How is cervical erosion determined? Advanced erosion: symptoms

Disappointing medical statistics indicate that diseases of the cervix (benign and malignant neoplasms of this organ), in terms of frequency of detection, remain the most common pathological process that is found in patients of any age. The reason for this increased attention to diseases of the cervix are that the concept of erosion is understood as two completely different in terms of the mechanism of development and causes of the disease. True erosion heals very quickly and does not cause the woman any particular inconvenience, while pseudo-erosion, despite its “frivolous” name, is much more dangerous.

What is cervical erosion? How dangerous is cervical erosion? Is its treatment always strictly necessary?

True erosion is a violation of the integrity of the epithelial cover of the vaginal part of the cervix, when it occurs, the epithelial layer is damaged - the surface of such erosion is not covered with epithelial cells. At its core, true erosion is an ordinary wound located on the vaginal part of the cervix. With this disease, there are no signs of epithelial ectopia - the differentiation of the cells of the cervical canal and its vaginal part is not disrupted, and the healing processes do not change.

Most often, true erosion occurs against the background inflammatory diseases cervix - accidental damage, which arise against the background of inflammatory diseases of the cervical canal and its cavity (endocervicitis and endometritis), heal quite quickly on their own, and therefore do not require treatment.

True erosion occurs when the stratified squamous epithelium covering the vaginal part of the cervix is ​​damaged and sloughed off. True erosion always has characteristic appearance– a defect in the mucous membrane surrounds the focus of active inflammation. This formation has a bright red color, Not correct form(usually round or oval) and bleeds easily when trying to touch or remove purulent plaque from the surface of the wound.

To establish an accurate diagnosis, a colposcopic examination may be required - such an epithelial defect is richly supplied with blood vessels, swollen, and infiltrated. At laboratory research scraping such a wound reveals fibrin fibers, shaped elements blood, mucous purulent discharge. In the vast majority of cases, in the absence of factors that aggravate the prognosis of the disease, such erosion is able to heal on its own.

If a woman’s epithelium is damaged during an examination and, based on the examination and colposcopy data, a diagnosis of “true erosion” is made, then a smear microscopy study is necessary to exclude sexually transmitted infections. When their causative agents are identified and the microbiological state of the vagina is disturbed (disbacteriosis is detected), the likelihood of independent successful healing of such damage and complete restoration of normal cellular cover decreases. It is precisely this type of erosion that requires mandatory anti-inflammatory and antimicrobial therapy– this helps prevent the spread of atypical epithelium lining the cervical canal directly to the damaged area. If such a condition develops, the doctor has every reason to diagnose “pseudo-erosion”.

What is pseudo-erosion?

It is pseudo-erosion that in the vast majority of cases is diagnosed by the doctor - this condition is characterized by a violation of the integrity of the cervical epithelium, in which the damaged area is not covered with a flat surface. stratified epithelium, as it should be normally, but by the cells of the columnar epithelium lining the cervical canal.

With the development of pseudo-erosion, the transition zone shifts - the place of contact of the multilayer squamous epithelium, located in the vagina, and a single-layer cylindrical, located in the cervical canal. U nulliparous women the cervical canal has a rounded shape, while in women after childbirth the external os takes the form of a horizontal slit. Accordingly, the transition zone in young women is normally located in the initial part of the cervical canal, while with age it moves beyond the external os (to that part, so the cylindrical epithelium can protrude into the vagina, but evenly). With the development of pseudo-erosion, a local (limited) change in the area of ​​the mucous membrane of the cervix occurs.

Such “grafting” of columnar epithelium very often occurs on the surface of true erosion when predisposing factors alter the normal physiology of cells and change the rate of their division. When saving normal conditions columnar epithelium, functionally adapted to alkaline environment the cervical canal does not extend beyond its limits. The main feature of columnar epithelium is a clear response to changes hormonal levels, which occur monthly in a woman’s body. The stratified squamous epithelium lining the inner surface of the vagina is functionally adapted to an acidic environment and is not rejected every month during menstrual bleeding.

In the case when pseudo-erosion occurs, the cylindrical epithelium entering the acidic environment of the vagina continues to function in the same way as in the cervical canal - it is rejected every month and the damaged area can only increase under the influence of provoking factors.

Pseudo-erosion is detected during colposcopy - such a formation on the cervix is ​​overwhelmingly round, regular in shape and noticeably different from the normal epithelium of this part of the internal genital organs.

Causes of cervical erosion

The immediate cause of any erosion of the cervix is ​​tissue trauma that occurs during rough conduct of any medical manipulations or sexual intercourse, which is accompanied by an infection. Its causative agent is the vaginal microflora - both its individual representative and an association of microorganisms. In a healthy woman (in the absence of dysbiosis), the vaginal microflora prevents the development of pathogenic and opportunistic microorganisms, so any damage heals without consequences.

Problems arise when a woman's normal processes tissue restoration - changes in the mucous membrane of the cervix that occur after childbirth, termination of pregnancy, due to inflammatory diseases and hormonal disorders cannot heal on their own and become covered with normal (typical) multilayered epithelium. Single-layer cylindrical epithelium has great repair abilities - which is why it can cover the surface of erosion, but does not prevent the penetration of infection.

The problem is that the cylindrical epithelium, which enters the acidic environment of the vagina, is more susceptible to dysplastic changes - it is believed that this is why, against the background of erosion, benign and malignant neoplasms of the genital organs, including cervical cancer, can develop. Columnar epithelium does not prevent the penetration of viruses - the human papillomatosis virus can penetrate into such cells, which causes the development of malignant neoplasms cervical epithelium.

Often the direct cause of inflammation of the mucous membrane of the cervix are pathogens that are sexually transmitted - chlamydia, ureaplasma, gardnerella, trichomonas, mycoplasma, and some of these microorganisms penetrate into the epithelial cells, which significantly complicates the treatment of erosion. Predisposing factors include hormonal disorders, occurring in a woman’s body - such processes disrupt the processes of normal maturation and rejection of the epithelium of the genital organs, which is also important in the pathogenesis of the development of erosion.

It is precisely the combination of hormonal and inflammatory factors explain the occurrence of erosion in adolescents and women who have never given birth in their lives and have not undergone gynecological manipulations.

Symptoms and signs of cervical erosion

In the vast majority of cases, cervical erosion is asymptomatic - the patient, regardless of age, does not experience any unpleasant subjective sensations (the opinion of many women about the special sensitivity of the outer part of the cervix is ​​erroneous - pain receptors are located only directly in the cervical canal, but not on its pharynx) . In addition, women may notice spotting or spotting between periods. Contact bleeding often occurs - it can be caused by both a gynecological examination and sexual intercourse, so a woman should pay attention to changes in her condition, and seemingly causeless bleeding should force the patient to visit a gynecologist before the next preventive examination.

A gynecologist can detect erosion when examining the cervix in speculums (it is performed on a gynecological chair) or when performing colposcopy. Actually, based on the results of the study, the gynecologist can identify:

• absence of pathology (in healthy women);
• true erosion - a condition that lasts no more than 7-10 days and heals without consequences (in the absence of provoking factors);
• pseudo-erosion is a condition in which the surface of true erosion does not heal (does not become covered again with stratified epithelium), but undergoes ectopia. In this case, the erosion surface is covered with columnar epithelium from the cervical canal;
• congenital erosion - in this case under the influence pathogenic factors The cylindrical epithelium moves to the outer part of the cervix even during the period of intrauterine development, but the active development of erosion begins only during the girl’s puberty.

In its development, pseudo-erosion goes through several stages, and depending on the condition of the mucous membrane, a diagnosis is made and an appropriate treatment program is prescribed.

1. the stage of development of erosion is the stage of replacement of squamous epithelium with cylindrical epithelium. At the initial stage of the disease, the ectopic (displaced) epithelium spreads only over the surface of the erosion, covering it in one layer, but as the changes progress (after several menstrual cycles), the manifestations of the disease change.
2. the erosion stage is characterized by the growth of columnar epithelium not only over the surface of the damage, but also into the depths of the tissues of the cervix - in this case, branching glandular ducts characteristic of columnar epithelium are formed. In the thickness of the erosion, cysts are formed, filled with secretions (the passages do not always open to the surface), so the formations constantly increase in size, and large cysts become noticeable even with a simple examination of the cervix in the mirror (small ones are visible only during colposcopy). Large cysts may superficially resemble cervical polyps and cause hypertrophy (marked thickening) of the cervix.

Depending on the structure of pseudo-erosion there can be:

• follicular - upon examination, convoluted glandular ducts and multiple cysts are found in such a formation;
• papillary - upon examination, pronounced inflammatory changes and growths in the form of papillae are detected in such a formation;
• mixed - combine signs of follicular and papillary erosions.

Pseudo-erosions in the vast majority of cases are relatively small in size at the onset, but with the progression of the pathological process (in the absence of adequate therapy) they can involve most vaginal part of the uterine os. When viewed, pseudo-erosions are visible in the form of formations various shapes, which have a bright red color and a velvety (uneven) surface, covered with mucous or mucopurulent discharge. The main difference from true erosion is the absence of a zone of inflammation (reactive hyperemia) - pale pink areas of unchanged stratified squamous epithelium are visible along the edges of the erosion.

The constant persistence of erosion is explained by the fact that during the next menstruation, not all cells that make up the erosion are completely rejected, and by the presence of an infection that exists in the altered cells of the cylindrical epithelium.

If during treatment or during self-recovery the erosion heals, the reverse process occurs - its surface is again covered with stratified squamous epithelium, the infection is destroyed, but in its place (under the normal epithelium) cysts (Nabothian glands) may remain, remaining at the site of blockage of the ducts.

Gynecologists consider the healing of pseudo-erosion to be complete only if the columnar epithelial cells and erosive glands are rejected over its entire surface and to its entire depth, and the process is completed full recovery normal stratified squamous epithelium on its surface. If these conditions are not met, it is necessary to continue treatment - otherwise there remains a high probability of recurrence of such erosion and the occurrence of complications.

Possible consequences and complications of cervical erosion

The main problem in the treatment of pseudo-erosion (erosion) is the possibility of development of atypical and dysplastic changes in the cells that form it. Columnar epithelial cells, finding themselves in an unfamiliar environment, begin to actively divide, and infection inside them (especially viruses) can cause changes in the genetic apparatus of the cells. That is why cervical erosion with foci of epithelial dysplasia is considered as a condition that can transform into cervical cancer (carcinoma), although this point of view is not shared by all oncologists and gynecologists today.

When congenital erosions form on the cervix before puberty, this process will not manifest itself in any way - the progression of changes begins only under the influence of changes in hormonal levels. When viewed in a speculum, such erosion will look like an area of ​​epithelium bright red and a small area, but there are no signs of active inflammation and pathological secretion from the cervical canal (the erosion remains “clean”). Such damage often heals on its own, and in place congenital erosion The stratified squamous epithelium typical of the external uterine pharynx is completely restored. If the surface of such a defect becomes infected, then all characteristic features inflammation. Against the background of congenital erosions, flat condylomas may appear (after infection of the body with certain types of human papillomatosis virus), but these erosions are not prone to the occurrence of atypia and metaplasia - carcinoma does not develop against their background.

How can cervical erosion affect pregnancy and childbirth?

If erosion (pseudo-erosion) does not occur against the background of sexually transmitted diseases, then no negative influence the development of pregnancy and subsequent births is not observed. On the contrary, during pregnancy, childbirth and the subsequent recovery period, significant hormonal changes occur in a woman’s body, which can contribute to the independent healing of erosion and complete epithelialization of its surface. That is why, when erosion is detected in women on early stages During pregnancy, an examination is carried out to exclude (confirm) STDs, and after receiving the results, a decision is made on the need for treatment and the likelihood of intrauterine infection of the fetus (some diseases can enter the child’s body and cause quite serious changes in tissues and organs there).

In addition, the cervix with pseudo-erosion existing on its surface (true erosion and during pregnancy heals within the 10-14 days “alleged” to it according to standards without consequences) can behave unpredictably during childbirth - it opens worse and is much more easily injured. That is why during pregnancy such a tissue defect needs to be identified, treated and monitored the condition of the woman’s birth canal - this will help prevent problems in the future.

What is the effect of cervical erosion during pregnancy?

Erosion itself (if it is not complicated by sexually transmitted infections) does not affect the course of pregnancy - never in any way. But in cases where this disease is detected before pregnancy, problems with its onset are possible - some experts believe that the role of disorders cannot be completely ruled out hormonal status in the development of this pathological process. Any problems that arise in the human body appear in most cases only when two conditions are combined - the body’s predisposition (with erosion, we can talk about changes in hormonal status) and the influence of factors external environment– injuries and infections.

That is why doctors note that women who experience erosion may have problems with the onset of pregnancy itself - there is no effect on the process of bearing it. negative influence erosion cannot have any effect. Moreover, for most women, a successful pregnancy becomes the reason for self-healing of erosion - restoration of hormonal levels and changes in body tissues contribute to this.

However, erosion remains a source of infection in the genital tract (which is why it needs to be treated throughout pregnancy with all available means and medications) and worsens the condition of the cervical tissue - this can cause complications during childbirth.

Is it true that it is better not to treat cervical erosion in nulliparous women?

This is not true; any erosion needs to be treated, regardless of whether it is found in a nulliparous or parous woman. Depending on this factor, the optimal treatment program is selected - for nulliparous patients, they try to select treatment methods that effectively eliminate damage (erosion itself) and concomitant infection, and at the same time minimally affect the surrounding healthy tissue of the cervix and do not provoke scar changes on its surface .

The only exception to this rule is congenital erosion before the girl begins her active sexual life - such an epithelial defect can heal on its own, but this is only possible in the absence of signs of an active inflammatory process on the surface of the erosion. Congenital erosion may not be treated, but such a patient should be under constant supervision of a qualified gynecologist and come for examination every 3 months. If congenital erosion does not heal on its own before the onset of sexual activity, its infection is almost inevitable - after all sexual contacts between partners always means an exchange of microflora (both normal and opportunistic and pathogenic). That is why congenital erosion in girls leading sex life, the gynecologist will treat you the same way as any other. In this case, the woman’s examination program does not change.

Tests and examinations necessary to detect cervical erosion

To accurately diagnose erosion, it is necessary to carry out a whole complex diagnostic studies. Its important parts are:

Only after receiving the results of all tests and completing all examinations (colposcopy can be performed on any day of the cycle, while it is advisable to perform a biopsy no later than the 7th day menstrual cycle) the doctor can make an accurate diagnosis and prescribe treatment. It must be remembered that the gynecologist prescribes treatment for each patient individually - this is how both the method of treating erosion and medications, necessary to eliminate infection and inflammation in the woman’s genital tract.

When is treatment for cervical erosion necessary?

Treatment of cervical erosion is almost always necessary - the only exceptions are cases of congenital erosion, which are not complicated by a layer of infection and inflammation. Talk about what erosion will pass yourself - irresponsible, because this disease worsens the condition of the cervix, which leads to serious complications during childbirth (all gynecologists admit this). In addition, dysplastic changes, which are often found in the erosion zone, can undergo malignancy. Erosion (pseudo-erosion) always remains a source of chronic infectious process in the genital tract of a woman - this condition cannot develop without infection; in a healthy woman, true erosion heals after a few days without consequences, and the columnar epithelium covering it on early stages healing, is completely replaced by normal stratified squamous non-keratinizing epithelium.

How is cervical erosion treated?

Modern gynecology has developed many effective treatment methods for the treatment of erosions that do not cause any complications and do not prevent pregnancy and normal birth in future. Surgical excision of erosion, which leaves marks and changes the condition of the cervix, has not been used for a long time.

The most effective treatment methods today are recognized as:

1. Cauterization of erosion involves treatment with solutions antiseptic drugs. This treatment method is indicated for the treatment of both true erosion and the initial stages of pseudo-erosion, because the elimination of active inflammation will contribute to the normal healing of the damage.
2. Cryodestruction (cryotherapy, freezing liquid nitrogen) is based on that. That liquid nitrogen, which evaporates from the surface of the erosion after its application, “freezes out” the erosion tissue. This procedure is practically painless, does not lead to the development of cervical deformation and can be successfully used even to treat young nulliparous patients. Normal squamous epithelium always forms under the surface of the scab. The period of complete healing can stretch up to 30-45 days.
3. Laser coagulation (laser cauterization) requires careful sanitation of the vaginal lumen before erosion treatment (carried out no later than on the 7th day of the cycle) and sufficiently long-term use of anti-inflammatory and antimicrobials after the procedure. But the results of using laser are currently recognized as the most effective.
4. Electrocoagulation (diathermocoagulation, cauterization of cervical erosion with an electric arc) is quite painful and can lead to the development of gross scar changes, and the healing process is quite long. That is why today this method, despite the relatively low cost of treating women, is used less and less.
5. Radio wave cauterization of cervical erosion with the Surgitron apparatus is recognized by most gynecologists as the “gold standard of treatment.” This procedure does not require complex preparation of the woman, it is carried out in a few minutes, and the healing process is minimally short - up to 14 days.

Which treatment method is more effective? How to choose a treatment method?

The choice of treatment method should be made exclusively by a specialist who takes into account not only the effectiveness of the method, but also the patient’s health status with possible contraindications.

If erosion was found on initial stages, then you can use the method of chemical coagulation, which is not an expensive procedure and is most often well tolerated by patients.

Diathermocoagulation, although also inexpensive, is dangerous possible education deep scars that will interfere with the normal course of labor. Most often it is poorly tolerated. A more gentle method with a similar effect is cryodestruction.

To the most modern and safe ways Treatments include laser therapy and radio wave method. The disadvantage of these methods is that they require a highly qualified doctor and the availability of special expensive equipment, which is not always available. In all other respects, these methods of treatment can be called the most effective.

Traditional methods of treating cervical erosion

Many patients, when any diseases are discovered, refuse to medical treatment and strive to follow advice traditional medicine, which often results in additional complications. Traditional medicine experts advise applying pumpkin and urine tampons to the cervix, and douching table salt, with calendula tincture, apply the bulb to the site of erosion. In fact, there is no scientific evidence that all these recommendations are effective, and urine therapy is especially not effective. If you wish, you can use the advice of traditional medicine as aids, but still the main treatment must be carried out using traditional methods.

Thank you

Surely every representative of the fair sex has come across the concept “ cervical erosion" This is not surprising, because this pathology occurs in every second woman.
Are you surprised? Don't be surprised, cervical erosion is really common to this extent. In fact, if you have been diagnosed with this, do not get upset ahead of time, since cervical erosion is a benign, not a malignant process. The only thing that is required of you is to start treatment for this disease on time. In order to contact a specialist in time, you need, first of all, to know the symptoms that indicate the presence of erosion..site) and will talk to you right now.

What is cervical erosion?

We think it will not be superfluous if we give a precise definition of the concept of “cervical erosion”.

What is it?
Cervical erosion means a violation of the integrity of the vaginal part of this genital organ. There are actually quite a few reasons for the development of this benign condition. These include: various cervical injuries, abortions, birth processes, early start sexual life, infections genitourinary tract such as genital herpes and some others. Let us immediately note that getting rid of cervical erosion is quite simple today. That is why you should not put off a visit to the gynecologist “for a long time”. Remember, cervical erosion is not dangerous only if it is detected and treated in time. If this process is not treated for years, then cervical cancer is not far away. We are not scaring you, we are only warning you.

So, what are the signs of cervical erosion?

To be honest, it is quite difficult for a woman herself to identify the presence this state. This is explained by the fact that cervical erosion may not manifest itself in any way for quite a long time. The only signal in in this case it could be considered copious discharge. This discharge is especially noticeable after sexual intercourse. If your discharge is also bloody, then you definitely need to see a gynecologist. In principle, in some cases, the presence of cervical erosion also causes painful sensations, which make themselves felt, usually during sexual intercourse. Every representative of the fair sex should understand that the development of any disease of the genital organs can be prevented only through regular visits to the gynecologist. Don't wait until you get sick. Try to visit to this specialist at least once every six months, and then everything will be not just good, but excellent.

Diagnostics

Diagnosing cervical erosion is quite simple. The doctor examines the uterus with gynecological speculum, which makes it possible to see the existing pathology. Another method for diagnosing erosion is colposcopy. Colposcopy means an examination using colposcope- a device that magnifies twenty-five to thirty times. Also, part of the affected tissue may be taken from the woman for examination. Tests for the presence of major sexual diseases are also mandatory.

Treatment

And now a few words about the treatment of erosion. Today, gynecologists have a very wide range of methods for treating this condition. This and cryodestruction, And laser coagulation, And chemical coagulation, And diathermocoagulation, and some others. The doctor will choose for you required method therapy for erosion based on its size and causes. Despite the fact that cervical erosion is a very common pathology, every woman should remember that the development of erosion can still be prevented. To do this you just need to follow existing measures prevention of this disease. As we have already said, every woman should visit a gynecologist regularly.

Also, do not forget that any diseases of the genital organs must be treated in a timely manner. In this case, one cannot do without a healthy lifestyle and the currently existing means of contraception in the form of condoms.

Before use, you should consult a specialist.

Reviews

Is it possible to treat erosion using a traditional method?

Is it possible to treat erosion? traditional methods? Or do you need to consult a gynecologist?

Hello. Can erosion occur due to severe freezing of the feet.

Hello, 2 days ago the gynecologist told me that there is still a small erosion. I’m already married. I want a child. It’s not working out yet. What should I do: cauterize or wait for pregnancy???

Is it possible for erosion to occur with very frequent and deep penetration of the penis into the vagina?

Tatyana, the pain of this procedure largely depends on the cauterization method. The most painless is cryodestruction or laser burning.
You will have to give up sexual activity for a month after cauterization.
On reproductive functions this type Treatment usually has no effect.

Please tell me whether it hurts to cauterize erosion. And how will this affect my sex life later, and will it harm my unborn child?

Lena! Unfortunately, erosion must be cauterized strictly during or (if they are too abundant) immediately after menstruation. The first time I was unsuccessful. When, having suffered through three years, I came, I came across a very good doctor. We performed diathermocoagulation. When you go, you definitely need to take a smear on the first day of your period, it turns out there is a difference. The result will depend on this.

Hello, I’ve had erosion after pregnancy for two and a half years now, but I’m afraid to jump, but when I get ready to go, the doctor tells me that cauterization is only after menstruation, but can I cauterize somewhere after 10 days after menstruation or not? Or is it for something? influences

Anna, cervical erosion can occur as a result of any infectious inflammatory process in the vagina.

I’m 18 years old, I’m not pregnant, I haven’t had any abortions, but this is irony!! Why is this all??

Hello! They cauterized a flat candyloma. HPV and other infections were not detected. What preventative treatment can I take? I was prescribed geneferon and isoprinosine. But I doubt the dosage.

Please tell me how it is treated, and can it occur in nulliparous girls?

Can erosion occur from postinor?

I was also diagnosed with erosion, but I heard that true erosion goes away on its own in the shortest possible time, maybe in most cases it turns out to be pseudo-erosion? I don’t have any signs of it. And I can’t even understand what could have caused it. It’s possible that doctors make mistakes, I think that was the case in my case, the clinic was private and very expensive, in such cases anything is possible... and as for the nerves, yes, I agree, take care of the nerve cells...

I was treated for the first time about 5 years ago, they did cryodestruction. The reason given was hormonal disbalance. A few months ago, the causes of erosion began to appear - discharge. I went to the doctor and he confirmed my fears, but was very surprised when he read my story. He says that after cryo there should not be a repeat. Maybe they didn’t complete the treatment the first time.

I was given cryotherapy once before I gave birth, and burned twice after giving birth, and here I am again. Is it possible to get rid of it once and for all?

My gynecologist diagnosed the same disease. By the way, there were no infections; I had already been married for 2 years. And I was treated vaginal tablets, about 2 weeks, and quite successfully, after six months the manifestations were minimal, and after a year it was not detected at all. I just don’t remember the name, it looks like it starts with “E”. I talked to doctors about what could be the reason, so - anything! Poor environment, infections, stress, poor nutrition, early onset of sexual activity, etc. In short, everything is individual, and appearance this erosion is also different. yes, I was also prescribed contraceptives (I didn’t use them) for about 2 months, but I adverse reactions there was a lot right away in the first week of use, so I stopped it with the doctor, tried a bunch of others - the same contraindications, refused to change my hormonal levels at all. I just want to note that at the time the erosion was discovered, I was going through a very turbulent time - a diploma, hard work (part-time work), eating in fits and starts... A year later, life stabilized - good job in my specialty, I have time to cook with my husband more often... (well, you get the idea)))
So, girls, look for an experienced gynecologist who will accurately determine the cause and treat it, but cauterization is completely radical, and only for those who have given birth. And think about the phrase “All diseases come from our nerves.” This may not apply specifically to this disease, but you need to value your peace of mind.

Isn’t it possible to treat erosion with medications, well, without any cauterization?

Please tell me, can there be erosion if you are not yet sexually active?

Cervical erosion - damage to the epithelial cover, or a violation of the integrity of the vaginal area of ​​the cervix.

Erosion is determined using special mirrors and consists of bright red areas, located mainly in the area of ​​the external os of the cervix.

This is one of the most frequent diagnoses, which is given today to representatives of the fairer sex. According to medical statistics, 50% of women in the world face this pathology. But it is often impossible to guess about its development without a gynecological examination.

What is true and false erosion?

Why does cervical erosion occur, and what is it? Gynecological specialists distinguish true and false erosion.

1. True erosion. This is a pathology that is acquired as a result of exposure to any unfavorable factors. The cause is various damaging factors (damage from bullet forceps, inflammatory exudate). As a result, the epithelium of the vaginal area of ​​the cervix becomes desquamated, and inflammation begins at the site of damage. True erosion often occurs on lower lip cervix. When diseased, it takes on an irregular shape and has a bright red color. Erosion is also characterized by bleeding from the eroded area.
2. False erosion. Epithelial cells are replaced by columnar epithelium. It would be more accurate to say that with pseudo-erosion of the uterus, the boundaries of the columnar epithelium (that is, the cells lining internal channel cervix) are displaced beyond the external os. Pseudo-erosion is detected at one time or another in 35-40% of girls. A woman, as a rule, does not worry about anything. When an infection occurs, complaints of leucorrhoea from the genital tract and the appearance of contact bloody discharge after sexual intercourse may appear.
   Congenital. The formation of congenital erosions of the cervix occurs as a result of displacement of the boundaries of the columnar epithelium lining the cervical canal beyond its limits. Displacement (ectopia) of the epithelium occurs during the prenatal period of fetal development, therefore such erosions are considered congenital.

Causes of cervical erosion

Cervical erosion, as well as the causes of its appearance, have been discussed by doctors for quite some time. long time. Currently, several theories have become widespread:

1. Theory comes first inflammation of the female genital organs, especially endocervicitis, which is accompanied by increased secretion of the glands of the cervical epithelium.
2. Mechanical injuries. Such injuries can occur as a result of rough sexual intercourse or during childbirth. Inflammation develops at the site of severe physical impact to stratified squamous epithelium.
3. STIs: candida, chlamydia, trichomonas, gonococci.
4. Early onset of sexual activity. The mucous membrane of the female genital organs finally matures by the age of 20-23. If infection interferes with this delicate process, pseudo-erosion cannot be avoided.
5. Menstrual irregularities due to hormonal problems.

Erosion and other pathologies of the cervix may also occur when the protective functions of the immune system are reduced.

Cancer provocateur

What is cervical erosion and why does it have virtually no symptoms? Gynecologists have awarded this disease the term “cancer provocateur.” The reason is that the cervix is ​​devoid of nerve endings.

Due to this, such pathological processes, like erosion, dysplasia, and often cancer, can remain silent for a long time, and often only preventive examinations by a gynecologist contribute to their accidental detection. Sometimes you can suspect something is wrong by spotting or bleeding caused by sexual intercourse.

Other underlying diseases of the cervix

1. Polyps are outgrowths of the mucous membrane. They can be located either on outer surface cervix and inside the cervical canal. The occurrence of polyps is most often associated with chronic inflammation or viral infection(papilomavirus infection, herpes, CMV). They are subject to mandatory removal.
2. Leukoplakia is an area of ​​keratinization. As a result viral infection(virus herpes simplex, HPV) or chronic inflammation, cells begin to rapidly divide, and a “crust” appears on the surface of the mucous membrane.
3. Ectropion is very similar to erosion, but has a slightly different cause. It appears as a result of inversion of the cervix into the vaginal lumen, most often after childbirth.

Symptoms of cervical erosion

When a woman has erosion, she does not experience any changes in her condition and well-being, and notice characteristic symptoms She cannot cervical erosion.

The fact is that the cervix is ​​devoid of sensitivity and even during sexual intercourse a woman does not experience a feeling of discomfort. However, after intimacy Some women experience minor bloody or bloody discharge, which is a good reason to visit a doctor.

As you can see, cervical erosion does not have a bright severe symptoms, so women most often find out about this problem at an appointment with a gynecologist.

Cervical erosion: photo

We offer detailed photos for viewing of what this disease looks like.

Diagnostics

For early detection and timely treatment erosion, even a healthy woman should visit a gynecologist at least twice a year. If the doctor sees that there are any defects on the cervix, it is necessary to conduct a colposcopy - an examination using a special device with an optical system. This procedure is painless and does not require special preparation.

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

How to treat cervical erosion?

The treatment approach is primarily determined by the type, size of ectopia, patient’s age, presence or absence concomitant diseases. That is, the treatment of cervical erosion is individual for each individual patient.

First of all, before starting the main treatment - accurate timely diagnosis And rational treatment STI (if detected), otherwise all efforts may be in vain. In addition, a mandatory clinical and laboratory examination of the sexual partner is necessary. Initially it is necessary to eliminate inflammatory process in the cervix and vagina. If ovarian function is impaired, it is also necessary to carry out appropriate treatment.

In the treatment of cervical erosions, practical gynecology adheres to the following rules:

1. True erosion and pseudo-erosion are treated simultaneously with the underlying diseases that caused or maintained them.
2. Observation of congenital erosions, no need for their treatment.
3. Erosion in the active stage inflammations are treated with gentle methods (vaginal tampons with sea ​​buckthorn oil, fish oil, solcoseryl ointment, syntomycin emulsion, aerosols containing antibiotics - levovinisol, olazol, etc.).
4. At presence of signs of inflammation the therapy should be aimed at infectious agents (trichoionases, chlamydia, gonococci, etc.).

Modern approaches to the treatment of cervical erosion are based on the use of the mechanism of destruction of columnar epithelial cells, their rejection and subsequent restoration of squamous epithelium on the surface of pseudo-erosion. For this purpose, the methods of diathermocoagulation, laser vaporization, cryodestruction, and radio wave method are used - we will consider them below.

Cauterization of cervical erosion

In order to remove the affected tissue, that is, to renew the cells of the cervix, doctors advise carrying out a procedure such as cauterization.

According to reviews from women, the most effective treatment methods today are:

1. Cryodestruction - the erosion area is treated with liquid nitrogen (ultra-low temperature), and the damaged area is “frozen” to healthy tissue using a thin and very cold manipulator.
2. Laser coagulation— the area of ​​erosion is exposed to a targeted surgical laser beam (a powerful beam of light). On a positive note is the ability to change the depth of exposure, which allows you to treat both superficial and deep erosions.
3. Radio wave cauterization cervical erosion using the Surgitron device is recognized by most gynecologists as the “gold standard of treatment”. This procedure does not require complex preparation of the woman, it is carried out in a few minutes, and the healing process is minimally short - up to 14 days.
4. Chemical coagulation. This method removal of cervical ectopia involves treating the pathological area with chemical solutions, for example, the drug Solkovagin. Its constituent components are organic acids(oxalic and acetic) and zinc nitrate with nitric acid. Chemical destruction is used only when treating small areas of ectopia.

The choice of method for cauterizing erosion should be made exclusively by a specialist who takes into account not only the effectiveness of the method, but also the patient’s health status with possible contraindications.

Cervical erosion after cauterization

After the procedure is completed, women may experience pain, bleeding, and discharge. In the event that after cauterization there appears profuse bleeding, then this means that he was hurt large vessel. In this situation, you should immediately consult your doctor. Only he can stop this dangerous bleeding.

With the help of antispasmodics, like no-shpa and spasmalgon, you can relieve weak nagging pain lower abdomen. It is better not to use them without a doctor's permission.

Effect on pregnancy

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

Doctors warn that a planned pregnancy with a preliminary examination for the presence of all types of problems and their treatment before conception increases the likelihood of a successful pregnancy and the birth of a healthy baby.

Content

If there is a defect in the mucous membrane on the vaginal part of the cervix, the doctor can determine that the woman has an erosive lesion. Experts distinguish between true and false erosion. An accurate diagnosis is established after a full comprehensive examination patients and differential diagnosis.

Characteristics of the pathology

More than 50% of women have experienced cervical erosion in their lives. This pathology is diagnosed both in young girls and in women who are of childbearing or premenopausal age. There is no need to panic if the doctor has discovered erosion; it is important to understand the reasons for its occurrence and determine how to proceed further.

Most often, patients encounter pseudo-erosion. This is the name of the condition in which flat epithelial cells are replaced by cylindrical ones. Upon visual examination of the cervix, redness will be visible. With true erosion, ulcerations form on the surface of this organ, which can bleed.

Pathology is fertile ground for possible development precancerous and cancerous changes in cells. But women are not always immediately prescribed treatment; sometimes the doctor advises to monitor the erosion. In some cases it goes away without treatment.

Characteristic symptoms

Self-diagnosis of cervical erosion without examination by a gynecologist is impossible. Changes on the surface of this organ can only be seen by a specialist. But erosion is not always asymptomatic. Sometimes women come with complaints about:

• pain in the lower abdomen;
• bloody issues;
• irritation;
• burning;
• pain when urinating;
• the appearance of abundant cloudy, mucous, yellowish, white discharge;
• unpleasant smell of discharge.

As a rule, pain and bleeding intensify after sexual intercourse, douching, gynecological examinations and other manipulations that injure the cervix. But blood can appear only with true erosion.

When unpleasant discharge, smell, pain, itching and other discomfort, you should immediately see a doctor. Specified signs characteristic of infectious lesions. They can cause erosion.

At the same time erosive lesion cervix increases the likelihood of infection. After all, the integrity of the protective layer is compromised: it is easier for pathogenic microorganisms to penetrate the tissue and begin to damage cells.

Only a doctor can determine the cause of discomfort. Therefore, when discomfort There is no point in delaying your visit to the gynecologist. After all, any change in the structure of the cervix can lead to a weakening of the protective forces. As a result, various pathogenic microorganisms will be able to penetrate cells and disrupt their gene structure. As a result, they will begin to degenerate.

Diagnostic procedures

All women are required to visit a gynecologist at least once a year. This must be done even if nothing bothers them. After all, many women's diseases They are asymptomatic and cannot be detected unless diagnosed in a timely manner. Even with serious illnesses At first, women have no pain, no atypical discharge, and no menstrual irregularities.

If the doctor detects erosion, then the diagnosis does not end there. Before choosing treatment tactics, the doctor conducts a comprehensive examination.

The survey is aimed at:

• clarification of the diagnosis;
• determination of the causes of damage;
• identifying developed complications.

How to determine cervical erosion? Preliminary diagnosis placed based on the results of an examination with mirrors when redness is detected. But diagnosis includes not only a standard gynecological examination, but also:

• microflora smear;
• conducting extended colposcopy;
• collection of material for cytological examination;
• tissue biopsy (if cancer is suspected);
• collection of material for bacteriological examination (the laboratory assistant can determine the state of the microflora and identify what pathogenic organisms the disorder was caused, identify the most effective medicinal substance);
• carrying out diagnostics using the polymerase chain reaction method: it allows you to identify sexually transmitted infections.

After completing the diagnosis, the doctor can determine why cervical erosion has developed. When concomitant diseases are identified, it is first necessary to get rid of them, and then select the necessary treatment tactics.

Using PCR diagnostics, a laboratory technician can determine whether a woman has:

• chlamydia;
• ureaplasmosis;
• mycoplasmosis;
• trichomoniasis;
• human papillomavirus;
• other STDs.

When identifying infectious diseases First of all, you need to get rid of them. The doctor begins to treat erosion only after eliminating the cause of its occurrence.

An experienced gynecologist can distinguish true from false erosion by visual examination. To determine the type of lesion, it is enough to touch the cervix. When palpating true erosion, blood appears in most cases. This method preliminary diagnostics used by many gynecologists.

Features of colposcopy

One of the most reliable methods for determining erosion is colposcopy. This is the name for examining the cervix through a colposcope - a device that magnifies the area being examined by 20-30 times. This procedure makes it possible to examine pathologically altered lesions in detail.

Most often, an extended colposcopy is performed. This is a special diagnostic method that allows you to determine pathologies of the cervix and carry out differential diagnosis.

It is done according to a certain scheme.

1. The doctor treats the cervix of the uterus with a 3% solution under the control of a colposcope. acetic acid. It dissolves cervical mucus, provokes swelling of the epithelial layers and narrowing blood vessels. The gynecologist has the opportunity to determine what type of tissue is in the lesion, its boundaries, and identify pathological vascular reactions.
2. A 2% Lugol's solution is applied to the cervix (this diagnosis is called the Schiller test). Healthy tissue become brown, and areas with pathologically altered epithelium remain unpainted.

At the same time, during colposcopy, material is taken for cytological examination. The gynecologist makes a smear from cervical canal and from the surface of the cervix. Taking material from altered areas allows for a more accurate diagnosis.

If, based on the results of a cytological examination, it was determined that there is pathological changes in tissues, then a targeted biopsy is performed. It is used to determine the presence of cancerous changes in the cervix. After receiving the diagnostic results, the doctor can determine which scheme to follow for further treatment.

Minor defects in the form of wounds and small ulcers that appear on the mucous membrane of the cervix, in medical practice called erosion, related to benign tumor. Before the use of colposcopy, erosion was a generalized and selective concept. During examinations, gynecologists discovered redness on the mucous membrane of the cervix and made this diagnosis. Today, diagnosis, in addition to visual examination, includes examination of the cervix under a microscope, extended colposcopy and other necessary tests.

Causes of erosion

The cervical mucosa can be deformed for various reasons. There is acquired and congenital erosion. With congenital erosion (), protrusion of the prismatic epithelium beyond the boundaries of the cervical canal is observed. The doctor sees erosion as velvety redness. It is believed that the cause of pseudo-erosion is high level progesterone in the blood. Acquired erosion occurs against the background of diseases such as chlamydia, gonorrhea, ureaplasmosis, trichomoniasis, herpes virus and microplasmosis. Bacterial candidiasis and vaginosis can also cause erosion. The cervix is ​​also injured during abortions and rough sexual intercourse. The risk group includes women who began sexual activity early and often change sexual partners.

Symptoms of erosion

Unfortunately, signs of cervical erosion are too subtle. Few people examine the vagina at home using a speculum, so do not neglect planned gynecological examinations. Only a doctor knows exactly how to identify cervical erosion and prescribe treatment.

However, women should be aware of the symptoms that occur with erosion so that, if necessary, they can begin treatment immediately. So, the first sign is a variety of discharge. With erosion, this is profuse leucorrhoea, purulent discharge and even blood. Do not confuse normal physiological mucous discharge with leucorrhoea. Unlike pathological ones, such discharge is transparent, slightly whitish. If there are a lot of them, the color changes, and the smell becomes unpleasant, then the help of a gynecologist is needed. In laboratory conditions, during erosion, an analysis of secretions () and blood from a vein is performed. This allows you to determine whether the body contains chlamydia, herpes virus, gardnerella, papillomavirus, trichomonas and other pathogens. Sometimes a biopsy is recommended.

If the question of whether there is discharge during erosion and what nature it is, everything is more or less clear, then other symptoms do not even suggest the idea of ​​this disease. Thus, pain in the lower abdomen that occurs during erosion is quite mild and periodic. They are easily confused with the sensations that occur during the premenstrual period. By the way, the lower abdomen does not always hurt due to erosion. In addition, with erosion, it is painful to have sex, as the cervix receives additional injuries.

If at the same time an inflammatory process occurs in the body, then with erosion the body temperature may increase. Conventional antipyretics will only be effective for certain time, since they do not eliminate the source of inflammation.

Treatment of erosion

There are plenty of methods that allow women to get rid of erosion. The doctor will suggest the most effective and at the same time the most gentle method. Traditional methods include drug treatment, cryodestruction, laser coagulation, diathermocoagulation and radio wave method.

Prevention

To prevent the formation of erosions, it is necessary to take a shower twice a day, carefully select partners, avoid casual relationships and use contraceptives, since abortion is a colossal injury to the cervix, which increases the risk of erosion significantly.