Ectopia of the cervix
Ectopia of the cervix is an atypical position of the cylindrical epithelium covering the cervical canal of the uterus inside, the norm is the presence of a flat epithelium. Clinical symptoms appear only in a complicated form: white discharge, discharge with blood impurities, itching and burning of the vulva, dyspareunia. Diagnosis of cervical ectopia of the cervix is carried out by gynecological examination, colposcopy, in individual cases — biopsy. Treatment of ectopia is necessary only in a complicated form; uncomplicated form does not need treatment, but only requires control over the disease.
The content of the article:
Cervical ectopia of the cervix: what is it?
Causes of cervical ectopia of the cervix
Symptoms of cervical ectopia
Diagnosis of ectopia of the cylindrical epithelium of the cervix
Treatment of cervical ectopia
Prevention and prognosis of cervical ectopia
Ectopia of the cervix
Cervical ectopia of the cervix: what is it?
Modern medicine uses such definitions as pseudo-erosion, endocervicosis, false erosion to designate the disease ectopia. Ectopia of the cylindrical epithelium of the cervix occurs in 40% of women, while more than 11% of all cases are congenital anomalies. The risk group includes patients of childbearing age (up to 50% of all cases). The presence of a history of ectopia in women increases the risk of the formation of malignant tumors, as well as the development of various inflammation of the vulva.
During gynecological examination without ectopia, the cervix is covered with a flat epithelium in several layers. When using mirrors and internal examination, the cervical canal opens, which is covered with a cylindrical epithelium. In the presence of ectopia of the cervix, the photo shows that the line between the epithelium is deformed and shifted closer to the outer cavity of the vagina, being placed either locally or in a circle, the picture is completely different.
Classification of cervical ectopia of the cervix
Modern medicine defines several forms of ectopia both by origin and localization, and by the course of the disease. Ectopia can be either a congenital disease (about 11% of all cases) or acquired. Signs of ectopia may be uncomplicated, which is the norm on an individual basis and does not require treatment; complicated ectopia is often caused by inflammation inside the genitals, which also provides for diseases such as colpitis and cervicitis. These diseases are infectious, their complete cure is necessary first of all. In the future, the prognosis of ectopia may not have any signs and a relapse may occur.
With changes in the structural and skin elements of the cervix, as well as with dysfunction of their relationship, cervical ectopia is an ectropion.
According to histological signs, there are:
pseudo-erosion;
papillary — structural formations of the cylindrical epithelium of the uterus;
glandular — ectopia with inflammation, there is an abscess of the glands with branching.
Scarring in ectopia is accompanied by the transformation and renovation of the epithelium from cylindrical to flat. Additional cells take part in the process, which by dividing turn into an immature form, and then acquire the stage of maturity.
With colposcopy, it is possible to differentiate changes in the skin. Under negative conditions, cellular transformation may not have a logical conclusion. In this case, a relapse of ectopia occurs. It is also possible to have a retention cyst of the cervix, provided that the pharynx has a metaplastic skin growth.
Causes of cervical ectopia of the cervix
Ectopia of the cervix can develop in conditions of changes in the functional systems of the body, including:
hormonal disorders;
inflammatory processes;
the presence of injuries and damage to the genitals;
a general decrease in immunity against the background of chronic diseases.
The causes of uterine ectopia are based on diseases of the reproductive system that occur in the patient’s anamnesis and that have reached a relapse. Such diseases include chlamydia, mycoplasmosis, vaginitis, endocervitis. A change in the vaginal microflora, a quantitative increase in opportunistic flora due to bacteria such as streptococcus, Staphylococcus, E. coli, etc. – all this can lead to the development of ectopia. In addition, vaginal discharge provokes a change in the squamous epithelium of the cervix, where erosion is formed. In the future, erosion is differentiated as ectopia.
Ectopia can be caused by injuries and mechanical damage, difficult childbirth, surgical termination of pregnancy, douching, IUD placement — also increases the risk of pseudoerosion and the development of the inflammatory process.
Hormonal imbalance of the body is also one of the causes of ectopia. Very often it is a concomitant disease with ovarian dysfunction, endometriosis, fibroma.
A decrease in immunity and protective properties of the body can develop due to diseases such as diabetes mellitus, obesity.
Such conditions play an important role:
early sexual life;
frequent change of partners;
unprotected sex;
multiple births;
multiple abortions.
All this is a favorable ground for the emergence of pseudo-erosion.
Symptoms of cervical ectopia
The symptoms and manifestation of ectopia are observed in a complicated form. As a rule, it is accompanied by diseases such as dysplasia, leukoplakia, polyps. There may be whitish discharge or with admixtures of blood in the presence of colpitis or endocyrvicitis diseases.
At the initial stage of a complicated form of ectopia, the patient may complain of a change in the nature and timing of the menstrual cycle, as well as the inability to get pregnant for a long time (1 year).
The uncomplicated form of cervical ectopia of the cervix has no special signs. During a gynecological examination, it is easily detected by a specialist.
Diagnosis of ectopia of the cylindrical epithelium of the cervix
Diagnosis of pseudoerosion at the initial stage includes a primary gynecological examination by a specialist, thanks to which it is possible to identify the nature of ectopia — congenital or acquired. With a congenital form and no complaints from the patient, further diagnosis and special treatment are not required. With the acquired form, it is necessary to evaluate the previous character of the cylindrical epithelium of the cervix and compare it with the changes in the vagina at the time of diagnosis.
Diagnostics with the help of gynecological mirrors and instruments reveals a violation of the epithelial line, the presence of a red inflammatory focus of the uterus, which can bleed when pressed.
Colposcopy and Schiller tests are mandatory measures to detect ectopia of the cylindrical epithelium of the cervix. These methods reveal the following indicators of the disease:
transformation of uterine tissues into new structural compounds;
the presence of a cylindrical skin zone and the displacement of the connection line closer to the exit of the uterus;
leukoplakia;
punctuation;
mosaic.
With these signs of ectopia , further diagnosis consists in:
bacteriological sowing;
PCR diagnostics;
microscopy;
cytological examination;
in some cases, a biopsy is indicated.
Additionally, the ovaries are examined, their functionality and the presence of possible hormonal disorders are determined. If any violations are detected, it is mandatory to consult a gynecologist-endocrinologist.
Treatment of cervical ectopia
The complicated form of pseudoerosion has several treatment options, depending on the nature of the detected disorders. Anti-inflammatory drugs are necessarily prescribed. Together with a gynecologist-endocrinologist, an individual contraceptive program is selected. Hormonal abnormalities in the body are also treated.
Treatment of cervical ectopia provides for the possibility of undergoing various therapies:
laser therapy;
cryotherapy;
radiosurgery;
diathermocoagulation, thanks to which the internal inflammatory process of the cervix stops and ectopia recurs.
When diagnosing diseases of the genitals, further treatment takes place on an individual basis, depending on the specific disease, the nature and its localization.
Uncomplicated ectopia does not require treatment. A patient with a history of this disease should simply be under the supervision of a doctor and follow his recommendations, which should contribute to the regression of the disease. If signs of ectopia are detected, a woman needs to be examined as soon as possible to detect pseudoerosion of a complicated form.
Prevention and prognosis of cervical ectopia
Cervical ectopia of the cervix has a positive prognosis when the disease is detected. The disease is controlled by colposcopy every six months, even in the absence of complaints about well-being.
Preventive measures are carried out in the timely diagnosis and further treatment of any diseases that the patient has. Women with endocrine disorders fall into the risk group, they need constant monitoring by a gynecologist-endocrinologist to monitor the state of the body and timely detection of violations.
Also, for the prevention of ectopia, a constant examination by a gynecologist is necessary to detect infectious diseases of the genitals.
Proper conduct of intimate life, properly selected contraception, avoiding unwanted pregnancy — all these are the main preventive measures that must be followed.
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