Ectopia - "eversion", ectropion of the inner layer of the cervix, cylindrical epithelium, outward. As a result, the aggressive environment acts on the cells, causing their transformation, provoking inflammation and other unfavorable changes. Ectopia of the cervix can be both normal and pathological condition. What are the reasons for the formation of ectropion, what is different from erosion and should it be treated?
Causes of ectropion of the cervix
Many specialists do not separately distinguish ectopia( ectropy), but make all similarchanges on the neck in the category of "erosion". This diagnosis sometimes frightens women, although not always necessary some aggressive tactics, for example, surgical removal.
At the time of puberty, normal anatomy of the internal organs is established. The vagina gradually passes into the cervix in the area of the external throat. Next comes the cervical canal, which leads to the uterine cavity. This area is called the internal( uterine) pharynx.
Normally, in the area of the external pharynx there is a transitional epithelium - the transformation zone. Here most often there are all kinds of changes - from inflammation to malignant growth. Therefore, it is important in the analysis to collect tissue from this area. In some girls, the transformation zone shifts outward. As a result, the cylindrical epithelium, which normally should not be in the vagina and therefore has other properties, is visually detected as bright red areas. This is ectopia( ectropion).
We recommend reading the article about cervical ectopia of the cervix. From it you will learn about the signs of cervicitis and its effect on the cervix, the causes of the combined pathology and treatment.
And here it is more detailed about analyzes at erosion shejki uteruses.
Congenital
Normally, this condition can be observed in girls under 25 years of age, even without having a pregnancy. In this situation, the term "ectopia" is more popular.
It is believed that until this point, hormones have not stabilized definitively, and the growth of the cervix and the body of the uterus continues. Predisposing factors for the development of ectopia in young girls:
- Elevated estrogen content, as well as simply an imbalance of sex hormones.
- Anomalies in the development of genital organs. This is the most rare reason.
Acquired
In this case it is common to use the term "ectropion", although not all adhere to this gradation.
Acquired forms of pathology appear under the influence of some provoking factors. Most often, ectropion is formed in the following situations:
- Pregnancy and childbirth. To safely endure a baby, the hormonal background of a woman changes radically. This provokes changes in the epithelium of the cervix. Sometimes it is ectropion, in other cases - a decidual polyp.
The same happens if the tissues are poorly aligned or the seams are misplaced. In such situations, ectopy will be formed against the background of cicatricial deformity of the cervix. Risk factors are as follows:
- large fetus;
- wearing obstetric pessaries;
- complex delivery with the use of vacuum extraction, obstetric forceps, etc.;
- weakness of labor;
- fast delivery.
- Any manipulation on the cervix, which are accompanied by its fixation. This curettage( including instrumental abortion), hysteroscopy, repeated biopsies, etc.
Symptoms of ectropion of the cervix
Most often, the ectropion, innate and acquired, does not manifest itself in any way. And for some minimal signs the girl does not always pay attention. The main complaints and symptoms begin when an infection is attached or some other complications occur. In this case, the girl can notice the following:
- Periodical spotting spotting after sexual intercourse, physical exertion. This is due to the fact that the cells of the cylindrical epithelium are very easy to injure.
- Soreness during intimate relationships.
- Abundant mucous discharge, the number of which does not depend on the day of the cycle. This happens because on the ectropion the number of cells synthesizing such a secret increases.
- When the infection is attached, the nature of the discharge can vary - from yellowish and white to purulent, green, etc. It can appear itching and burning in the perineum, vagina and external genitalia. Also, periodic or even persistent pains in the lower abdomen, lower back and sacrum are attached.
Look at the video about the ectropion of the cervix:
Concomitant diseases of ectropion of the cervix
The presence of ectropion increases the likelihood of various pathological processes in the cervix uterus. The fact is that if there is ectopia, infection is easier and easier to gain a foothold. There is no specific cell barrier. Therefore, in girls with this pathology the probability of contracting HIV, hepatitis and other sexual infections is several times higher. Especially if the ectropion is complicated - with inflammation, etc.
Cervicitis
Cervicitis is an inflammation of the cervical canal of the cervix. Very often accompanies ectopia due to anatomical and physiological features of the disease.
In most cases, there is no clear clinical picture of the disease. Therefore, the main way to identify - the removal of smears from the cervix.
Keratosis( atypical degeneration)
If the ectopia runs for years on the background of inflammation( a woman, if not examined, may not know it), eventually the epithelium of the cervix is so transformed that it starts to cornify - harden. There is keratosis and subsequently leukoplakia. Not always a physician can visually detect this pathological process, but carrying out colposcopy, biopsy dispels all doubts.
Revealed keratosis or even leukoplakia is an indication for intensive treatment of ectropion.
Erosion formation
Often you have to deal with an erosion ectropion. The condition occurs due to inflammation, after childbirth, trauma, etc. In this case, competent conservative and often surgical treatment is also necessary.
Dysplasia
Against the background of ectopia( ectropion), the degree of dysplasia is more often developed. This pathology in a few years can be transformed into cervical cancer.
Than the ectropion of the cervix
is dangerousCongenital ectopy, under condition of good tests( smears, on STIs, etc.) can normally be in girls under 25 and even 28 years.
If the same is present at an older age or appears after childbirth, especially against the background of cicatricial cicatricial deformity, the risk of developing oncology-prone diseases is high. These include:
- leukoplakia,
- dysplasia.
Especially dangerous if they acquire atypical signs at the cellular level, which can be seen only when histologically examined material.
Cervical cancer does not occur in a year, it takes 5 to 10 years to form it. But it should be borne in mind that leukoplakia and dysplasia are not always detected immediately after their appearance. Therefore, it is not necessary to delay treatment, choosing the most effective methods.
Is pregnancy possible with an ectropion of the cervix
? By itself, pathology is not an obstacle to conception and gestation. If the ectropion has a complicated course during gestation, and the woman does not undergo proper treatment, the risk of various complications increases. Namely:
- Development of ischemic-cervical insufficiency and miscarriage.
- Cervicitis can lead to infection of the fetus, impaired functioning of the placenta.
- During childbirth, there is a higher probability of deep cervical rupture and bleeding.
However, "healthy ectopia / ectropion", especially in girls who have not yet given birth, does not threaten such complications.
Diagnosis of cervical ectropion
It is not difficult to detect the disease. Even with the usual gynecological examination, the doctor may notice abnormal redness on the surface of the cervix. And congenital ectopy has regular rounded forms, often compared with a coin. And the acquired ectropion can have absolutely different sizes and outlines. It all depends on the reason that caused this process.
All other methods are necessary in order to clarify the prevalence rate, the presence of complications( dysplasia, inflammation, etc.).The following are used:
- smear on oncocytology or PAP test;
- colposcopy;
- biopsy( rump, knife and any other types);
- RDV or hysteroscopy with concomitant pathology( eg, if there are fibroids, polyps, etc.);
- in the presence of signs of inflammation, an examination for STIs( better PCR) is performed, a smear on the flora.
Treatment of ectropion of the cervix
Treatment of ectopia can be performed both in conservative ways and with the help of surgical methods. The approach in each case is individual.
Concerning congenital ectopia, in the absence of any complications, it does not require any treatment. If any pathological process joins, then therapy corresponds to the disease.
Drug therapy
The recent recommendations of gynecologists-oncologists boil down to the fact that only a small part of ectopias and erosions should be subjected to surgical intervention. Experience has shown that often after such treatment a small part of the cells remains, but already deep in the cervix of the uterus. And the usual screening methods( smear on cytology) do not allow to detect a malignant process on time.
Conservative therapy is aimed at eliminating any complications in the presence of ectropion, for example, inflammation, and the like. The following drugs are used:
- Antibacterial and anti-inflammatory drugs, if smears or other studies have signs of infection. Optimal choice of the drug taking into account the sensitivity of microflora. It can be like tablets, candles and even injections( less often).
- Antiviral agents for the detection of HPV, HSV, CMV, etc.
- Immunomodulating and vitamin complexes, for example, interferons and the like.
- Means for the restoration of microflora.
- Wound healing and improving the reparative properties of tissue preparations. This is Dexpanthenol, sea buckthorn oil, etc.
Treatment with Solkagin
Surgical treatment
Operational techniques involve the complete removal of the altered zone. It is often performed in the following cases:
- in the presence of cicatricial deformity;
- if a woman does not plan a pregnancy in the near future;
- in the presence of dysplasia, leukoplakia.
The range of methods is wide, in each case, one should individually approach the choice of the most suitable. The following are used:
- Cryotherapy. Implies exposure to liquid nitrogen. Effective method with small restrictions and a relatively short rehabilitation period.
- Laser therapy is a painless and low traumatic procedure.
- Radiowave treatment with Surgutron. One of the available, effective ways to treat ectropion.
Often carried out not just moxibustion, and the removal of a portion of the cervix, as a rule, it is conization. In this case, the tissues are resected in the form of a cone with a wide base outward, and narrow - inward. Conization can be carried out with a conventional scalpel, or with a laser, with radio waves. Such removal of part of the cervix is carried out only with complicated flow of ectropion or with severe deformation.
Conization of the cervix
Can ectopy reappear after treatment or go on to the chronic form
Even after the most radical treatment, the probability of recurrence of ectopia( ectropion) is. This is provoked by birth, trauma( scraping, abortion) and all that leads initially to this pathology. This is why women are often asked to wait with surgical treatment if she is planning a pregnancy in the near future. And give preference to conservative methods.
Chronic ectopy does not happen. Simply if you do not treat this condition, you can pass only congenital forms on your own, and this is not always the case.
We recommend reading the article about cervical leukoplakia. From it you will learn about the causes and symptoms of the disease, the diagnosis and treatment methods.
And here is more about the treatment of cervical erosion without cauterization.
Ectropion( ectopia) - a fairly common condition of the cervix even in nulliparous healthy girls. Appears in both normal and pathological conditions. The management tactics depend on the presence of concomitant diseases, complaints and survey results. But this condition unambiguously requires regular competent observation for the timely exclusion of more dangerous diseases.