Ectropion is an inversion of the mucous membrane of the cervical canal.
Cervical ectropion is considered to be a complicated form of cervical ectopia , which combines pseudo-erosion and cicatricial deformity of the cervix. Normally, the cervical canal is covered with a cylindrical epithelium and is in an alkaline environment, with ectropion, the mucous membrane of the cervical canal turns into the vagina and enters the acidic environment, which contributes to the development of various complications, primarily the inflammatory process.
By origin, they produce acquired and congenital ectropion . Congenital ectropion is diagnosed in young, birthless women who have recently begun sex life. Congenital ectropion occurs very rarely and is the result of hormonal imbalance.
The leading cause of cervical ectropion is injury to it.
Cervical injuries that go unnoticed after childbirth or were improperly sutured lead to the development of the disease:
- complicated course of independent labor (cervical stiffness – “tight” neck, extensor insertion of the fetus, large fruit, etc.);
- surgery in the laboring period (delivery of the fetus to the pelvic end, the imposition of obstetric forceps, fruit-destroying operation), which leads to the formation of cervical ruptures (usually bilateral);
- artificial termination of pregnancy in the later stages (forcible dilation of the cervical canal);
- disturbed hormonal balance (functional origin).
As a rule, ectropion of the cervix is asymptomatic and is detected during a routine examination.
The disease is usually accompanied by inflammatory, atypical or dystrophic processes of the cervix uteri (pseudo-erosion, leukoplakia , endocervicitis ), which determines the clinical picture of ectropion . There are complaints about an increase in mucous or milk secretions (the appearance of muco-purulent evidence of an active inflammatory process of the genital organs), pulling pain in the lower abdomen, contact bleeding (after intercourse, douching), menstrual abnormalities ( inter- menstrual bleeding, increased menstrual flow).
To diagnose cervical ectropion is quite simple. Already during the examination of the cervix in the mirrors, the gynecologist can determine ectropion .
The bright red color of the mucous membrane, located around the external pharynx of the cervix, its impaired folding, scar deformity is determined.
To clarify the diagnosis is carried out extended colposcopy , if necessary, targeted biopsy of the cervix. The contents are taken from the cervix for bacterioscopic and cytological analysis. Women with congenital ectropion determine hormonal status (functional tests, blood test for sex hormones).
The gynecologist is involved in the treatment of cervical ectropion . The treatment of the disease has the following objectives:
- restoration of the anatomical structure of the cervix;
- treatment of the inflammatory process;
- correction of vaginal microflora.
The treatment of ectropion is selected individually, taking into account the age of the patient, concomitant diseases of the cervix and history (parity). Ectropion is removed by destructive methods and surgically. Destructive methods include:
- diathermocoagulation – treatment (cauterization) of the ectropion with electric current (the most painful and ineffective way);
- lazerovaporizatsiya – treatment of the pathological area with laser beams;
- cryodestruction – cauterization of the ectropion of the cervix with liquid nitrogen (suitable for unborn women).
After using destructive methods of treatment, which are carried out on an outpatient basis, the patient’s working capacity is maintained (that is, the treatment takes one day).
In case of severe cervical ectropion , surgical treatment in the hospital with the issuance of a sick-list for 7-14 days is indicated. Carry out conization of the cervix (removal of the conical section of the cervix in the circumference of the external pharynx) or reconstructive plastic surgery of the cervix.
In the postoperative period, sexual rest is prescribed for 6 to 8 weeks, douching and the use of tampons are prohibited.
Complications of cervical ectropion include:
- development of dysplasia ( cervical precancer );
- cervical cancer;
- inflammatory diseases of the pelvic organs ( endometritis, adnexitis );
- impaired reproductive function.
The prognosis for timely cured cervical ectropion is favorable.