Symptoms of cervical erosion and rational approaches to its treatment

Opinions on the tactics of women with changes in the cervix are different. Nevertheless, cancer of this localization takes the second place in the frequency of occurrence among all malignant diseases in women. Instead of classical erosion, doctors have to deal with ectropion, cicatricial deformity of the cervical tissue, dysplasia and ectopia. The concepts are different, as are the treatment tactics. In order to visualize what erosion is, just look at the photos that are easily found on the Internet.

What causes susceptibility to erosion of shem? What are the modern methods of treatment? Will hyaluronic acid help cure erosion? How do gynecologists look at conservative erosion treatments?

What is hiding "under the mask"

According to ICD-10, the disease is classified under the N86 code. True erosion is rare. It is an epithelial defect due to inflammation or trauma. Most often, the term "erosion" means any redness on the cervix, which is not entirely true. Hence the “rumors” that someone “allegedly erosion” went away on their own, others had to be removed, and someone else had cervical cancer.

All pathological processes in this area can be divided into the following groups.

Ectopia

This is a physiological condition, in most cases not requiring treatment. It occurs in nulliparous girls under 30 years old. It may indicate hormonal deficiency, but most often this is one of the stages of puberty.

How arises

When examining the cervix in the mirrors, only the flat epithelium, which covers the cervix from the outside, is normally visible to the review. Inside the cervical canal is lined with a cylindrical epithelium. In girls, the border between the two species shifts outward, as a result, the cylindrical epithelium under the illumination looks like a red spot. Ectopia is compared with a coin, since its borders have the correct shape. It is commonly called erosion of the cervix in nulliparous. Ectopia needs treatment only in the following cases:

• with the addition of inflammation;
• in the presence of dysplasia.

Cicatricial deformity and ectropion

Often used to describe the term abbreviation "RDSHM", "RKSHM". It is formed after childbirth, if they were accompanied by ruptures, after abortions and similar manipulations on the cervix. In this case, the surface of the cervix becomes tuberous, protrusions may appear, traces of sutures are noticeable.Due to the violated anatomy and abnormal location of the epithelium, the cervical cancer can contain nabotov cysts - clogged ducts of the glands, from which small cavities are formed, filled with secretions.

Cicatricial deformity in some cases is accompanied by ectropion - an eversion of the cervix. In this case, the cylindrical epithelium is located outside, while it should be inside. A hyperemic (reddened) area is visually determined on the altered surface of the cervix.

Pseudo-erosion

Pseudo-erosion is a site of the former erosion of the cervix, which has already begun to be covered on top with epithelium - with epidermization according to the results of a histological examination. This is the first stage of healing of true erosion. Sometimes the term psedoerosion is used to describe the ectopia of the cervix, which is not entirely true. Signs of pseudo-erosion are nabotovy cysts with glandular secretions, visually defined as “ripe cherries” on the surface.

Treatment of pseudo-erosion depends on the cause of its appearance, it can be conservative and surgical.

How does it manifest

Symptoms of cervical erosion are not always bright. It all depends on its size, related complications. Sometimes this is a “find” during a routine examination by a gynecologist, especially if a woman has not visited a specialist for a long time.

The main symptoms are as follows.

• Discharge. If there is no concomitant inflammation, the whites are mucous in nature. Sometimes there are a lot of them throughout the cycle. With the addition of inflammation, the discharge may become yellowish, greenish. There is an unpleasant odor - "fishy", putrid, sharp sour. If erosion is extensive, even with the slightest injury, it may produce small spotting, spotting.
• Pain. Most often, the pain syndrome joins in the presence of inflammation, as well as with severe deformations of the cervix after childbirth.
• Infertility. Cervical ectopy and small changes do not affect pregnancy and conception. But significant areas of damage, the presence of inflammation in the cervical canal can cause problems with conception.

Who develops more often

Cervical erosion is diagnosed in every third woman. But if you remove the ectopia of the cervix from this category, but the frequency decreases markedly. Most often, the pathology occurs against the background of injuries and inflammation. Given the causes of cervical erosion, the following groups of women can be distinguished, in whom the disease occurs more often:

• after difficult birth - a large fetus, with a weakness of labor, using forceps, a vacuum extractor;
• with inflammation - in the presence of genital infections, promiscuous sexual intercourse;
• with injuries - after frequent abortions, curettage of the uterine cavity, sometimes against the background of an established intrauterine device;
• with hormonal disorders - more often erosion and ectopia are formed in women with irregular periods, polycystic, hyperprolactinemia.

What is dangerous

When erosion of the cervix is ​​detected, the question always arises of why it is dangerous. The least formidable is ectopia, if it is not complicated by inflammation. Otherwise, true erosion can also form on it.
The presence of changes in the cervix increases the likelihood of the following diseases:

• mild, moderate and severe dysplasia;
• cervical cancer;
• infertility.

Is cervical erosion treated before pregnancy?

Cervical ectopy is most often found in girls who have not yet had a pregnancy. Cicatricial deformities and erosive ectropion - already in those giving birth. Therefore, the important aspect is when it is nevertheless necessary to treat cervical erosion - during pregnancy planning or after it. In each case, an individual approach. It is necessary to be guided by the following.

• Ectopia of the cervix. Before pregnancy does not require surgical treatment. With the appearance of inflammatory changes in smears - conservative therapy.
• If there is dysplasia. If CIN (dysplasia) is found together with erosion, treatment must be done before planning pregnancy, since hormonal levels and stress during gestation can provoke rapid malignant cell growth.

In other cases, the need for conservative or surgical treatment is determined taking into account the results of the examination. The use of destructive methods of therapy can affect subsequent gestation as follows:

• increase problems with conception - obstruction of the cervical canal may occur, which will create a mechanical obstruction in the way of spermatozoa;
• increase the likelihood of miscarriage - when performing a cone-shaped excision of tissues, the percentage of preterm birth and isthmic-cervical insufficiency during pregnancy (insufficiency of the closure function of the cervix) increases;
• birth breaks - after coagulation of erosion, the probability of injury to the cervix during the birth of the baby may increase, since the scar does not have sufficient extensibility.

How to detect

Identification of erosion is associated with a routine gynecological examination. When removing the cervix in the mirrors, a reddish spot is visualized on its surface. It can be of different diameters (from 2-3 mm to 2-3 cm), with a smooth or asymmetric contour. But one examination to clarify the diagnosis and determine the treatment is not enough. Additional diagnostics include the following tests:

• vaginal swab - to identify concomitant inflammation;
• cytology smear - to exclude dysplasia and malignant cells;
• STI screening - it is especially important to make a polymerase chain reaction (PCR) for HPV types 16, 18, 31 (others can be), HSV types one and two, as well as chlamydia, myco and ureaplasmas, Trichomonas, gonococci;
• colposcopy - with erosion allows you to more accurately determine the boundaries of the altered tissues and accurately perform a biopsy;
• cervical biopsy - depending on the amount of erosion, it can be performed with a conchotome, loop or scalpel;
• cervical canal scraping - performed to exclude the spread of altered tissues deep.

Only after the examination can you decide whether conservative or surgical treatment is necessary.

Conservative therapy

If changes are detected in the analyzes, the treatment of any erosion should begin with a conservative stage. For this, the following groups of drugs are used.

• Antibiotics. Appointed in the presence of genital infections, obvious signs of inflammation. Depending on the severity of the changes, this may be taking medication inside or topically (suppositories). The duration of the course and drugs are selected taking into account the results of the analyzes. Most often these are penicillins (Ampicillin, Amoxicillin), macrolides ("Azithromycin"," Erythromycin "," Josamycin "," Clarithromycin "), tetracycline group ("Doxycycline").The appointment of antibiotics is ideal, taking into account the bacteriological culture of vaginal and cervical secretions.
• Antiviral. Appointed upon detection of a lesion of HPV or HSV.
• Immunomodulators. Most often used for signs of viral damage. From popular: "Geneferon"," Methyluracil "," Lycopid "," Groprinsin. "

In addition, tampons with various healing components can be used. Effective sea ​​buckthorn oil, "Methyluracil", "Levomekol"," Panthenol. "

Surgical intervention

Surgical treatment involves the removal (excision of the affected tissue) or cauterization of the pathological area, which leads to the destruction of the upper layers of the epithelium and its subsequent recovery. After the procedure, there is always a recovery period with restrictions on sex and physical activity. During pregnancy, conization and cauterization is not carried out.

Conization

Tissue excision is carried out using conization - a cone-shaped removal of a part of the cervix, with the base turned outward and the apex deep into the cervical canal.

Three options are possible:

• radio wave;
• laser;
• knife

The most successful in all respects is radio wave conization. It is carried out on the Surgitron apparatus. Its advantages are as follows:

• control of the depth of tissue removed - superficial and deep conization is performed;
• cells are not destroyed - histological material can be prepared from them, this is especially necessary in order to make sure that the border of the excised area is healthy tissue, and not the continuation of the changed;
• quick healing - in comparison with other methods, after radio wave conization there are fewer secretions during epithelization;
• low risk of bleeding - radio waves coagulate blood vessels, preventing heavy bleeding;
• performed on an outpatient basis - local anesthesia and two hours of observation are sufficient.

Knife conization is also used. In this case, tissue removal is carried out using a conventional scalpel. Disadvantages - higher risk of bleeding, most often performed in the operating room.

Moxibustion

Cauterization - treatment of the surface of the cervix from the vaginal part. Not suitable if changes are found inside the cervical canal (for example, areas with metaplasia). Performing cauterization in the presence of dysplasia can lead to the fact that the area of ​​cells prone to malignant growth will remain in depth, while control smears from the surface of the cervix will give an excellent result. As a result, the development of cervical cancer, which can be detected only at the III-IV stage. That is why any moxibustion should be treated with caution, giving preference to conization.

Cauterization is possible in the following ways.

• Chemical. It is carried out using the drug "Solkovagin" - a mixture of acids. After processing the surface of the neck, it is covered with a small, delicate white coating (tissue burning occurs). After it is gradually rejected and there is a simultaneous healing of the site. The course requires two to four treatments.
• Liquid nitrogen. The method is called cryodestruction - exposure to low temperatures. There is a “freezing” of pathologically altered tissues and their subsequent rejection.
• Electric shock. This is the oldest method - DEC (diathermoelectrocoagulation). Special electrodes cauterize the area. A scab forms at the burn site, which gradually recedes.All the time of healing a woman is bothered by purulent copious discharge.
• Laser moxibustion. The surface of the cervix is ​​treated with a laser, as a result, pathological tissues are “burned out”.
• Argon. The method is similar to laser cauterization, it has the same indications, the technique of execution and healing.
• Ultrasound. Special devices that emit high-frequency ultrasonic waves process tissues. As a result, the cells “explode” and collapse, subsequently being replaced by new ones.

Folk methods

As an addition to the main treatment, you can use folk remedies at home. The most effective application of local therapy is douching, sessile baths, tampons with medicinal compounds. Herbs and animal waste products that have healing and anti-inflammatory properties are used. Most commonly used formulations based on the following:

• chamomile;
• calendula;
• sea ​​buckthorn;
• uterus;
• propolis;
• calamus;
• mummy.

Top Questions

Given that many women experience erosion, one can often come across the following questions.

• Can she disappear herself. If the changes on the cervix are physiological in nature, but during puberty, as well as after childbirth, it can pass.
• Does conception. Small erosion (especially ectopia of the cervix) without inflammation and other complications does not affect the fertilization process.
• When can I get pregnant after treatment?. After taking medication and two to three months after cauterization or conization.
• Is it possible to give birth with such a diagnosis. Erosion does not interfere with the course of the normal birth process. Extensive against the background of cicatricial deformities can increase the risk of ruptures, including second and third degree.
• What is the chance of cancer?. Malignant cells develop only in 3-5% of erosions, in 95% of cases against the background of human papillomavirus infection.
• If appeared after treatment. After cauterization, an “island” of erosion may remain, these are the costs of the procedure and the experience of the doctor. If erosion appeared after childbirth, it is most likely affected by hormones and injuries.
• Could virgins be. Even in girls who have never lived sexually, ectopia is detected - "false erosion." This is not a sign of the disease, but the stage of tissue maturation.

Prevention

It is not always possible to prevent the appearance of changes in the cervix. The following recommendations serve as prevention of the disease:

• accidental sexual intercourse should be avoided;
• to prevent the use of a condom;
• follow all the recommendations in childbirth;
• regularly undergo examinations by a gynecologist.

Cervical erosion is a common pathology that includes several conditions - ectopia, ectropion, cicatricial deformity, and true erosion. Alertness to this disease is primarily due to the likelihood of malignancy. As a treatment, preference should be given to the radio wave method, and cauterization of cervical erosion should be used in extreme cases with simple processes.

Reviews: “I have not treated her for 4 years, and there have always been discharge, after cauterization everything returned to normal”

I agree with the angel. I also had terrible erosion. For the whole neck. But my genecologist (very experienced and knowledgeable), said that it’s not worth touching before delivery. He says it often happens that after childbirth she goes away by herself. And if it doesn’t work, then heal. If the treatment does not help, then cauterize. This is an extreme measure.

Vera, http://www.woman.ru/health/woman-health/thread/3925922/

I was interested in this question.from the beginning of sexual activity, they diagnosed erosion, but before who knows? Different doctors said different things: do not touch - it's early, you need to conduct a study, and finally WHAT DO YOU FOOL THINK, YOU WANT TO DIE !!! In short, they say different things. I am 25, did not give birth, that is, I have been with her for about 8 years. Last week I went for a visit to a new gynecologist and she asked what was there and how. I'm talking about erosion. She looked at me and poked for a long time - WHAT DOUBLE DIAGNOSIS MAKED ME FOR? And I was at least 6 different doctors! It turned out I didn’t have erosion. I think I should go to another doctor for a check - I could have missed it, but she could not have been warned not to see. and it’s not logical. In general, I read that underdevelopment of the cervical epithelium often goes for erosion, but it develops to 25. In general, do what you want.

Nata http://www.woman.ru/health/woman-health/thread/3925922/

Girls can come in handy for someone I am writing my story that began with erosion. Seven years ago she gave birth and the geneticist after the birth says you have a little erosion, it’s not terrible, you can not treat it, it must go through itself. Well, I was calm once a year, making cytology from everything was fine. But honestly, I have not visited the geneticologist for the past two years. And so I decided to go burn. Because the erosion doctor took cytology and came the dysplasia tests 1.B1. The doctor sent one to do a more advanced analysis called PAP test. According to that analysis, atypical cells with a greater degree of infection come, it’s already dysplasia 3 they send me to the oncologist, he does a biopsy and the result of the display is 3 cancer 0 degree carcinoma in situ. The oncogenician says to me, is it really not clear that every erosion goes to cancer only in some after 5 years and in others after 15. To say that I was in shock is nothing to say, I immediately collected all the tests and for the operation of the horse recording the mother’s neck. They removed a piece of the cervix where there was erosion and sent for histology, but God heard my prayers and analyzes came that there was dysplasia 3 and there was no cancer yet. Believe me, for these two months in my 30 years I have become gray-haired. And the oncogenicologist told me that even with erosion, it is better to close the cone and remove the entire bad area because when erosion is cauterized, the upper layer of the epithelium is cauterized and there have been cases that women have come with stage 2 cancer for 40-50 years due to the fact that they were cauterized in depth there was some kind of non-living area and over the years it has grown into oncology

Helena, http://www.sikirina.tsi.ru/forum/ginekologicheskie-zabolevaniya/eroziya-sheyki-matki-lechenie1.html

I had the same situation until I found a normal gynecologist. She explained everything in detail, painted all the stages of treatment and advised me to cauterize, although I was not giving birth .. it all depends on the size of the erosion. After cauterization, she became pregnant six months later without any problems .. pah-pah .. and when she came to the state clinic there the gynecologist asked and who burned you so well with erosion? I did not treat her for 4 years and there were constant discharge, after cauterization, everything returned to normal, and the always hung white blood cells in the smear returned to normal. So it’s your personal decision to cauterize or not! Doctors have differing opinions in this regard!

Caprice, https://mamochki.by/forum/44/60496/

I burned with liquid nitrogen before delivery, I was about 20 years old, and the doctor did not even ask for my consent, that's all. When I became pregnant, I found out that such things should not be done before childbirth. But now for 13 years now there have been no problems, at all examinations the neck is clean, without adhesions, etc., and before that, at every inspection, what erosion !!! why don’t heal !!! The procedure itself is painless, only then the discharge is bright and strong for several days. But it was a long time ago, now, probably, it has become even easier

Xale, https://mamochki.by/xale/