According to the Association of Gynecologists, at least 20% of women suffer from cervical erosion. This disease is dangerous in that it contributes to infertility and can degenerate into a malignant formation if it is not cured in a timely manner.

Normally, in a healthy woman, the vaginal part of the cervix is ​​lined with squamous stratified epithelium, while the inner surface of the cervical canal is covered with a single-layer cylindrical epithelium.

Replacement of the squamous epithelium with a cylindrical one can lead to the development of chronic erosion of the cervix. There are several causes of pathology:

1. Hormonal disorders.
2. Mucosal injury.
3. Inflammatory processes of the genital area.

Additional risk factors include:

1. Early sexual life.
2. Pregnancy before the age of 16.

Erosion treatment methods include conservative methods and the damaged part of the organ . In medicine, radioknife, electrocoagulation and are actively used. The safest thermal method of therapy is cauterization of cervical erosion with a laser.

Symptoms and signs

The disease is fraught with complications due to the fact that there are no specific symptoms at an early stage of the pathology. It is possible to identify erosion only when examined by a gynecologist. A woman may notice some discomfort and not attach importance to it, attributing it to other reasons.

If there are discomfort during intimacy or unusual discharge, this may indicate erosion or ectopia.

Pink, reddish or brown discharge appears when blood particles get into the whites. This is due to mechanical damage to microvessels.

A purulent secret indicates that concomitant diseases have developed against the background of erosion.

The danger of cervical erosion is that it can lead to the development of diseases of the female genital area. In order to detect erosion in a timely manner, it is necessary to visit a gynecologist regularly. Only a doctor can diagnose or prescribe conservative treatment or cauterization with liquid nitrogen, laser or radio waves.

If the disease is started, then the erosion of the epithelium will continue, and this affects the general condition of the reproductive system and leads to the development of complications.

After cauterization, tissue regeneration occurs within a month, after which squamous epithelial cells form at the site of erosion, and the risk of severe complications is significantly reduced. In order to avoid the re-formation of the focus of the disease, a woman must follow all the doctor's recommendations in the postoperative period:

• do not use tampons;
• do not overheat the body in the bath, solarium, on the beach;
• refrain from swimming in open water and taking a bath;
• stop drinking alcohol.

For 5-6 weeks it is forbidden, and for the next six months it is better to use a barrier method of contraception to reduce the risk of infection. Before planning a pregnancy, it is necessary to undergo an examination by a gynecologist. In the event that the birth of a child is not included in the immediate plans of a woman, to assess the success of the treatment, you need to visit a doctor.

Consequences and complications of erosion

Violation of the integrity of the cervical tissues contributes to the development of pathogenic microflora, which leads to inflammatory diseases. The most commonly diagnosed are chlamydia, trichomoniasis and various fungal infections. If erosion is not treated, then the appendages and the uterine cavity are affected by infections.

The danger of erosion lies in the high likelihood of adhesions and other serious diseases. The consequences of erosion can be:

• dysplasia;
• oncological diseases;

Timely examination by a gynecologist and treatment of the identified pathology will allow for a long time to maintain reproductive ability and general health.

cervicitis

One of the consequences of cervical erosion can be cervicitis. This pathology leads to miscarriage and premature birth. Cervicitis provokes the formation of polyps, inflammation of the uterus and appendages. Symptoms of pathology:

• cloudy or purulent discharge;
• pain when urinating;
• discomfort during intercourse;
• pain in the lower abdomen.

Large erosion contributes to infection and inflammation of the vaginal part of the cervix. Cervicitis is accompanied by other pathologies:

• vulvitis;
• vaginitis;
• neck eversion.

This disease mainly affects women of reproductive age. The percentage of the disease during menopause decreases sharply.

endometritis

Launched erosion contributes to the development of endometritis - inflammation of the uterine mucosa. Often affects the muscle layer. The acute form of the disease, if left untreated, becomes chronic, which proceeds almost asymptomatically, in advanced cases, bleeding is possible. The consequences of endometritis for the uterus are as follows:

• thickening of the mucous membrane;
• serous plaque.

The severity is determined by the size of the focus of the altered structure of the endometrium. The chronic form of the disease leads to infertility, miscarriage and other complications of pregnancy and the postpartum period.

Dysplasia

At this stage, neglected erosion triggers pathological processes, during which epithelial cells degenerate into atypical ones. Dysplasia occurs at the border of cylindrical cells lining the cervical canal and squamous stratified epithelium. This condition is considered precancerous. The third degree of dysplasia degenerates into squamous cell carcinoma. With timely treatment, the prognosis is favorable.

Cancer

Oncological diseases of the cervix are often diagnosed in women of reproductive age, and very often untreated erosion becomes the cause. The development of benign processes threatens to degenerate into malignant ones, in which case the treatment process is more complicated, and the prognosis for recovery is much lower and depends on the stage of development of the pathology.

Infertility

Violation of the protective functions of the cervix contributes to the penetration of pathogenic microorganisms into its cavity. Depending on the stage of inflammation, the fallopian tubes can become impassable, which excludes the onset of pregnancy. The erosive surface complicates the process of penetration of spermatozoa into the organ. The appearance of erosion in those giving birth and the lack of treatment leads to secondary infertility.

Other complications

Pathological changes in the epithelium can occur at any age, although the reproductive age gives the highest risk of the disease, since it is during this period that a woman is most sexually active, gives birth to children and, unfortunately, has abortions. Nevertheless, in adolescence and during menopause, there is also a possibility of developing a defect in the cervical mucosa.

puberty

Erosion can occur in girls during adolescence with the onset of puberty. The formation of the menstrual cycle leads to hormonal fluctuations, the reproductive system at this age is quite vulnerable. The reasons for the development of erosion include:

1. Hypothermia.
2. Errors in the hygiene of the genital organs.
3. Early onset of sexual activity.

At the age of 11-14 years, menstruation is irregular. Hormonal restructuring of the body causes previously unfamiliar sensations, so there is a great danger of missing the symptoms of the onset of the pathological process.

In the future, erosion can lead to diseases of the genital area and infertility.

menopause period

During menopause, the level of female hormones decreases, and the cervical canal produces less secretion. At this age, the likelihood of pathogenic infections entering the uterine cavity increases. Insufficient secretion of the vaginal mucosa leads to the formation of microcracks and the further development of erosion. To minimize friction during moments of intimacy, you need to use lubricants or consult a gynecologist about the advisability of using therapeutic ointments and suppositories with a softening effect.

Untreated erosion can lead to cancerous processes in the neck. If a woman has spotting during menopause, and sexual intimacy causes discomfort, it is necessary to visit a gynecologist, as oncogenic risks increase with age.

Alarming symptoms should not be ignored - cervical cancer can metastasize to the body of the uterus and other organs of the small pelvis. Timely diagnosis allows you to determine the disease at an early stage. The earlier the pathology is detected, the higher the chance for a favorable prognosis.

Pregnancy

When planning a pregnancy, a woman must undergo examinations in advance. If erosion is detected, then it must be cured no later than six months before the intended conception. Untreated pathology of the cervix can provoke the penetration of infection into the uterine cavity, which is fraught with intrauterine infection of the fetus, or infection of the child during birth.

If a small erosion is found in a pregnant woman, cauterization is not performed, since manipulations with the neck can lead to its opening and provoke a miscarriage. When the lesion is extensive, sparing treatment methods are indicated that do not cause the formation of scar tissue.

Poorly performed erosion treatment entails coarsening of the mucosa. A decrease in the elasticity of the cervical tissue leads to its rupture during childbirth.

postpartum period

The cause of postpartum erosion can be:

• ruptures and cracks of the mucosa;
• damage to the epithelium with instruments;
• suturing;
• infection.

In addition to mechanical injuries, hormonal disorders and exacerbation of chronic diseases contribute to the development of pathology. A woman can take the symptoms of erosion for the features of the postpartum period. It is necessary to undergo a preventive examination in order to timely identify and cure the disease and maintain reproductive function.

(ICD-10 N86 - code for the medical classification of diseases) is a widespread disease. Most often, a woman finds out about him by chance, during a routine examination or when registering during pregnancy. What procedures does the doctor prescribe and what to do with cervical erosion? Answers to the most common questions can be found in this article.

What is cervical erosion, is it dangerous?

This diagnosis is quite common, and at least 30% of women face it. But not everyone understands whether it is dangerous. Cervical erosion is a small defect on the mucous membrane in the form of an ulcer. The disease is successfully treated if not started. With inaction, erosion can provoke various diseases, including cancer, and sometimes it can interfere with conception.

The disease is divided into pseudo-erosion and true. The first occurs in young girls and women with elevated levels of estrogen in the blood and consists in the release of the prismatic epithelium beyond the cervix. The true one is a wound in the form of a red spot on the mucous membrane.

Causes of erosion

The most common factors that provoke the disease:

• Sexually transmitted diseases - chlamydia, mycoplasmosis, gonorrhea, genital herpes and others.
• Inflammatory diseases of the female genital organs - thrush, colpitis, vaginitis and others.
• Mechanical injury to the mucosa - after an abortion, childbirth, due to hard sexual intercourse.

A drop in immunity, a violation of the menstrual cycle, as well as early sexual activity and hormonal imbalance can provoke the appearance of erosion.

Symptoms of the disease

Basically, a woman learns about the presence of erosion at a routine examination by a gynecologist. This situation occurs because the disease mostly proceeds without severe symptoms. Rarely, cervical erosion bleeds, and then the woman herself turns to the gynecologist with complaints about the appearance of blood during intercourse or between periods. Less commonly, patients notice mucopurulent discharge or feel pain during intimacy. This may be due to the appearance of an infection that enters the wound and worsens the condition of the disease. If there are severe symptoms, the treatment of cervical erosion and the recovery period may be delayed.

Erosion diagnostics

Already at the initial examination, the doctor detects the disease. But visual diagnostics alone is not enough, and the gynecologist carries out a number of standard measures:

• Detailed examination in the gynecological chair.
• Tests for examination in the laboratory for the presence of infections that can cause damage to the mucosal tissue.
• Oncocytology is a study in which material is taken from the cervix and checked for the presence of cancer.
• Colposcopy - examination of the damaged area with a device that can magnify the image several times.
• Biopsy - a detailed examination of the area of ​​damaged tissue to make an accurate diagnosis.

The use of additional research methods allows the gynecologist to identify the exact cause of the disease, as well as learn about the features of its development.

Is it possible to get pregnant with cervical erosion?

The disease reduces reproductive function. Many women are interested in whether it is dangerous. Cervical erosion does not cause infertility, but can affect the course of pregnancy against the background of low immunity. If the general condition of the woman's body is normal, then pregnancy can contribute to the treatment of erosive diseases, as well as other pathological transformations. During the bearing of a child, hormonal changes occur, which prevents changes in epithelial cells. Also, the disappearance of menstruation has a positive effect on the atrophy of the affected area and can contribute to the restoration of the epithelium. It is advisable to cure the disease before conception in order to avoid undesirable consequences.

Planning pregnancy with erosion

Before conception, it is desirable to undergo a complete examination and treatment, which requires a long time. You should also withstand 1-2 months until the tissues of the cervix recover completely. Subject to this period, the risk of relapse, as well as the occurrence of inflammatory processes, is minimal. To treat erosion, the doctor can apply the cauterization method, which requires accuracy and perfect execution. If unsuccessfully performed after this procedure, scars and scars are sometimes formed, which provoke injuries and breaks in childbirth.

Therefore, it is important to choose an experienced doctor and a clinic with a good reputation for this procedure. After cauterization, the onset of pregnancy can occur with complications and requires regular medical examination. Is it dangerous? Erosion of the cervix weakens the walls of the vagina, making them more susceptible to the pain of prenatal labor, which can cause tears. Therefore, it is desirable to withstand time until the body is fully restored.

Erosion of the cervix in nulliparous

The disease is most common in parturient women. The causes of cervical erosion in nulliparous women are different:

• Complications after an abortion.
• infectious diseases.
• Viral infections.
• advanced inflammatory disease.
• Hormonal disruptions.

Methods of treatment for nulliparous patients

There are many gentle ways to cauterize erosion. For this, laser therapy and chemofixation are used. Treatment is best done in specialized centers under the supervision of experienced professionals. The advantages of these methods are the absence of pain and a short recovery period. In this case, you should not postpone treatment until childbirth, as the disease can develop into a cancerous tumor. For young girls, classic methods are not suitable: burning or freezing, since there is a possibility of scarring. They, in turn, will negatively affect the process of childbirth and can provoke breaks. Women who have not given birth can also use medication. Regular examination by a gynecologist will help to identify the disease in time, since erosion occurs most often without symptoms, which can lead to negative consequences.

Medical treatment

If the gynecologist detects an inflammatory process and the results of the Pap test show 1-2 degrees of dysplasia, then he can prescribe anti-inflammatory drugs before performing a colposcopy and biopsy. In this case, the cause of the disease can be chlamydia and gonococci, less often viruses.

Treatment can be carried out with special suppositories or tablets, depending on the pathogen. Upon completion of the course of procedures, the gynecologist prescribes repeated tests. Drug treatment can be prescribed when a large area is identified that captures the vaginal mucosa.

Moxibustion

The procedure is carried out in several ways:

• Electrocoagulation - cauterization of a diseased area with an electric current. A few years ago, this method was the main method of treating cervical erosion. At the moment, it is of little demand, as it often leads to scarring, bleeding and deformities.
• Cryodestruction - freezing of the affected area with liquid nitrogen. The most popular method due to its low price. This method can be applied to nulliparous women, since it does not leave a scar, which favorably affects the course of childbirth. But after cryodestruction for several days, abundant watery discharge may disturb. Also, the procedure is not suitable for large lesions - more than 3 cm and in the presence of scar tissue, which is often observed in women who have given birth.
• Laser coagulation - this method acts directly on the affected area, which must be removed. It is used under local anesthesia, for this they make an injection of "Lidocaine". With this method of treatment, bleeding may rarely occur. But laser treatment is not recommended for nulliparous women.
• Radio wave treatment - the essence of this procedure lies in the fact that a stream of high frequency waves is directed to the affected area, which leads to the evaporation of the affected areas. The method is not in demand due to the high price. But this method is suitable for women who have not given birth and have given birth, which for them will be the best treatment for cervical erosion.

Before using one of the described services, it is necessary to undergo a histological examination of the affected tissues. This may include a biopsy, Pap test, and colposcopy. Such a thorough examination is necessary to exclude the presence of oncology, which is treated by other methods. During cauterization, a woman may experience pain in the uterine region, since exposure to her neck causes cramps similar to menstrual syndrome. After the procedure, you need to refrain from intimacy for some time and carefully monitor intimate hygiene. You can not take a bath, bathe and douche with erosion of the cervix until the wound is completely healed.

Folk remedies

The use of this method of treatment is possible if cervical erosion is mild. The most popular folk remedies:

• Sea buckthorn oil - contains useful substances and vitamins that accelerate the healing process of wounds. For treatment, a cotton swab is taken and soaked well with oil, then it is inserted into the vagina. Leave it on for a few hours, and preferably all night. For the procedure, it is better to use a special swab with a string for easy removal after the procedure is completed.
• Honey - wrapped in gauze and injected into the vagina for 3-4 hours. The procedure is carried out once a day. Can be used together with onions, for this they make a recess in it and add honey. Next, the product is baked in the oven, cooled and inserted into the vagina in gauze. For treatment, 10 procedures are required.
• Propolis has anti-inflammatory and antibacterial action. In the treatment of erosion, an ointment is used, which can be prepared independently. To do this, melt 100 grams of vaseline, adding 10 grams of propolis there. The agent is impregnated with a tampon and placed in the vagina for 10-12 hours, preferably at night. Carry out the procedure 1 time per day for 10 days.

So, erosion is a common disease that manifests itself in the form of an ulcer on the cervix. Most often, a woman has no complaints and symptoms. Treatment of cervical erosion is carried out by medication, cauterization, as well as folk remedies. The disease can lead to serious consequences and provoke the appearance of cancer, so you should regularly visit a gynecologist in order to detect erosion in time.

In the frantic pace of modern life, it is difficult for women and girls to pay attention to their health. They seek medical help at the last moment in the hope of a quick cure. Gynecologists recommend examinations at least once a year.

This is done in order to recognize and cure the disease in time. Many of the fair sex ignore this recommendation, because nothing bothers them. Low medical literacy of the population leads to a lack of understanding of the dangers of cervical erosion.

It is diagnosed only during a doctor's examination on a gynecological chair and, when neglected, can lead to sad consequences.

General information about the disease

Cervical erosion is a defect in the mucous membrane. Such a diagnosis is a collective medical term, by which doctors mean various primary or secondary changes in the cervix. It can occur for many reasons. The main types include true erosion and pseudo-erosion.

The latter may be congenital and is a variant of the norm for the development of the reproductive system in girls, does not require treatment and has no consequences. True erosion and secondary pseudo-erosion require careful monitoring and adequate therapy. After all, it is with such processes that the likelihood of developing complications is high.

In the absence of therapy, consequences such as:

• various inflammatory and infectious processes;
• premature birth, miscarriage;
• malignant neoplasms;
• adhesive processes (fusion of mucosal areas).

Incorrect aggressive treatment of the disease can lead to such consequences.

Cervical erosion refers to non-tumor processes according to the medical classification, but the risk of an oncological process in the absence of disease therapy is high. Since not all layers of the epithelium of the cervical canal are affected in this pathology, there is a high probability of its healing without significant consequences.

Due to constant local inflammation and impaired integrity of the cervical wall, the following pathologies occur:

• adnexitis - inflammation of the uterine appendages - fallopian tubes, ovaries, round ligaments;
• colpitis - a lesion of the mucous membrane in the vagina;
• endometritis is a disease of the inner layer of the uterus.

These diseases are accompanied by violent symptoms and bring a lot of suffering and inconvenience to the patient. In their severe course, inpatient treatment is recommended. The clinical picture is dominated by pain in the lower abdomen, purulent discharge, fever, menstrual irregularities.

Their treatment is mandatory. It is comprehensive and includes:

All these activities are carried out in conjunction with the treatment of the underlying disease. When the cause of the development of complications is eliminated, the chances of recovery increase.

Medical and non-traditional methods of therapy

Preparations for the treatment of the consequences of erosion are prescribed in the form of tablets, injections, suppositories. The prescription regimen with the choice of specific drugs, dosages, and the course of therapy is selected by a specialist, taking into account the individual characteristics of the patient, the severity of the disease, and the type of complication.

Antibiotics are used to suppress the infectious process. They are selected taking into account the result of a blood test to determine the pathogen and its sensitivity to antimicrobial agents. The disadvantage of such a study is the long wait for the results. In such cases, the drug is prescribed empirically, that is, at the discretion of the doctor.

In such cases, broad-spectrum antibiotics are prescribed. The course depends on the severity of the condition and is determined by its specialist. On average, it is 10-14 days. If necessary, combinations of two antibiotics or their combination with antifungal drugs are prescribed. The route of administration may be by injection.

List of the main groups of antibiotics prescribed for erosion:

• cephalosporins: Ceftriaxone, Zinnat, Tsiprolet, Cedex;
• macrolides: Azitrox, Erythromycin;
• respiratory fluoroquinolones: Glevo, Sparflo, Ofloksin.

To correct the disturbed microflora of the vagina, agents containing living organisms that normally exist in humans are used: Bifidumbacterin, Acipol, Baktisubtil, etc.

Anti-inflammatory drugs are prescribed Diclofenac, Nimesulide, Meloxicam.

To improve the immune status, interferons (Viferon, Genferon), immunocorrectors (Likopid) and vitamins are used.

Solkovagin, Vagotil are used to improve cell regeneration processes.

Non-traditional methods include physiotherapy and herbal medicine.

Of the physiotherapeutic agents are widely used:

1. Ultrasound.
2. impulse currents.
3. UHF therapy.
4. Balneotherapy (irrigation of the vagina with special solutions).
5. Electrophoresis.

They are contraindicated in the acute period of the disease.

Physicians' attitude to phytotherapy is ambiguous. Non-traditional methods only complement rational drug therapy.

When diagnosing pathology, the doctor faces a number of difficult tasks. Knowing what threatens uterine erosion in the future, the specialist will actively carry out preventive measures to prevent the development of complications.

The main thing in this case is early diagnosis, observation and treatment of the underlying disease, compliance with all doctor's recommendations.

Infertility, pregnancy and adhesions during erosion

Due to constant local inflammation and damage, the cervical mucosa is deformed, and the fertilization process can be difficult. More often this happens if the patient has a large erosion, as a result of which adhesions can form. They are areas of mucosal fusion.

If the inflammation has spread to the fallopian tubes, their patency is impaired. It can also cause infertility. Treatment in such cases is surgical. In severe adhesive process during the operation, the uterus with appendages can be removed.

Pregnancy against the background of erosion can be difficult due to frequent infectious and inflammatory processes, which can serve as a background for the onset of premature birth.

The deformed changed neck cannot fully open during contractions, while the risk of bleeding increases many times and a threat to the life of the mother is created. Such patients are delivered by caesarean section.

Is it possible to degenerate cervical erosion into cancer?

The answer is simple - everything is possible. However, the presence of erosion in the patient does not guarantee the appearance of a tumor, but increases the chances of malignant growth, especially with a long course of the disease (more than 10 years). At the same time, “cancer” atypical cells begin to form in the cellular composition.

To control this process, at each visit to the gynecologist, a smear is made from the erosive area. Under a microscope, look at the cellular composition. When atypical cells appear, the analysis will give a positive result.

After all of the above, we can conclude that what threatens cervical erosion. To avoid health problems, you need to find time to visit a doctor. When making this diagnosis, there is no need to postpone treatment until later. After all, it is neglected and improperly cured erosion that leads to serious consequences and threatens the most important purpose of the female body - bearing and giving birth to children.

The following causes of cervical erosion are distinguished:

• hormonal imbalance;
• mechanical and other injuries;
• infectious diseases of the genitourinary system;
• immune disorders associated with extragenital pathology;
• early onset of sexual activity;
• frequent change of sexual partners;
• hereditary predisposition;
• taking hormonal oral contraceptives.

Is it dangerous?

Is cervical erosion dangerous? Yes, like any genital pathology, especially in women of childbearing age, it carries a certain danger. Erosion should be constantly monitored by a gynecologist. If indicated, the doctor prescribes the appropriate treatment.

Important! Often, ESM is asymptomatic and can only be detected by chance, so regular gynecological examinations should not be neglected.

What is the danger of erosion? You can be afraid of complications such as:

This pathology needs to be treated with caution., but with constant monitoring and timely treatment, it is not dangerous and will not affect the quality of life.

Effects

The consequences of this disease can be very diverse - from harmless discomfort to serious pathologies, in particular cancer. It all depends on the degree of damage, the duration of existence, treatment was carried out or not, etc.
What does pathology lead to and what does it threaten? All complications can be divided into immediate and distant.

The closest ones are:

• copious discharge from the vagina;
• accession of a secondary infection with ascending spread;
• problems during pregnancy;
• pain and discomfort during intercourse;
• feeling of discomfort in the abdomen.

Reference. The first of the above pathologies are abundant discharge, incl. bloody, as well as discomfort and pain in the lower abdomen. The increase in the amount of vaginal discharge is mainly due to the fact that, in response to inflammation, the cells of the cylindrical epithelium begin to actively produce a mucous secret.

Pain during intercourse is associated with even greater trauma to the penis, already damaged epithelium. Especially often this can occur in couples who are supporters of rough intercourse or use various sex toys that can mechanically injure a woman.

The accession of a secondary infection is due to the fact that the eroded cervix is ​​the entrance gate for any pathogenic or opportunistic flora. Thus, it is often possible to detect infection with the own flora of the vagina as a result of a violation of the natural balance, which creates problems in the treatment of such an infection.

Infections in the cervix can be ascending. Is it scary? Yes, because leads to damage to overlying organs, for example, the cervical canal (cervicitis), the uterine mucosa proper (endometritis), fallopian tubes (salpingitis), ovary (ovaritis), in severe cases, the infection can spread to the peritoneum and cause such a serious complication as pelvioperitonitis which requires urgent surgical intervention.

Problems during pregnancy can be associated with the early opening of the cervix, which leads to miscarriage.

Long-term effects mainly occur with long-term erosion. As a rule, they are more dangerous, proceed more severely and are less amenable to therapy. These include:

Long-term erosion is constantly injured, resulting in the formation of a huge amount of scar connective tissue. In this case, the cervix loses its elasticity and does not open well during childbirth, which can lead to the use of a caesarean section.

The formation of warts is associated primarily with the human papillomavirus (HPV), which is one of the reasons for the formation of erosion. The appearance of genital warts indicates the progression of the process and requires timely treatment to prevent degeneration into a malignant process.

Chlamydia and other infections can be not only close, but also long-term consequences. The longer the erosion exists, the more favorable the environment for the reproduction of microorganisms is created, as well as the fewer obstacles for the spread of infection, which can even lead to infertility.

Malignancy of pathology is the most unfavorable outcome of erosion. It occurs mainly when infected with oncogenic strains of HPV and the absence of observation and treatment. Cervical cancer is a rapidly progressive pathology and requires timely detection for earlier treatment.

Important! The appearance of any symptoms from the genitourinary tract in the presence of ESM is a reason to consult a doctor in order to timely prevent or eliminate the complications of this pathology.

How to avoid complications?

To minimize the risk of developing complications with ESM, follow certain rules:

1. Constantly monitor this pathology at the gynecologist.
2. If you experience profuse purulent discharge, the presence of other unpleasant symptoms, immediately consult a doctor.
3. Follow all doctor's recommendations for the treatment of this condition.
4. Follow the rules of personal hygiene to prevent secondary infection.
5. Refuse rough sexual intercourse, as well as reduce the possibility of injury to the cervix (improper use of coils, tampons, etc.).

Useful video

From the video you will learn what cervical erosion is, why it occurs, in what cases erosion needs to be cauterized:

Conclusion

Cervical erosion is a common pathology that requires dynamic monitoring and appropriate treatment. Any erosion can be complicated. The most severe of the consequences is cervical cancer, which occurs with long-term erosion and infection with oncogenic strains of HPV. Any erosion carries a certain danger to a woman's health, but, subject to all the rules and recommendations of a doctor, the risk of complications can be reduced.

Cervical erosion: Is it so dangerous, and what doctors are silent about.
Let's discuss the question, what is cervical erosion? Is it really scary, or is it another overreach, a manifestation of overdiagnosis or medical illiteracy?

When a doctor examines you during a gynecological examination - in the mirrors, all he sees is redness on the outer surface of the cervix, often around the external cervical canal. The area of ​​redness can be small, sometimes over the entire surface of the cervix (“great erosion!”), Around the cervical canal symmetrically, or away from the external pharynx.

There are over twenty diseases that can look like redness to the naked eye.(red spot) a section of the mucous membrane of the cervix, which an inexperienced or illiterate doctor would call in one word - erosion.

Cervical erosion: types, diagnosis and treatment

True cervical erosion is a defect in the integumentary epithelium (mucosa) as a result of exposure to chemicals (soap, medicines, acids and alkalis), injuries with tampons, diaphragms, intrauterine devices, other foreign bodies, after instrumental or therapeutic interventions.

Such an area of ​​the cervix, when examined, will be edematous or loose, often bright red in color, with bleeding. A woman may complain of spotting or bleeding after intercourse.

In most cases, true cervical erosion resolves without treatment if the factor damaging the cervix does not have a sufficient period of time necessary for erosion to heal.

Many doctors call erosion a whole group of diseases, such as ectropin, acute and chronic cervicitis, and other benign conditions of the cervix, which is a mistake.

Many nulliparous young women may have what is known as ectopia rather than erosion. Some doctors call this condition ectropion. The term "ectopia" means not normal (anatomically) placement of something (organ, tissue, cells) within the body (organ). The term "ectropion" means eversion from the inside out, that is, it characterizes the mechanism of the occurrence of ectopia.

The inner lining of the cervical canal may extend beyond it during certain periods of a woman's life: during puberty, pregnancy, the use of hormonal contraceptives. Since this area of ​​the mucosa consists of only one layer of integumentary cells, the vessels translucent through it give a bright red color to the area of ​​​​the cervical mucosa where the ectopia occurred.

Doctors of the older generation call ectopia false cervical erosion, or pseudo-erosion. Treatment of pseudo-erosion, especially by surgical methods (cauterization, freezing, laser treatment) do not need to be carried out except in those rare cases when its presence is accompanied by discomfort and spotting.

Inflammatory processes of the cervix(colpitis, cervicitis) accompanied by reddening of the mucous membrane of the cervix, which can also be mistaken for erosion. For example, viral cervicitis often covers the entire surface of the cervix, making it bright red, friable, and bleeds easily, which can give the false impression of a "great and terrible erosion."

Therefore, when the diagnosis of “cervical erosion” sounds, check with your doctor what he means by the concept of erosion. And if your doctor starts telling you that you're a cervical cancer candidate, don't be afraid to challenge this often ridiculous and unsubstantiated claim.

What should be done in this case?

Not treatment, but first an examination, which consists of examining the cells of the damaged area of ​​the cervix (cytological smear) and examining the cervix under a special microscope (colposcope). Of course, it is necessary to exclude the inflammatory process, so the study of secretions and the identification of pathogens in them for a number of sexual infections is also important to carry out before any type of treatment.

Cervical erosion. Biopsy

Often I receive letters from women complaining that a biopsy, that is, tissue sampling of the affected area of ​​the cervix, is carried out without the consent of the woman, including already pregnant women, often rudely, without warning about what discomfort the woman may experience during and after the biopsy.

In practice, few doctors take into account the fact that this type of examination cannot be carried out against the background of the inflammatory process of the vagina. And it is unlikely that any doctor warns a woman that after a biopsy she should avoid sexual intercourse for 7-10 days to prevent infection and additional traumatization of the mucosal area from which tissue was taken.

Yet again, I want to once again focus your attention on the fact that it is not necessary to biopsy all women in a row, and you may be one of the women for whom this type of examination is not indicated, and may be contraindicated.

Why is a cytological examination of a scraping from the surface of the cervix and colposcopy performed? To identify just the condition of the cervix, which can be precancerous, is called cervical dysplasia.

The problem is that even the most “terrible” erosion may not be a precancerous condition at all, and at the same time, a healthy-looking cervix may have areas of precancerous changes.

In order not to scare you with cancer, I can say with confidence that cervical cancer is a rare disease in all countries of the world, including Russia, Moldova and other former republics of the Soviet Union.

What does "rare disease" mean in terms of the prevalence (scale of damage) of cervical cancer? And if this is a rare disease, why do doctors scare women so much about them and rush to treat erosion immediately?

Each country has its own definition of "rare diseases", and most likely such a definition has more to do with statistics than with the disease itself, since statistics give us information about the prevalence of the disease.

If I tell you that about 13,000 cases of cervical cancer are diagnosed in the US every year, then you will say that this is a lot. In other words, that's just over 1,000 per month, 250 per week, 35 per day, and 1 per hour for more than 300 million people in this country. However, the frequency of the disease in terms of the female population is one case per 21,000 women.

If I tell you that 225,000 people a year die in the US due to medical malpractice (official data from 2000, according to the latest figures, these figures are even higher), then it turns out that medical error is much more dangerous than cervical cancer and other diseases.

WHO (World Health Organization) data from 2002 show that road traffic crashes are the cause of adult death in 2% of all deaths. Data for the countries of the former Soviet Union are very inaccurate, underestimated, but look worse than the figures for many other countries in the world.

Returning to the definition of rare diseases, a rare disease is considered to be a disease, one case of which is diagnosed by a regular doctor (not specializing in this disease) no more than once a year when a doctor visits from 20,000 to 200,000 patients.

Thus, if you ask your doctor how often there were diagnosed cases of cervical cancer in her practice, if your doctor does not work in an oncology dispensary, then the honest answer will be: one case in one to three years.

I worked in the prevention department, where examinations of women were carried out regularly in order to detect many dangerous diseases, including cervical cancer. The office worked in two shifts, and from 60 to 120 women were examined per day. Out of about 35,000 women that I had a chance to examine, cervical cancer was diagnosed in 3-4, no more.

The frequency of detection of cervical cancer by a doctor of antenatal clinics is even lower, since the influx of people at doctors of such institutions is less (mostly 5-15 people a day), and a large category of women consists of regular patients. Therefore, the myths that are composed by the doctors themselves that almost every woman will develop cancer if erosion is not treated are greatly exaggerated.

Returning to different concepts of erosion, let us once again clarify that not every erosion of the cervix, or what doctors call erosion, is a precancerous condition of the cervix. The only common precancerous condition is cervical dysplasia, and only severe dysplasia (not all doctors classify moderate dysplasia as a precancerous condition of the cervix).

Dysplasia is a laboratory diagnosis that characterizes the state of the cells of the mucous membrane of the cervix. Against the background of a "healthy eye" of the cervix, there may be areas of dysplasia. By the way, the term "dyslasia" has not been used in medicine for more than 30 years.

It is important to note that not all dysplasias turn into cancer, so not all cases of dysplasia need to be treated. According to the depth of damage to the tissues of the cervix, dysplasia is divided into light, moderate and severe.

According to the US National Program for the Early Detection of Breast and Cervical Cancer, abnormal cytological smears occur in 3.8% of cases (mild dysplasia - 2.9%, moderate and severe dysplasia - 0.8%, epithelial cancer – 0.1%).

There are no exact data for Russia and other post-Soviet countries, however, the level of detection of dysplasia in smears in these countries will not be significantly higher or lower, that is, on average, the indicators will be almost the same.

Unfortunately, only 1.5-6% of the total female population in most countries of the world (and in some even less) undergo a cytological smear.

Many women do not take such a smear correctly, so the results are false positive or false negative. However, 4% of detected abnormalities for this number of women surveyed is a very low indicator of the prevalence of abnormality.

About 3% of abnormalities are mild dysplasia, which in almost 90% of cases resolve without any treatment, and only in 10% of cases can progress to moderate or severe dysplasia.

Moderate dysplasia is self-limiting in 70% of cases, but can progress to severe dysplasia in 20% of cases.

Severe dysplasia can result in a complete recovery without treatment in 30% of cases, but in 12% of cases it can turn into cervical cancer.

These data were obtained and rechecked by numerous long-term studies in a number of countries around the world. Therefore, the recommendations of doctors regarding mild dysplasia are as follows: observation of women with repeated cytological examination every six months. You must understand that it takes at least 10 to 15 years for the development of cancer, so there should be no rush in the treatment of mild dysplasia.

If the main causative factor in the occurrence of erosion is trauma to the mucous membrane of the cervix, then many factors play a role in the occurrence of dysplasia: a large number of births, deficiency of vitamins A, C and beta-carotene in the diet of women, long-term (more than 5 years) use of hormonal contraceptives, immunodeficient conditions, individual genetic predisposition to gynecological malignancies, sexually transmitted infections, HPV infection (human papillomavirus), number of sexual partners (more than 3), smoking (active and passive), low social level, sexual behavior pattern, early age of the first sexual intercourse (up to 16 years) and others. These same factors are often involved in the occurrence of cervical cancer.

The only infectious agent that can cause the development of dysplasia and cervical cancer is the human papillomavirus (HPV). Scientists have not found a link between dysplasia and the presence of herpes simplex virus, cytomegalovirus, Epstein-Barr virus, human herpes virus (types 6 and 8), diplococcus (the causative agent of gonorrhea) and chlamydia.

Women with a mixed infection caused by human papillomavirus and herpesvirus (type 7) were more likely to have moderate and severe types of dysplasia.

If you have been diagnosed with changes in the cervix, what should be the next steps in diagnosing the condition of the cervix?

Ureaplasma and mycoplasma most often affect the male urethra, and are very safe for women. Each type of pathogen requires a different diagnostic method, so it is impossible to determine everything “at one time in one smear”.

Another important examination method is the study of a cytological smear. If the smear does not show dysplasia, depending on the size of the cervical lesion, a colposcopy can be performed, that is, to examine the surface of the cervix under magnification.

It is important that the results of cytology and colposcopy coincide, and not contradict each other. If the results are inconsistent, then re-examination is carried out after three months.

A biopsy is performed only if cervical cancer is suspected and in cases of severe dysplasia. In almost all developed countries, surgical treatment of the cervix is ​​prohibited.(cauterization, laser excision and evaporation, freezing), if the results of several methods of examination do not match.

What modern types of treatment for dysplasia exist in medicine?

The chemical cauterization method is a very popular method of treatment in a number of countries, mainly the former socialist camp. Relatively satisfactory results can only be obtained in the treatment of lesions that are small in size and depth, mostly mild dysplasia. With moderate and severe dysplasia, this type of treatment is not effective.

Modern surgical treatment includes mainly three types: cauterization by electric current(diathermocoagulation), h freezing with liquid nitrogen(cryolysis) and laser excision or vaporization.

Knife excision (conization) and removal of the cervix (amputation) are used extremely rarely according to strict indications.

Each method has its pros and cons, but no advantages over each other. In the presence of a long-term HPV infection, the best treatment results are observed with the use of laser vaporization and diathermocoagulation (cauterization).

Surgical treatment of the cervix is ​​best done in the first (follicular) phase of the menstrual cycle.

Under the influence of increasing levels of female sex hormones (estrogens), the growth of the epithelium of the cervix takes place, which contributes to the healing process. Surgical treatment of the cervix has many contraindications and complications that the attending physician should discuss with you before the operation.

How often are side effects and complications of any treatment discussed with you?

If not often, be sure to ask your doctor about it. The main contraindications for surgical treatment of the cervix are the following: pregnancy, lack of skills in performing an operation by a doctor, discrepancy between the results of examination by different methods, the presence of an active infectious process in the vagina and uterine appendages, the size of the affected area is beyond the technical possibilities of treatment, suspicion of cervical cancer, and a number of others.

The doctor should also warn you about some of the unpleasant symptoms that you may experience after treatment.

Such symptoms are: pulling pain in the lower abdomen in the first 1-2 days after the procedure, vaginal discharge with or without odor for 2-4 weeks.

You can take painkillers to relieve pain. You should not lift weights during the entire recovery period (at least 4 weeks), as well as use tampons, douche and have sex, as all this provokes trauma with subsequent bleeding and infectious processes of the cervix.

Prophylactic antibiotics are not justified and therefore should not be carried out. Some doctors prescribe hormonal contraceptives to artificially delay menstruation, which is supposedly the prevention of cervical endometriosis, but studies have shown that this type of prevention is not effective, and hormonal drugs should not be prescribed for this purpose.

When can pregnancy be planned in such cases?

The period of abstinence from pregnancy depends on the speed of healing of the postoperative wound, that is, on the rate of restoration of the normal mucous membrane of the cervix. Usually, the healing process takes from 6 (60% of cases) to 10 (90% of cases) weeks.

The cytological smear returns to normal within 3-4 months. In 10% of women, the healing process takes up to 6 months. Therefore, hasty conclusions about whether your treatment was successful or not should not be made for at least six months from the moment of surgical treatment.

And now let's talk about the complications of surgical treatment, which most doctors usually keep silent about.(either they don't know or they don't care about your future, especially with regard to pregnancies).

Complications of surgical treatment of precancerous conditions of the cervix are as follows:

• Infertility due to narrowing of the cervical canal, decreased production of cervical mucus, functional inferiority of the cervix and secondary tubal dysfunction due to ascending infection
• Formation of scars of the cervix and its deformation
• Occurrence of cancer due to incomplete or inaccurate examination
• Menstrual dysfunction
• Exacerbation of inflammatory diseases of the genitourinary system
• Preterm labor and premature rupture of membranes(a significant risk of this complication is observed after diathermoelectrocoagulation, that is, cauterization with electric current and cryodestruction, therefore, the doctor must seriously approach the choice of treatment for women of reproductive age, especially women who have not given birth, in whom surgical treatment may be delayed for a certain period of time).

Thus, if you have not given birth and / or are planning a pregnancy, if you find any changes on your cervix, find out and clarify using a number of diagnostic examination methods whether these changes are precancerous or not. If it is dyslasia, specify what degree.

If this mild dysplasia, you can safely become pregnant or undergo a re-examination in 3-6 months. If you have moderate dysplasia, repeat Pap smear and colposcopy in 3 months. And if you have severe dysplasia, discuss with your doctor one of the types of treatment, taking into account the fact that you are planning a pregnancy in the future.

Important: All information provided on the Greatpicture website is for INFORMATION ONLY and is not a substitute for advice, diagnosis or professional medical care. If you have any health problems, contact a specialist immediately.