Endocervicitis is a disease in which there is an inflammatory process in the mucous membrane of the cervical canal. Endocervicitis mainly affects women of reproductive age and sexually active with frequent changes of partners.
Depending on the course of the disease, acute and chronic endocervicitis is isolated, and it should be noted that the acute process very quickly turns into a chronic phase.
According to the prevalence of inflammation, endocervicitis can be focal (local) and diffuse (prevalent).
Since endocervicitis is an inflammatory disease of the cervix, therefore, infectious agents can safely be attributed to the causes of its development. Often the disease develops against the background of activation of opportunistic microflora, which include streptococci , staphylococci , E. coli, fungi and other microorganisms.
Specific endocervicitis is caused by sexually transmitted microorganisms (gonococci, trichomonas, ureaplasmas , chlamydia ). But to start the inflammatory process in the cervix requires certain conditions, that is, predisposing factors:
- the presence of other inflammatory diseases of the genitourinary system ( colpitis, adnexitis, endometritis, cervical ectopia ); age.
- a large number of sexual partners;
- uncontrolled use of certain contraceptive methods (spermicides, acid douching);
- weakened immunity;
- mechanical manipulation of the cervix and uterus (abortion and curettage, introduction of the IUD, rupture of the neck during childbirth);
- premenopausal and menopausal age.
The clinical picture of the disease depends on the stage of the process and the pathogen, which triggered the development of endocervicitis.
Acute endocervicitis occurs vividly, patients complain of discharge (usually it is pussy and dull-slimy and thick), itching and burning in the vagina. Often women are disturbed by so-called “causeless” pains in the lower abdomen of a pulling or whining character.
If the infection rises above with acute endocervicitis, then inflammation of the uterus and / or appendages develops, which is characterized by increased pain syndrome, fever and the development of intoxication syndrome.
Chronic endocervicitis is either sluggish or asymptomatic. There is usually no pain, itching and burning too. The only thing that patients can pay attention to is the constant whites of a strange kind (thickish, dull, possibly mixed with blood or with an unpleasant smell).
When viewed in the mirrors, a hypertrophied and compacted cervix is seen, pseudo-erosion often develops (constant discharge irritates and injures the cervical mucosa). This picture gynecological examination characteristic of chronic endocervicitis.
Differential diagnosis of endocervicitis spend
- with ectopia (pseudoerosis) of the cervix: when examining the cervix in the colposcope, a characteristic picture of ectopia is visible – a cylindrical epithelium is visualized on the vaginal part of the cervix;
- with cervical cancer (the cervix is significantly hypertrophied, looks like cauliflower, “dug” and bleeds at any touch).
It is quite simple to diagnose the disease: it is possible to suspect endocervicitis already at the initial gynecological examination. In addition, additional instrumental and laboratory research methods are assigned:
- colposcopy (allows differentiation of the disease from other pathologies of the cervix uteri);
- Ultrasound of the pelvic organs (transabdominal and transvaginal) to identify concomitant pathology of the genital organs;
- microscopic examination of vaginal smears;
- smear on oncocytology from the cervix and from the cervical canal (exclude cell atypia);
- Wasserman reaction (exclude syphilis );
- blood for hepatitis and HIV infection;
- OAK and OAM (exclude the general inflammatory process in the body);
- blood clotting;
- PCR reaction to genital infections ( HPV , genital herpes , chlamydia and ureaplasmosis , cytomegalovirus infection);
- tank. seeding vaginal secretions on microflora and sensitivity to antibiotics.
First of all, endocervicitis therapy is aimed at combating and eliminating the infectious pathogen. Depending on the selected pathogen, antibacterial, antiviral or antifungal drugs are prescribed.
Acute endocervicitis is preferred to be treated with systemic drugs that have a complex effect, since local treatment contributes to the ascent of the infection.
In chronic endocervicitis, suppositories and tablets with multidirectional effects are used for local therapy: antimicrobial, antifungal, and antiprotozoal. It can be Poliginaks, Klion-D, Terzhinan.
In case of chlamydia and ureaplasma infection, tetracyclines are prescribed systemically (tetracycline, josamycin, doxycycline).
When viruses are detected, antiviral drugs are prescribed (acyclovir, zovirax), and antimycotic (flucostat, diflucan, orungal) for fungal infections.
Anti-inflammatory therapy lasts 7-10 days, after which they proceed to the 2nd stage of treatment – restoration of the normal microflora of the vagina. To do this, topically used acylact, bifidumbacterin, lactobacterin, hilak-Forte and oral immunocorrectors to restore immunity.
The second stage of treatment is 7-14 days.
Untreated endocervicitis may become chronic, causing cervical erosion or ascending infection (adnexitis, endometritis).
In extremely rare cases, an untreated disease causes cervical cancer.
The prognosis is favorable.