Inflammation of the cervical canal. Cervical canal of the cervix. Symptoms and manifestations of the disease
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The cervical canal of the cervix is a formation that is located in the thickness of the cervix and it performs many functions, the main one of which is the connection between the external and internal genital organs. In girls, it develops gradually and reaches normal size closer to puberty. Normally, the anatomy of the internal female genital organs is located as follows: the vagina passes into the cervix, which begins with the external uterine os, then the cervical canal of the cervix begins, which ends with the internal uterine os and passes into the uterine cavity. This anatomy allows you to regulate the process of opening the cervix in the first stage of labor. Thanks to the uterine os, the cervical canal begins to open from the internal uterine os, and then, like an hourglass, the external os opens. During the process of involution of the uterus in the postpartum period, first the internal uterine os closes on days 5-7, and then on the 21st day the external os of the cervical canal closes.
Such anatomical features contribute to these physiological changes already in the postpartum period, while the external os does not close completely after the first birth, and this contributes to the fact that repeated births go faster.
As for the histological structure of the cervical canal of the cervix, this also has its own characteristics. The vagina, which is also called the exocervix, is lined with stratified squamous non-keratinizing epithelium, and the cervical canal, or endocervix, is built of single-layer columnar epithelium. Between these zones there is normally a small border, which is called the transition zone, and it is normally located at the level of the external pharynx. This structure must be known in order to further understand the concept of “dysplasia” and the real threat of such a condition.
When examining a woman in the mirrors, you can see the cervix, or rather its external os, and knowing the anatomical features of this area and physiological changes, one can assume one or another dysfunction. It is also important for the woman herself to understand what a particular diagnosis means, in comparison with normal values.
The cervical canal during pregnancy has its own characteristics, which is associated both with the influence of hormones and with the further preparation of the birth canal for the birth of the fetus. Normally, the length of the cervix is 35-45 millimeters, and the diameter of the canal is 5 millimeters; any deviations in one direction or another pose a risk of complications. The length of the cervical canal closer to 32-35 weeks of pregnancy can decrease to 35 millimeters, and this is considered a physiological indicator, which is due to preparation for childbirth. If the length of the cervix is less than 35 millimeters, and this is often 20-25, before the 30th week of pregnancy, then they talk about such a thing as isthmic-cervical insufficiency. This is a risk of premature birth, so surgical treatment is carried out in the form of an obstetric suture - a pessary - which circularly fixes the cervical canal and prevents its premature opening. At 35-36 weeks the suture is removed. If not diagnosed in time, this condition can lead to premature birth. If the length of the cervical canal during pregnancy and childbirth is more than 45 millimeters, then they speak of a long cervix, which also has its negative consequences. During pregnancy, the normal attachment of the placenta may be disrupted, since the anatomical structure of the uterine pharynx is disrupted and the placenta may have a central, lateral or low attachment. A number of complications can also occur during childbirth. One of the manifestations may be prolonged labor, which lasts more than 12-14 hours in primiparous women and more than 9-12 hours in multiparous women. This occurs because the elongated cervix is not prepared before childbirth and opens slowly. A long and hard cervix does not smooth out, which leads to the unpreparedness of the birth canal. Therefore, contractions last a long time, lead to fatigue and exhaustion of the woman, and this condition can lead to secondary weakness of labor, which requires active tactics in the form of stimulation of pregnancy.
There may also be obstacles to the normal passage of the baby through the birth canal, since the elongated cervix is not dilated enough and the baby’s head or presenting part may remain in the same plane for a long time, which increases the risk of hypoxia and may require additional methods.
Another important feature of the cervical canal during pregnancy is its important protective function: during normal functioning of the epithelium of the cervical canal, the glands secrete a huge amount of secretion, resulting in the formation of a mucus plug that prevents pathogenic microorganisms from entering the uterine cavity. Just before childbirth, this mucous plug comes off.
Thus, it becomes clear that any disturbances in the anatomical structure of the cervical canal of the cervix can cause complications in the future, and therefore require timely diagnosis and treatment.
Diseases of the cervical canal
Pathology of the cervix can play a large role in the development of diseases, both during pregnancy and outside of pregnancy, even with possible infertility.
Conventionally, pathologies of the cervical canal can be divided into:
- anomalies in the structure and structure of the cervical canal;
- inflammatory diseases;
- neoplasms of the cervical canal.
Anomalies in the structure and structure of the cervical canal can be either congenital or acquired. Congenital anomalies, as a rule, are accompanied by concomitant anomalies of other genital organs - vagina, uterus. More often in women of reproductive age, acquired anomalies in the structure of the cervical canal occur, which arise as a result of adhesions, scars, and deformations after various surgical interventions. Among such pathologies are the circular canal of the cervix, narrowing of the cervical canal and its obstruction.
Circular canal of the cervix is a pathology in which the canal has a funnel-shaped shape due to the incorrect arrangement of muscle fibers in a circular direction. This pathology can occur with ruptures of the internal genital organs due to childbirth and their surgical treatment - suturing; in the future, this can be the cause of such a process if the tissues do not heal properly. This pathology may not manifest itself in any way due to its insignificance, that is, all physiological processes in the uterus and ovaries do not suffer. Problems may arise during the next pregnancy, when there may be incoordination of labor due to improper contraction of the muscle fibers of the circular canal of the cervix, which prevents the normal opening of the cervix. There is no treatment for this pathology as such, since these are structural changes that cannot be corrected. Treatment may be symptomatic if complications occur.
Narrowing of the cervical canal– its dimensions are less than 5 millimeters. In this case, a woman of reproductive age may already experience symptoms in the form of menstrual irregularities such as oligomenorrhea, since a narrow cervical canal can interfere with normal menstruation, which prolongs the period of menstruation with small amounts of discharge. As for pregnancy, this can be a direct threat to normal labor, in case of poor opening of the cervix and an indication for cesarean section. But there may also be a sufficient hormonal background with good dynamics of cervical opening and labor, then this condition is not dangerous. The extreme degree of narrowing of the cervical canal is its obstruction. Obstruction of the cervical canal of the cervix is a condition that already requires intervention, since there are complications. With this pathology, a mechanical barrier is formed, which in women of reproductive age can cause a delay in menstrual blood with its accumulation in the uterine cavity and the formation of an acute condition in gynecology - a hematometer. Then a clinical picture of acute abdominal pain, tension in the anterior abdominal wall occurs, and anamnesis data indicate a delay in menstruation for several weeks or several times in a row. Upon examination, you can determine the tension and soreness of the uterus. This is a condition that requires immediate surgical intervention.
Among the inflammatory diseases of the cervical canal of the cervix, endocervicitis is the most common - this is a pathology that is characterized by focal inflammation of the cervical canal. The etiological cause can be any pathogenic or opportunistic microorganism that enters through the ascending route. At the same time, inflammation occurs in the cervical canal with local symptoms in the form of purulent vaginal discharge, pain during sexual intercourse and at rest, and menstrual irregularities. In addition to local symptoms, general symptoms appear in the form of fever, intoxication, and changes in blood tests. Treatment must be comprehensive - local and general. Local treatment is douching with antiseptics, suppositories with antibiotics, and genital hygiene. General treatment involves the systemic use of antibiotics for a course of 7-10 days, as well as symptomatic therapy. At the time of illness and treatment, it is necessary to exclude sexual relations and treat the partner better at the same time, especially in the case of verification of specific urogenital flora.
Cervical neoplasms can be benign or malignant. Among benign diseases, polyps of the cervical canal of the cervix are the most common. This is a pathology that is characterized by the formation of a characteristic cauliflower-like structure on a stalk or a broad base. This structure is visible to the naked eye. The cause of this formation is most often the human papillomavirus, which affects the epithelial cells of the genital organs due to its high tropism. Polyposis of the cervical canal of the cervix is often multiple and is combined with other localization of polyps - in the cervix, vagina.
Among the benign formations of the cervical canal of the cervix, a cyst is also found. This is a thin-walled formation that has a thin capsule, liquid contents inside and a tendency to grow. Since the cervical canal has a limited diameter, complications often arise in the form of cyst rupture or infection. Then it is also necessary to carry out complex treatment. The course of such a cyst, if small in size, may be asymptomatic, then it may simply be an accidental finding on an ultrasound. Sometimes the contents of the cyst can be menstrual blood, then they speak of an endometrioid cyst. Treatment tactics can be surgical if such a formation is accidentally found.
Malignant tumors may include cancer of the cervical canal of the cervix. This pathology does not occur as often as cancer of other localizations, but it is quite dangerous in terms of its asymptomatic course. Therefore, such cancer is often diagnosed already at the stage of metastasis to other organs. In the first and second stages of the disease, treatment is radical surgical with extirpation of the uterus and regional lymph nodes, as well as preoperative and postoperative radiation therapy. In later stages, treatment is combined.
These are the main diseases that can be localized in the cervical canal of the cervix.
Diagnosis of pathology of the cervical canal of the cervix
Diagnosis of these pathologies must be comprehensive to exclude other conditions and correct treatment.
First of all, it is necessary to listen to complaints with full detail of symptoms. It is also necessary to clarify the anamnestic data to determine the date of the last menstruation. Examination in the mirrors allows you to see only the external os of the cervical canal, but if there are polyps in the vagina, then we can assume that there is also polyposis of the cervical canal of the cervix. There may also be bloody discharge when a cyst of the cervical canal of the cervix ruptures or purulent discharge when it suppurates.
An important stage in the vaginal examination of a woman in the speculum is taking two types of smears - for bacterial flora and for histological examination. A smear from the cervical canal is taken for screening from each woman with a special brush. The correct technology must be followed - a smear is taken from three zones of the cervix - the endocervix, the intermediate zone and the cervical canal, that is, all three types of epithelium must be present. Next, all smears are sent to the laboratory for cytology and histology.
Operations on the cervical canal
Surgical interventions on the cervical canal are not performed very often, since it is a very difficult to reach place. Minimally invasive interventions are more often performed for certain indications. In case of anomalies in the structure of the cervical canal of the cervix, such as narrowing or obstruction of the cervical canal, a special procedure is performed - bougienage of the cervical canal. This is an intervention that consists of expanding the canal with a special tool - a bougie. This is most often a metal tool, which is selected by number, which corresponds to its size, and starting from the smallest to the widest. It is often necessary to repeat the procedure several times, since once is not enough. This intervention is effective for small degrees of narrowing.
Among the surgical methods for treating pathologies of the cervical canal of the cervix, in this case with polyps of the canal, cryodestruction, burning with liquid nitrogen, and laser burning are used. Cryodestruction method consists of using cold, which freezes the polyps and they fall off. This procedure is repeated 1-2 times a week until the polyp completely disappears. Cauterization with liquid nitrogen works on the same principle.
Laser therapy- this is the use of a laser beam with a scalpel-type mechanism of action.
Curettage of the cervical canal can be carried out for both diagnostic and therapeutic purposes. Diagnostic curettage of the cervical canal is carried out if an ectopic pregnancy is suspected or if a foreign body is suspected. In this case, it is important to send all the obtained material for histological examination. Therapeutic curettage of the cervical canal is carried out in the postpartum period when complications occur or if an inflammatory focus in the uterus is suspected. This method of treatment can also be carried out if more minimally invasive methods are ineffective in treating polyposis or if it is multiple in nature.
The cervical canal of the cervix is a formation that has important functions in the process of fertilization, pregnancy and birth of a child, as well as in the pathology of the female reproductive system. It is necessary to know some features of the anatomical structure of the cervical canal of the cervix for timely diagnosis of pathology and determination of possible treatment tactics.
The cervical canal is considered an important element of the reproductive system.
Many women begin to think about its presence and functions only during pregnancy, when the course of pregnancy depends on its condition. Like any organ, this canal is subject to various diseases, of which polyps of the cervical canal and inflammation of the cervical canal are particularly prominent. To ensure women's health and maintain the reproductive system in good condition, all diseases in this organ must be identified in a timely manner and measures taken to treat them.
Anatomical and physiological features
From an anatomical point of view, the cervical canal is a fusiform portion of the uterine cervix, connecting the vagina with the uterine cavity through the external and internal openings (throat). Inside, this canal is lined with cylindrical epithelium, capable of secreting a mucous composition - cervical mucus or hydrogel, the basis of which is glycoproteins. The length of the cervical canal in normal condition (in a nulliparous woman) is on average 35-45 mm, and the diameter is about 6.5-8.5 mm. After childbirth, under various influences, as well as under the influence of a number of factors, these parameters may change. The internal and external pharynx create natural narrowings to hold the plug inside the canal, and during pregnancy they also hold the fetus.
The physiological tasks solved by the cervical canal are very important for the functioning of the reproductive system and the protection of the uterine cavity from infection. The most important function is the creation of a protective mucous plug in the uterine cervix, which prevents infection. In this case, the plug has a porous structure, and the pores tend to expand during the ovulation period, which ensures the unhindered passage of sperm and eggs.
The production of mucus in the epithelium is a hormone-dependent process. The amount of secretion and its composition depend entirely on the supply of female hormones, i.e. regulated by the pituitary gland of the brain. The composition of mucus varies significantly depending on the stage of the menstrual cycle. At the beginning of the cycle, the secreted composition has a pronounced acidic environment, which is destructive for most pathogenic microorganisms, which prevents their penetration into the uterine cavity. In addition, during this period, surviving sperm lose their motility and ability to fertilize.
The picture changes dramatically during ovulation, when estrogen levels increase significantly. The mucus produced becomes alkaline and has a liquid consistency, which provides sperm with free access to the eggs for several days, i.e. Maximally supports the fertilization process during ovulation. Upon completion of this stage, the active production of progesterone begins in the ovaries, which turns cervical mucus into a viscous mass. The resulting plug becomes strong and reliably closes the entrance to the uterine cavity, thereby protecting the embryo from any infections.
Features of the canal during pregnancy
The role of the cervical canal increases significantly during pregnancy. The health of the developing fetus and the course of pregnancy largely depend on its condition. From the very beginning of the conception process, the cervical canal provides the task of a reliable locking element. On the cervix there is a ring formed by muscle tissue, which normally allows one to quite reliably cover the opening of the canal. It is the narrowing in the area of the pharynx that holds the fetus during the entire pregnancy and does not allow a miscarriage to occur. High muscle tone is maintained until birth.
The mucus plug during this period protects the fetus from infections. The plug comes out shortly before birth. At the same time, the time of this process is of a purely individual nature and is not an indicator of any violations. Before childbirth, the length of the cervical canal is shortened, and the diameter increases by 25-35 mm, reaching full opening (about 100 mm) during childbirth. At this moment, the uterus and vagina become a single path for the exit of the fetus.
One of the types of dangerous pathology during pregnancy is the expansion of the cervical canal and pharynx. As a result of this phenomenon, an important function is lost - retaining the embryo in the uterine cavity, which creates a real threat of miscarriage. Often such an anomaly is recorded in the 15-19th week of pregnancy, when active growth of the fetus and its movement occurs. Main causes of pathology:
- excessive formation of male hormones that reduce muscle tone of the cervix;
- pregnancy with several embryos;
- injuries and abnormal fetal development.
The threat of miscarriage in this case is usually eliminated through inpatient treatment. In particular, drug therapy is used to strengthen the tissues of the uterine cervix. Quite often, a reinforcing ring is installed - a pessary, which is subsequently removed before childbirth (36-38 weeks). Sometimes surgical intervention is used by applying sutures.
Possible congenital pathologies
Significant problems in terms of reproductive functions in women can arise from congenital defects of the cervical canal. The practice of gynecology distinguishes 2 typical areas of congenital pathologies: the formation of two canals and obstruction or atresia of the canal. In the first case (very rare), a dual reproductive system occurs with duplication of the uterus and its cervix. In this case, a normal pregnancy is possible, but if infertility develops, only surgical treatment is possible.
Canal atresia is a lack of communication between the vagina and the uterus, which leads to infertility and the accumulation of menstrual fluid in the uterine cavity, up to its rupture. Both atresia and blockage (obstruction) of the canal are considered dangerous pathologies, fraught with serious complications. This pathology requires surgical intervention.
Common pathologies
The functions of the cervical canal can be disrupted by various diseases and processes that develop under the influence of external and internal factors. The following characteristic pathologies can be identified:
- Inflammatory diseases. The most common representative is endocervicitis - an inflammatory reaction of the mucous membrane of an infectious type. The causative agents can be various pathogenic bacteria, viruses and fungi. Most often, the etiological mechanism is based on a sexually transmitted infection (gonorrhea, chlamydia). Bacteria – staphylococci and streptococci – can also provoke the disease. The exact pathogen is determined by testing strains for bacterial culture from the cervical canal and smear microscopy. Treatment is based on the prescription of an antibiotic.
- Tissue stenosis. Stenosis of the canal is caused by its critical narrowing, blocking the passage. The actual lumen can decrease so much that reproductive functions are completely disrupted. The most common causes of this disease are postoperative complications, trauma, inflammatory processes and lack of proper treatment of the inflammatory reaction.
- Polyps in the cervical canal. This pathology is quite common in this location. Polyps are benign formations that rarely cause cancer. However, their presence causes obstruction of the canal and often causes infertility. The only treatment option is surgical removal of the cervical canal polyp. At the same time, when a polyp of the cervical canal is treated (removal), reviews come in large numbers with a positive assessment of the effectiveness of the method. It should be taken into account that in addition to a true polyp, pregnant women sometimes have a false formation - the so-called decidual polyp. This temporary formation, caused by a sharp hormonal imbalance, does not require special treatment, and disappears on its own when hormonal levels normalize.
- Cervical tumors. In addition to polyps, other tumor formations can form in the cervical canal: fibroids, myomas, hemangiomas, fibromyomas, leiomyomas. They are also benign in nature. Symptoms of such formations may include the following manifestations: spotting, urinary disturbances, intestinal problems, pain. The degree of manifestation depends on the growth of the tumor and the degree of channel occlusion. Treatment is surgery. In addition to benign tumors, adenocarcinoma, which is an oncological pathology, can develop. This disease is highly aggressive.
- Cyst. Cystic lesions of the cervical canal (Nabotov cyst) are benign neoplasms. Its etiology is associated with blockage of the iron ducts, resulting in the formation of isolated cavities filled with mucous secretion.
Study of leukocyte content
One of the informative methods for diagnosing the disease is to study smears of cervical mucus for the content of leukocytes in it. When leukocytes are detected in the cervical canal, the norm is about 10-12 pieces per smear. An increase in the level of leukocytes indicates the development of an inflammatory reaction. In this case, an active inflammatory process can cause an increase in their number to 120 units. The largest amount is found in sexually transmitted infections. It should, however, be taken into account that a certain increase in their level is recorded during pregnancy.
A decrease in the number of leukocytes below normal also cannot be considered a normal phenomenon, since it indicates a decrease in protection and vaginal atrophy. In older women, the level of leukocytes in a smear can drop to almost 0.
Some methods of treating pathologies
Quite often, when conducting diagnostic studies and treatment, curettage of the cervical canal is prescribed. As a therapeutic procedure, this technology is used for hyperplasia to remove polyps before surgery. Currently, given the high risk of injury, such a procedure is rarely used for treatment, but continues to be widely used for sampling for histological studies.
One of the methods of surgical treatment is bougienage of the cervical canal. The essence of the technology is to normalize the patency of the canal using a special device, which is called bougie. The procedure is a surgical procedure and is performed under local anesthesia.
Inflammatory diseases of the genital organs occupy a leading position among the main causes of infertility in women. They are accompanied by uncharacteristic vaginal discharge and discomfort in the lower abdomen. Many representatives of the fair sex ignore such symptoms, attributing them to stress or hypothermia. Among all the pathologies of the female reproductive system, inflammation of the cervical canal takes “honorable” place. This is a common disease that responds well to treatment. However, neglecting the doctor’s recommendations ends in infertility for many women. How else is the disease dangerous?
The cervical canal connects the vagina to the uterine cavity. It has the shape of a cone or cylinder, and its length does not exceed 4 cm. The cervical canal of the cervix performs two functions: it protects against infections and promotes the advancement of sperm during ovulation. Under the influence of various external and/or internal factors, its mucous membrane can become inflamed. This disease is called endocervicitis. It does not pose a danger to women's health if diagnosed and treated promptly. Otherwise, the pathological process can lead to serious complications.
Main causes of endocervicitis
Inflammation of the cervical canal can have an etiology of both infectious and non-infectious nature. In the first case, various pathogenic microorganisms (candida fungi, streptococci, chlamydia, gonococci, papillomas and others) act as factors provoking the disease. Most often they enter the body through sexual intercourse. However, infection is also possible through the digestive tract or lymphatic system. Non-infectious inflammation of the cervical canal in most cases is caused by external influences or congenital anatomical defects. This group of causes includes trauma, radiation exposure, and tumor formations.
Separately, factors that indirectly influence the development of the inflammatory process should be considered:
- decreased local immunity;
- frequent stress;
- menstruation;
- damage to uterine tissue due to abortion, installation of an IUD.
Normally, the mucus plug is always located in the lumen of the cervical canal. It protects the uterus from pathogenic flora. Due to various medical manipulations, the cork is deformed and its chemical composition changes. As a result, any infection freely penetrates the uterine cavity, causing inflammation. Pathogenic flora can also enter the cervical canal along with menstrual blood. Therefore, during this period it is necessary to pay special attention to genital hygiene.
Symptoms and manifestations of the disease
Inflammation of the cervical canal is characterized by a certain clinical picture. First, an unpleasant itching and burning sensation appears in the genital area. Then the symptoms are complemented by abdominal discomfort and heavy discharge. Lack of timely treatment of the acute form of the disease is dangerous due to its transformation into a chronic one. In this case, the described symptoms disappear. However, this does not mean that the woman recovered without medical care. The body thus adapted to the infection, and the disease became latent. If therapy is neglected at this stage, the inflammation can spread to neighboring organs. The prolonged course of the disease leads to changes in the tissues of the uterine canal. As a result, doctors diagnose erosion or dysplasia. The inflammatory process changes the qualitative composition of the mucus produced in the cervix, which threatens infertility.
Establishing diagnosis
Symptoms of inflammation provide grounds for conducting a diagnostic examination, which makes it possible to differentiate the pathology from other diseases. What tests need to be taken?
- Bacterial culture from the cervical canal to determine the causative agent of the pathology.
- Colposcopy allows you to evaluate the affected area.
- Cytological examination helps determine the condition of epithelial cells.
- Smear microscopy is necessary to identify pathogenic flora and assess the inflammatory process (its presence is confirmed by leukocytes in the cervical canal).
Only after a complete examination of the patient and identification of the pathogen can the doctor make a final diagnosis and select therapy.
Treatment with drugs
The treatment regimen for inflammation depends on its severity and the type of pathogen. Therefore, even at the diagnostic stage, bacterial culture from the cervical canal is prescribed. Drug therapy solves several problems simultaneously: eliminating pathogenic flora, symptoms of the disease, and preventing relapses. Most often, to eliminate these problems, doctors prescribe the universal antibacterial drug Polygynax.
Additionally, medications are prescribed to restore immune defense. If the cause of the disease is a fungal infection, antibiotics of the tetracycline group (Doxycycline, Monomycin) and macrolides (Erythromycin) are used for treatment. When Trichomonas is detected, the use of antiprotozoal agents is considered appropriate. Restoring vaginal microflora involves the use of drugs based on lactobacilli. The doctor selects the medications for treatment and dosage, taking into account the patient’s health condition. Self-use of medications is not recommended. The duration of the course of therapy depends on the severity of the pathological process.
Curettage of the cervical canal
Usually, to confirm the inflammatory process in the cervical canal, a vaginal smear is taken from the patient, and then sent for histology. Sometimes the cause of the disease cannot be determined. In such cases, a curettage procedure is used, during which the top layer of the endometrium is removed with a special instrument for subsequent examination. Over time, it is restored, so all manipulations are safe for the patient’s health. As a rule, curettage of the cervical canal is prescribed if the malignant nature of the disease is suspected.
Ways to prevent inflammation
To prevent the development of pathology, you should be examined by a gynecologist twice a year. If any of the listed symptoms appear, you should consult a doctor. An examination in a gynecological chair and a series of tests can confirm inflammation of the cervical canal. Treatment is prescribed after a diagnostic examination. The doctor cannot confirm the diagnosis and prescribe medications based solely on the patient’s complaints. You can avoid this disease if you follow fairly simple rules:
- use condoms during sexual intercourse;
- do not neglect personal hygiene;
- undergo regular examination by a gynecologist;
- have one regular sexual partner.
Inflammatory diseases of the reproductive system in women are quite common. These pathologies are considered the most common in gynecology. Inflammation of the cervical canal of the cervix occurs mainly in women of reproductive age from 20 to 40 years.
Inflammation of the cervical canal is called endocervicitis. The disease is infectious in nature and is often accompanied by inflammation of the uterus, appendages and vagina. Let's look at the causes and symptoms of inflammation of the endocervix and how it is treated.
Anatomy
Before understanding the causes and treatment of inflammation of the cervical canal, it is necessary to understand what it is and where it is located. The cervical canal or endocervix connects the uterus and vagina, and it is located inside the cervix.
The cervical canal is involved in the process of fertilization. Mucus forms inside the cervix, which changes its viscosity depending on the day of the cycle. So on normal days, mucus is viscous and has poor permeability, but during ovulation it becomes more liquid and porous, making sperm penetration possible.
Passing through the cervical canal and mucus, sperm are filtered. Thus, only the most mobile individuals reach the uterus, while the rest are eliminated and die.
Subsequently, the cervical canal will serve as the birth canal. It must be closed throughout the entire pregnancy, and during labor the endocervix expands to allow the baby to pass through.
Inflammation of the cervical canal disrupts all these functions. If inflammation occurs during pregnancy, the birth process may be disrupted, as well as infection of the fetus during childbirth.
In the absence of proper treatment, the pathology can become chronic, affecting the uterus and appendages. The consequence of such a violation can be infertility, and the risk of miscarriage and cervical cancer also increases. Timely treatment of endocervicitis will help to avoid all these complications.
Causes
The cause of inflammation of the cervical canal of the cervix is infection. The inflammatory process can be triggered by opportunistic microorganisms, as well as microorganisms that cause STDs, for example, chlamydia, trichomonas, etc.
There are also a number of factors that increase the likelihood of developing the disease:
- Inflammatory processes in the ovaries (adnexitis), uterus (endometritis), vagina (colpitis), bladder (cystitis). In this case, the infection migrates from another organ to the cervical canal.
- Inflammation can also be caused by trauma to the cervical canal, which occurs during abortion, natural childbirth and other manipulations.
- Endocervicitis can be a consequence of hormonal disorders, in particular with a lack of estrogen, this is often observed during menopause.
- The reason may be the installation of an intrauterine device, injury to the cervix when douching with acid, too active sex and the use of low-quality condoms.
- Prolapse of the vagina and cervix.
- Promiscuous sex without using condoms. In this case, the risk of STIs and inflammation of the cervical canal greatly increases, respectively.
Improper lifestyle and weakened immunity contribute to the development of inflammatory diseases. If a woman eats poorly, smokes, abuses alcohol, or suffers from overwork, then she is at risk.
Symptoms
Inflammation of the cervical canal is not accompanied by severe symptoms, with the exception of the gonorrheal form, in which ulcers form in the cervical area. Typically, the disease is characterized by a change in discharge; it becomes cloudy, more abundant, and may have an unpleasant odor.
If inflammation of the cervical canal is accompanied by damage to the vagina, then the woman is bothered by itching, burning, and pain during sexual intercourse. If the uterus and appendages are affected, pain in the lower abdomen and lower back may occur, body temperature may rise, and general condition may worsen.
To detect inflammation of the cervical canal at an early stage, you need to regularly see a gynecologist. The specialist will be able to promptly detect that the cervix is swollen and determine the inflammatory process. If a woman is not cured in time, the disease becomes chronic.
In the chronic form of inflammation of the cervical canal, no pronounced symptoms are observed. The discharge is similar to normal, the woman may not be bothered at all. The danger of such an asymptomatic course lies in the manifestation of complications in the form of pseudo-erosion, the transition of the inflammatory process to neighboring organs and the development of infertility.
Diagnostics
It is impossible to diagnose inflammation of the cervical canal on your own, since the disease does not have specific symptoms. The pathology can be detected by a doctor during a gynecological examination in the speculum. The gynecologist will see poor discharge, as well as a swollen cervix. To confirm the diagnosis, an examination is carried out:
- Microscopic examination;
- Cytological examination;
- Cervical biopsy;
- Bacterial sowing;
- PCR diagnostics for identifying specific pathogens.
In a comprehensive diagnosis, the patient is recommended to undergo a pelvic ultrasound to assess the condition of the uterus and appendages. The method allows you to exclude inflammatory processes, benign and malignant (precancerous) neoplasms in the pelvic area.
Treatment
Treatment of inflammation of the cervical canal is conservative. Therapy with antibiotics and other antimicrobial agents is prescribed. Drugs are selected individually, depending on the identified pathogen.
After eliminating the infection, it is necessary to restore the natural microflora, for this purpose the introduction of lactobacilli into the vagina is prescribed. An example of such a drug would be Lactonorm, as well as Vagilac. The capsules contain beneficial bacteria and help restore the vaginal microflora.
To strengthen the immune system, proper nutrition is prescribed, as well as taking immunostimulating drugs. If necessary, the doctor prescribes physiotherapeutic treatment, for example, a magnet, UHF, etc. If the disease is combined with oncology, then surgical intervention may be indicated.
Prevention
To avoid inflammation of the cervical canal, the following recommendations must be followed:
- avoid promiscuous sex, protect yourself with a condom;
- lead a healthy lifestyle, give up alcohol and smoking;
- strengthen immunity;
- be regularly examined at the antenatal clinic.
A healthy lifestyle and regular examination by a gynecologist are the surest ways to prevent the development of inflammatory processes throughout the body, including the cervix.
Inflammation of the cervical canal is cervicitis, a disease that women often encounter due to the peculiarities of the anatomical structure. The pathogen easily penetrates upward into the pelvic organs when the balance of the vaginal microflora is disturbed. If treatment is not started on time, the infectious process spreads further to the cervix (endocervicitis), which can affect reproductive function.
Causes of the disease
The main cause of cervicitis is weakened immunity. The body's defenses are reduced by the following factors:
- Nonspecific infections that occur during the development of general inflammatory processes and the introduction of pathogenic microorganisms through the bloodstream or lymph flow.
- Sexually transmitted sexually transmitted diseases (gonorrhea, trichomoniasis, ureaplasmosis, etc.).
- Lack of personal hygiene. If you rarely change tampons or pads during menstruation, the bloody discharge stagnates, which provokes an increase in the activity of pathogenic microflora and the development of vulvovaginitis. In case of inept washing from the anus, E. coli or Pseudomonas aeruginosa are introduced into the vagina.
- Diseases of the genitourinary system: cystitis, urethritis, colpitis, adnexitis.
- Therapeutic and diagnostic procedures: abortion, gynecological curettage, installation of an intrauterine device.
- Contraceptives in the form of suppositories or tablets with spermicides.
- Hormonal changes. Pregnancy, since due to hormonal imbalance the nature of the secretion produced changes. Natural aging - estrogen production decreases, the muscles that support the uterus and cervix weaken.
- Sexual promiscuity, neglect of barrier methods of protection.
- Unsuccessful experiments during sexual relations.
Under the influence of the above factors, the balance of the vaginal microflora is disrupted, the immune system cannot suppress the increased number of opportunistic and pathogenic microorganisms and fungi, and the area of the cervical canal becomes inflamed.
Main symptoms
The clinical picture depends on the cause of the disease and the type of pathogen. Against the background of infection with gonococci or trichomonas, the symptoms are pronounced, cervicitis occurs in an acute form. And with chlamydia, pathology is often detected during a routine gynecological examination, since the condition worsens slightly. A woman may notice a change in the structure of the vaginal secretion and the appearance of an unpleasant odor. Painful sensations rarely occur.
Symptoms of acute cervicitis:
- change in consistency and amount of discharge;
- discomfort in the intimate area - itching, burning;
- hypertrophy of the vaginal mucosa and swelling of surrounding tissues;
- aches in the sacral area and nagging pain in the groin;
- pain during coitus;
- frequent urination.
All signs resemble inflammatory processes of gynecological organs in the initial stage.
3–5 days after the introduction of the pathogen, the acute symptoms smooth out, the amount of discharge decreases, and the woman tries not to pay attention to minor short-term pain in the lower abdomen that occurs periodically. The improvement can be mistaken for self-healing, but the relief of the condition is explained by the fact that inflammation of the cervical canal has become chronic. Against the background of unfavorable factors, relapse occurs and complications develop.
Diagnostics
A preliminary diagnosis is made during an examination. The clinical picture for diseases of the reproductive organs is typical, therefore laboratory and hardware examinations are carried out to confirm the diagnosis:
- General blood analysis. An increased number of leukocytes indicates general inflammation, an increase in ESR (erythrocyte sedimentation rate) indicates a chronic process. Negative test results indicate the spread of infection throughout the body and possible damage to the reproductive system.
- Smear scraping from the cervix. Using the biomaterial, a bacteriological test is carried out, by which the type of pathogen is identified, and the intensity of inflammation is determined by the number of leukocytes in the field of view. A cytological examination of epithelial cells is performed.
- Colposcopy may be required - an examination using a colposcope equipped with optical mirrors and lighting. The inflammatory process is indicated by a red border on the cervix and swelling of the surrounding tissues.
If the diagnosis is confirmed, diagnostic measures are supplemented. Blood is taken from a vein to determine the sensitivity of the pathogen to antibiotics, a PCR test is prescribed - polymerase chain reaction if a specific form of the disease is suspected, and a vaginal ultrasound. They take a urine test, blood from a vein for hepatitis, the Wasserman reaction, and for antibodies to HIV infection. If erosion is detected during examination, a tissue sample is taken for histological examination.
Inflammation therapy
It is advisable to begin treatment in the acute phase, preventing cervicitis from becoming chronic. When drawing up a therapeutic regimen, the etiology of the pathogen and the factors that provoked the onset of the inflammatory process are taken into account.
- To destroy pathogenic microorganisms and suppress the vital activity of opportunistic flora, antibacterial, antifungal, antiprotozoal or antiviral agents are used.
- With cervicitis against the background of menopause, hormonal medications may be required.
- When a human papillomavirus infection is detected, cytostatics are prescribed. Various methods are used to remove papillomas, including cryodestruction, cauterization, excision with a radioknife or surgical scalpel, and laser therapy.
- For targeted treatment, combined antimicrobial and anti-inflammatory drugs are used in the form of suppositories and tablets.
- Local drugs are added after the acute inflammation has been eliminated. They are necessary to restore the acid-base balance of the vaginal microflora. Suppositories with lactobacilli and bifidobacteria are used, along with anti-inflammatory and soothing medications that stimulate the restoration of the mucous membrane.
- To strengthen the immune system, immunomodulators, probiotics and prebiotics, and vitamin-mineral complexes are introduced into the therapeutic regimen.
Traditional medicine helps speed up recovery. To suppress pathogenic microflora, decoctions and infusions of natural antiseptics are used: chamomile, oak bark, sage, St. John's wort. To increase the body's defenses, currant leaves, rose hips, and golden mustache are brewed. You can buy tincture of ginseng or lemongrass at the pharmacy. When introducing traditional medicine recipes into a therapeutic regimen, it is necessary to consult with your doctor.
If the inflammatory process of the cervical canal provokes erosive damage, then surgical intervention is necessary. The methods are the same as for removing papillomas.
To make sure that cervicitis has not become chronic, a month after the end of treatment, a woman needs to take smears from the vagina and cervical canal. Sometimes the gynecologist decides to repeat the colposcopy.
Complications
The consequences of cervicitis can be dangerous complications. Pathogenic microflora ascends into the urethra and cervix and spreads to the pelvic organs. Endometritis, adnexitis, cystitis, urethritis, and pyelonephritis develop.
The combination of an acute process of the cervical canal with specific (venereal) infections can cause inflammation of the Bartholin glands, damage to the reproductive organs, and secondary infertility.
Erosion provokes the development of cervical dysplasia, a precancerous condition. The risk group includes patients whose cervicitis is combined with HPV (human papillomavirus). In this case, the probability of malignant degeneration of the cells of the cervical canal mucosa reaches 5%.
Disease prevention
- Follow the rules of intimate hygiene.
- When having sexual contacts with unfamiliar partners, use barrier methods of contraception.
- Try to avoid abortions.
- Visit a gynecologist regularly - at least 2 times a year.
The appearance of pain in the lower abdomen or sacral area, a change in the nature of discharge, frequent urination or discomfort in the intimate area is a sufficient reason to seek medical help. The earlier the disease can be identified, the easier it is to restore health.
Inflammatory processes of the genital organs are quite often diagnosed during an examination by a gynecologist. Typically, the appearance of symptoms is caused by infectious tissue damage and the gradual spread of inflammation due to the anatomical proximity of the organs of the reproductive system.
The favorite localization of the inflammatory process is the cervix. This part of the uterus acts as a kind of barrier, as it is a connecting link between the vagina and the organ cavity.
The cervix is the object of close attention of the gynecologist. Upon examination, only the vaginal part is visible, which is pink in color. The part of the cervix adjacent to the vagina is covered with flat multilayered cells, which give the epithelium a peculiar smoothness.
To a greater extent, the protective function of the cervix is provided by the cervical canal. The cervical canal directly connects the sterile uterine cavity and the vagina, which contains a significant number of microorganisms. To prevent pathogenic flora from penetrating into the uterus, the glands of the cylindrical single-layer cells of the cervical canal produce protective mucus.
However, in the presence of certain unfavorable factors, the defense mechanism may weaken, causing inflammation in the cervix. This inflammatory process can cover both part of the cervix and its entire surface.
If inflammation develops in the cervical canal, they speak of endocervicitis. As a rule, inflammation of the cervical canal has pronounced symptoms. Infectious agents enter the cervical canal, causing pathological changes in the epithelium. If a woman at this stage ignores the symptoms and does not undergo treatment, the inflammation becomes chronic.
During the acute phase, symptoms of tissue hyperemia and its subsequent destruction occur. Most often, there is active production of mucus, which causes heavy discharge. Their nature depends on the pathogen that caused inflammation of the cervical canal.
Over time, the inflammatory process spreads to deeper layers, while signs of healing appear on the surface of the mucosa. This phenomenon does not indicate recovery, but indicates chronic inflammation of the cervical canal.
Reasons for development
The inflammatory process is caused by infection. Experts note that microflora can be divided into two large groups:
- opportunistic microorganisms;
- pathogenic flora.
Conditionally pathogenic or nonspecific microflora enters the cervical canal primarily from the vagina. It is possible for bacteria to penetrate along with the lymph flow, as well as with the blood flow from the urinary tract. It is possible that the infection may spread from the rectum. Opportunistic microflora can be represented by:
- Candida mushrooms;
- coli;
- staphylococcus;
- enterococcus;
- Proteus;
- streptococcus.
Nonspecific flora is normally found on mucous membranes and skin. However, during inflammation, active growth of opportunistic microorganisms is observed, which causes the appearance of characteristic symptoms.
Pathogenic or specific microflora is characterized by the following pathogens:
- gonococcus;
- chlamydia;
- mycoplasma and ureaplasma with intensive growth;
- Trichomonas.
When an infection occurs, inflammation in the cervical canal does not always develop. The appearance of an inflammatory process is possible when the epithelium of the cervical canal and the body as a whole are exposed to unfavorable factors:
- cervical injuries as a result of difficult childbirth, abortion, curettage and other surgical procedures;
- decreased immunity;
- early intimate life;
- lack of a regular sexual partner;
- ignoring barrier methods of contraception;
- frequent use of topical medications, including spermicides;
- age-related changes in the tissues of the cervical canal;
- cervical prolapse.
The development of inflammation of the cervical canal can be caused by a complex of negative factors. The effectiveness of treatment largely depends on eliminating the factors that provoke inflammation.
Symptoms
The appearance of symptoms is associated with the characteristics of inflammation. The prevalence of inflammation, the stage of the pathological process and the causative agent of the disease are essential.
Usually the inflammation begins acutely. The symptoms do not differ from those of other inflammatory diseases. Symptoms of the acute phase of endocervicitis include:
- abundant purulent or mucous discharge, which may be brown, yellow, green in color, have an unpleasant odor and different consistency;
- discomfort, burning, dryness in the mucous membrane;
- discomfort during intimacy;
- pain in the lower abdomen;
- frequent urination when infection spreads to the urethra and bladder.
If a woman ignores the symptoms, their severity decreases over time. This indicates the development of a chronic phase of inflammation of the cervical canal. In this case, there is a systematic exacerbation of symptoms, especially after menstruation and sexual intercourse.
Infection with certain infectious agents and subsequent inflammation can occur without symptoms. This is typical, for example, for chlamydial infection.
Diagnosis and treatment
Detecting the inflammatory process is not difficult. Cervicitis is determined during an examination by a gynecologist. The cervix is edematous and hyperemic. During the chronic phase, areas with erosion and cysts are observed. Pathological discharge also indicates inflammation.
In order to accurately make an appropriate diagnosis, it is necessary to undergo an examination. In order to diagnose inflammation of the cervical canal, experts prescribe:
- general flora smear;
- bacterial sowing;
- detection of sexually transmitted infections by PCR;
- cytological examination;
- simple, extended colposcopy;
- biopsy;
- blood and urine tests;
- Ultrasound of the pelvic organs.
Treatment of endocervicitis has several main goals. First of all, it is necessary to eliminate the infectious factor and stop the inflammation. It is very important to eliminate the symptoms, as well as restore the damaged epithelium. To avoid relapses, it is necessary to conduct a full examination and prescribe adequate therapy.
The purpose of treatment corresponds to the identified pathogen. For chlamydia, for example, antibiotics are prescribed. If a fungal infection is detected, it is advisable to prescribe antifungal therapy. Herpes and HPV require treatment with antiviral drugs. If the cause of changes in the cervical canal is an age factor, hormonal suppositories are used.
The main treatment is supplemented with agents that promote tissue healing and normalize the vaginal microflora. Traditional medicine and physiotherapy are also used as part of complex therapy.
The cervical canal refers to that part of the uterus that is located between the vagina and the uterine cavity and connects them. Inflammation of the canal mucosa is called endocervicitis. Women of working age are most often affected by this disease.
Causes of inflammation of the cervical canal
The causes of endocervitis are infectious and non-infectious. The first include infection with microorganisms such as streptococci, gonococci, E. coli, chlamydia, trichomonas, candida, ureaplasma, staphylococcus, herpes viruses and papilloma. Non-infectious causes of inflammation can be trauma, neoplasms, radiation, cervical erosion, and cervical prolapse. However, they are quite rare.
Most often, the disease begins with an inflammatory process in the vagina, which then spreads to the cervix. It is often accompanied by colpitis.
But not all women necessarily develop endocervitis. There are several factors that can provoke the development of the disease. These include:
· Deformation of the cervix after abortion, probing of the uterus, insertion of an intrauterine device, trauma during childbirth, diagnostic curettage;
· Local or general decrease in immunity after inflammation of the genital organs;
· Onset of normal menstruation;
· Frequent stress.
Normally, in the lumen of the cervical canal there is almost always a mucous plug, which protects the uterine cavity from the penetration of pathogenic microorganisms from the vagina. During various medical procedures, the plug is destroyed, its physical and chemical composition changes, as a result of which the infection can freely penetrate the uterus through the cervical canal, thereby causing endocervicitis, and then endometritis.
The infection can also enter the cervical canal through menstrual blood. That is why it is during this period that you especially need to remember the rules of personal hygiene.
Symptoms of inflammation of the cervical canal
What can be the symptoms of endocervicitis? From the first days, a burning sensation, itching, nagging pain in the lower abdomen, discomfort during sexual intercourse, copious or small amounts of discharge appear in the genital area. If treatment is not started in a timely manner, the acute period turns into a chronic course.
Of course, there will be no more complaints, but this does not mean that the woman has recovered. The disease simply entered a latent period, and the female body adapted to the infection. If it is not treated, the inflammation will spread to neighboring organs and complications may arise in the future.
In some cases, endocervicitis is asymptomatic and does not affect the woman’s health, however, the presence of inflammation in the cervical canal can lead to pathological changes in the cervix and serve as the basis for the development of cervical erosion, and then its dysplasia. When the canal becomes inflamed, the composition of the cervical mucus changes, which can subsequently be one of the causes of infertility.
Diagnostics
In order to prevent and diagnose the disease, a woman should visit a gynecologist at least once a year. If any complaints appear, you should also visit a doctor to determine the nature of the disease and its treatment. The diagnosis is made as a whole, after questioning and examining the patient.
Typically, women undergo the following tests:
· Examination using gynecological speculum - in the presence of inflammation, redness and swelling in the area of the cervical canal and purulent discharge are observed;
· Smear microscopy – when it is carried out, the intensity of inflammation is determined by the number of leukocytes and the presence of pathogenic microorganisms in the canal;
· Bacteriological examination of smears, identifying the causative agent of the disease;
· Colposcopy – it visually shows signs of inflammation thanks to the use of a special device – a colposcope, with special illumination and optical magnification;
· Cytological examination of a smear after colposcopy - in this case, epithelial cells are examined.
Only after a thorough examination and identification of the pathogen strain, the doctor makes a diagnosis and prescribes individual treatment. It will depend on the cause of the disease and the duration of its course.
Depending on the woman’s condition, she is prescribed appropriate drug therapy, which can be supplemented with immunostimulating therapy to maintain immunity. After treatment, antifungal therapy is carried out to restore the vaginal microflora. After recovery, the woman is recommended to retake tests after some time to confirm the result.
Endocervitis can be avoided if you follow simple and effective rules: be confident in your sexual partner or always use condoms, maintain intimate hygiene and undergo an annual preventive examination with a doctor with mandatory tests. All this will help a woman to always be confident in her health!
Inflammation of the cervical canal can only be diagnosed by a specialist. Its manifestations are in many ways similar to other gynecological diseases. And the disease can only be treated comprehensively, since it is usually accompanied by vulvovaginitis.
If a woman is healthy and has a healthy immune system, then after gynecological manipulations she will not develop inflammation of the cervical canal. In women, in normal condition, there is a mucus plug in the cervical canal, which prevents pathogenic flora from entering the reproductive organs. The integrity of the plug is damaged under the influence of certain medications, during abortion, during curettage, during menstruation if the rules of personal hygiene are not observed.
If a woman notices that she experiences pain during coitus, bloody discharge appears after it, and periodically sees mucous discharge on underwear or pads that resembles pus, then she may have developed inflammation of the cervical canal.
Inflammation of the cervical canal - inflammation of the cylindrical epithelium, which is located at the entrance to the canal - can be external and internal and rarely occurs alone in one part. The area of the uterus that connects the vagina and its body is called the cervical canal. Pathology of the epithelium from the outside - cervicitis, from the inside - endocervicitis. The disease occurs in women of childbearing age.
Symptoms of the disease may be subtle and may not be noticed. But still, more often in the acute form of the disease, you can notice bloody discharge during physical effort and during sexual intercourse, pain in the lower abdomen, mucous discharge of a purulent nature, and an unpleasant odor.
If the disease is not treated, then after an acute form it becomes chronic and subsides, manifesting itself with a general decrease in immunity, an outbreak of seasonal or infectious diseases, and hypothermia.
A woman with an inflammatory process in the cervical canal can be contagious, since this disease is rarely caused by traumatic injuries: medical manipulations or too violent sex. In most cases, its appearance is influenced by pathogenic flora: chlamydia, ureaplasma, gonococci, staphylococci, streptococci, candida, E. coli and others. Infections with sexually transmitted diseases often lead to inflammation of the cervical canal.
After eliminating the disease, medications are prescribed to help restore normal and natural flora.
Inflammation of the cervical canal is a disease that leads to pathology of the cervix, which in the future very often triggers oncological processes in the body.
A gynecologist diagnoses the disease based on the clinical picture and the results of microbiological and bacteriological analysis, which is examined after taking a smear from the vagina and cervical canal.
Hyperemia of the cervix is reflected in the gynecological speculum; when manipulating instruments, the woman experiences painful sensations, and slight short-term bleeding may occur.
The disease is treated with therapeutic and surgical methods. Surgical treatments include cryotherapy, laser therapy, and diathermocoagulation.
During cryotherapy, cervical erosion is cauterized with liquid nitrogen. The procedure is short-term and performed on an outpatient basis, usually in a antenatal clinic in a treatment room. The effect on the cervix during diathermocoagulation is also carried out there, only the procedure is longer and after it you need to lie down for a while. The laser treatment of the cervical canal is carried out in a hospital setting.
Therapeutic treatment is effective until cercivitis becomes chronic. All drugs are prescribed after identifying the pathogen and establishing the body’s sensitivity to it.
Treatment may consist of broad- and narrow-acting antibiotics, antifungals, antivirals, or cytostatics. At the same time, immunostimulants and vitamins are taken. Local medications – ointments and suppositories – must be included.
Inflammation of the cervical canal can cause pathology of the cervix and, in the future, gynecological diseases such as endometriosis, endometritis, and cervical dysplasia. Dysplasia - this condition often triggers oncological processes in the body. In addition, pathogenic flora penetrates through the cervix into neighboring organs: the uterus, ovaries and causes infertility.
Inflammation of the cervical canal noticed in time can be treated and does not leave pathological consequences. Therefore, if you notice the above symptoms, you need to immediately consult a doctor. Self-medication of the disease is fraught with complications. Competent therapy is possible only when the causative agent of the disease is identified.