in the shortest possible time. As an alternative to such a rigid method as moxibustion, new ones have been developed: erosion of the cervix is removed by means of a laser and liquid nitrogen.
The laser is currently used almost everywhere. That only he does not heal! Also, its use in gynecology has more pluses than minuses. Of course, this is quite expensive, but it's worth it. The mechanism of action of the laser is that when exposed to biological tissues light energy is converted into thermal energy. This leads to their instant heating to high temperatures, evaporation of the intracellular and inter-tissue fluid, and the formation of a necrosis zone.
Advantages of laser treatment are the absence of scars after healing, by the way, very fast, extremely rare complications. The method is painless, its use is recommended even for the treatment of nulliparous women. Allows you to remove the damage under the control of the microscope at the required depth. Unlike cauterization, this method is not owned by all gynecologists. And, as a rule, this procedure is offered in specialized or paid clinics.
When cryotherapy( treatment with liquid nitrogen), damaged parts of the cervix are treated with liquid nitrogen. This, like laser therapy, a gentle method, it almost does not leave scarring and also painless. It is used, as a rule, with minor erosions, since the penetration depth of the substance is sufficient only for the treatment of ectopia and genital warts. Cryotherapy is ineffective for deeper or more serious injuries.
Cryodestruction is an even more sparing method of treating ectopia by affecting the pathologically altered site with liquid gas. Negative aspects of cryodestruction are the risk of insufficient freezing of tissues, because of which the death of all altered cells is not ensured. The duration of healing is 8-10 weeks.
After applying any of the above 3 methods, you can not live a sexual life for a month, and possibly longer. To be sure, wait for the doctor's permission. Do not think that if you have sex in a condom, it does not affect the wound. Restrictions in the sexual life after treatment of cervical erosion are introduced not only because of the possible infection: mechanical effects damage the wound and it will heal longer.
Above we talked about that pseudo-erosion( ectropion) is a healthy tissue that is not in its place. And treating it with tampons and syringings can not have any effect.(Do not forget that it is possible to treat erosion with the help of herbs only at the very beginning of the disease.) In addition to surgical interventions, another method was proposed for the treatment of erosion - tampons with synthesized medications that burn out the affected tissue. The most commonly used drug is "Solkagin", you can also use "Vagotil".The damaged area is cauterized in a few days. But this method is much inferior to diathermocoagulation, cryodestruction and even more so - the use of a laser. It can be used only with small ectopies without signs of inflammation or condylomata. Deeper pathological processes are not available for the penetration of the chemical, so when this method is used in women with severe cervical lesions, the diseases often remain and progress.
When using this method, as a rule, the apparatus "Surgitron" is used. The operation of the radio-knife is based on the high energy of the radio waves. Its advantage is that it does not burn out, but cuts off the damaged area, which can be subjected to histological examination, which will allow the doctor to make sure of the diagnosis. Treatment of erosion of the cervix by the radio-knife method is an alternative to a scalpel, while simultaneously hemostasis( i.e., cauterization of vessels and stopping of bleeding).
Operative intervention is resorted to when erosion of the cervix grows into a malignant tumor. If a biopsy shows the presence of malignant formation, it is necessary to continue treatment not for a gynecologist, but for an oncologist. Do not be afraid of this doctor, you need to understand that he knows his "pathology" better than any other specialist. Remember: cervical cancer in the initial stage lends itself to complete cure.
Despite the last fact, the neglect of pseudo-erosion and its overgrowing into cancer is very common. When there are pronounced precancerous changes, resort to surgery.
After surgical removal of the pathology of the cervix, the same recommendations are given as after the biopsy, only a gentle regimen should be observed longer: from 3 to 6 weeks. You can not lift weights, overheat( in a sauna, for example), live sexually. During this time, there are moderate, at first supracurricular and even bloody discharge, which should not cause concern, since the wound after a surgical operation is a burn surface, and then liquid serous discharge may appear. We must protect ourselves during this period. Allocations smoothly pass into the next menstruation, after its termination it is necessary to come on a control examination to the doctor.
It is worth noting: it is very important to perform a surgical procedure on the 5th-7th day of the cycle, so that the wound surface has time to heal to the next menstruation. Otherwise, the localization that began with the unhealed cervix of the uterus can lead to its endometriosis, which is manifested by bloody discharge before menstruation and with sexual intimacy.
Paradoxically, but true: this disease ranks 4th among female diseases by the number of patients. It would seem that the cancer could be prevented so easily - to show the gynecologist in a timely manner, not to start a disease, to monitor the condition of one's sexual organs, to be choosy about choosing sexual partners, to guard against the onset of unwanted pregnancy. At all this is not enough time, or simply no information.
The worst thing - the source of a cancerous cervical cancer are normal cells that cover the cervix. And depressing is the fact that over the past decade, cervical cancer, the uterus is significantly "younger".In other words, women are now ill not after 40, but on the contrary, in their reproductive age, to 35 years. I will not go deep into the causes of cancer, but I will remind you that a direct relationship between this disease and the viruses of genital herpes and human papilloma has been proved. Thus, it turns out that the cancer is "transmitted" sexually.
Many men and women are convinced that it is possible to change partners like gloves, the main thing is to use a condom with this. Yes, security is good, but far from all. It should be noted that the condom does not protect against genital herpes and human papillomaviruses. Doctors found that the presence of a woman with 6 or more sexual partners increases the risk of developing cervical cancer 11 times.
The risk group for cervical cancer includes women who:
The main thing that you need to pay your attention: cancer of the cervix is a consequence of a neglected disease. He can not appear just like that. Before the tumor begins to grow, a precancerous condition arises. It is to him and include dysplasia. If you have only an ectopia, then the cancer is still far away. Ectopia, or pseudo-erosion, is referred to background diseases, that is, against its background can develop cancer, as if under its cover. He generally will not, if in time to begin treatment of pathology of the cervix. But if you start erosion, then over time it will grow into a malignant tumor.
Certainly, erosion can heal on its own, like any slight damage in our body, but this applies only to minor changes in nulliparous girls and girls whose erosion is caused by a violation of the hormonal background. If you already have a child or you do not live with a regular partner and the doctor has diagnosed you with "erosion", then you must have her compulsory treatment. Yes, erosion can heal itself, and can become a fertile soil for the growth of a cancerous tumor. Therefore, every woman, in order to be absolutely protected from cervical cancer, should cure her pathology.
Recall some nuances.