Ectropion and true cervical erosion

Ectropion and true cervical erosion

Ectropion – eversion of the mucous membrane of the cervix, traditionally occurs during pregnancy, as well as when taking oral contraceptives. True erosion of the cervix – a defect in the epithelium lining the vaginal part of the cervix, occurs due to trauma (for example, with the imprudent introduction of mirrors); healing of true erosion traditionally occurs in 10-14 days.

Etiology

• • Since ectropion occurs when taking oral contraceptives and during pregnancy, the alleged root cause of its occurrence is the influence of progesterone
  • True erosion is mechanical damage to the epithelium.

Risk factors

• • Ectropion: pregnancy, taking oral contraceptives
  • True erosion: estrogen deficiency, as well as any manipulation that can lead to desquamation of the epithelium. Pathomorphology
  • Ectropion – oblique furrows and ridges (remains of folds of the mucous membrane of the cervical canal), epithelial-squamous metaplasia of the columnar epithelium is possible
  • True erosion – clearly defined edges of the ulcer, lack of epithelium.

Clinical picture

• • Ectropion
  • When viewed in the mirrors, the cervix within the uterine os is red (the normal color of the cylindrical epithelium).
  • true erosion
  • Light spotting (for example, after intercourse)
  • A clearly defined defect of the mucous membrane on the cervix, having a bright red color, bleeding with minimal physical impact.

Laboratory research

• • Exclusion of sexually transmitted diseases
  • Grom-stained vaginal smear
  • Sowing the contents of the vagina and cervical canal on nutrient media
  • Examination of native products of vaginal contents prepared with 0.9% solution of NaCl (excluding trichomoniasis)
  • Preparation of smears from the vagina and cervical canal in a solution of potassium hydroxide (excluding gardnerellosis)
  • Papanicolaou smears. With erosion, cells of the deep layers of the stratified squamous epithelium and leukocytes are found (in contrast to the results of a study with cervical dysplasia, which reveal cells of the cylindrical epithelium). Special Studies
  • Examination of the cervix in the mirrors
  • Colposcopy.

Differential Diagnosis

• • cervical dysplasia
  • cervicitis
  • Cervical cancer.

Treatment:

Drugs of choice

• • true erosion
  • Douching with 2% solution of sodium bicarbonate
  • If an infectious process is suspected, intravaginal administration of suppositories or tampons with antibiotics
  • With atrophy of the mucous membrane due to hormonal changes, estrogens are prescribed in the form of a vaginal cream (ointment) every day for 2 weeks, followed by estrogen replacement therapy
  • precautionary measures. When prescribing estrogens, special care will need to be taken if there is a history of estrogen-dependent neoplasm and a tendency to thrombosis. observation. Return visit to the doctor in a month.

Complications

• • Inflammatory processes with the addition of an infection
  • Severe inflammatory changes can lead to genital warts and cervical cancer. Course and forecast
  • Ectropion – unexpected recovery after childbirth or discontinuation of oral contraceptives
  • True erosion is an unexpected recovery or covering of the defect with a cylindrical epithelium with the formation of pseudo-erosion. Prevention. If possible, avoid manipulations that injure the mucous membrane of the cervix.

See also Cervical dysplasia, Gonococcal infection, Cervical cancer, Trichomoniasis, Chlamydia urogenital, ICD cervicitis. N86 Erosion and ectropion of the cervix