Ektropion of a uterus neck
Ektropion of a uterus neck – a pathological condition of a neck of a uterus at which the eversion mucous the cervical channel in a vagina cavity is observed. Clinical manifestations of an ektropion develop at accession of inflammatory or precancer damage of a neck of a uterus: it can be bleach, contact bloody allocations, violation of menstrual function, pain in a small basin. Ektropion necks of a uterus diagnose as a result of gynecologic survey, an expanded kolposkopiya, a cytologic and morphological research. Treatment of an ektropion at congenital or insignificant defeat can include electrothermic coagulation, laser vaporization and cryodestruction; at the expressed changes - a konization or an ekstsiziya of a neck of a uterus.
Ektropion of a uterus neck
Ektropion is considered in gynecology as the complicated clinical form of an ektopiya of a neck of a uterus combining a pseudo-erosion and cicatricial deformation. Ektropion of a uterus neck, as a rule, mentions its lower department and can be the congenital or acquired (post-traumatic) disease. The mucous membrane of the tservikalny channel (), unlike a surface of a vaginal part of a neck of a uterus (ekzotserviks), is presented by a cylindrical epithelium which cages allocate a mucous secret. At the ektropiyena of a neck of a uterus from the alkaline environment peculiar to it gets to acidic environment of contents of a vagina which breaks the physiological secretion of tservikalny glands and barrier functions of a neck of a uterus important for the prevention of infections and process of a reproduction.
Ektropion leads necks of a uterus to penetration of vaginal microflora on a mucous membrane of the tservikalny channel and to development of inflammatory process. Most often necks of a uterus is followed endotservitsity, tservitsity, by an endometritis. Existence of a chronic inflammation at the ektropiyena of a neck of a uterus creates conditions for development of other pathological states: true erosion, dysplasia, leukoplakia, atrophy of a tservikalny epithelium and cancer of a neck of a uterus.
Reasons of an ektropion of a neck of a uterus
Congenital uterus necks at the women of young age who did not have before pregnancy and childbirth is a consequence of functional disgormonalny violations. Acquired (post-traumatic) most often results from damages of tissues of neck of a uterus which were not eliminated or were taken incorrectly in at the time of delivery. It can be bilateral side ruptures of a neck of a uterus at independent childbirth or after rodovspomogayushchy operations (imposing of special obstetric nippers, extraction of a fruit). Sometimes lead uterus neck injuries to development of an ektropion during abortion on late terms of a gestation.
The gap and the subsequent scarring of muscle fibers of a neck of a uterus are followed by violation of microcirculation, an innervation and traffic of fabric structures of the tservikalny channel that leads to its deformation - "gaping" of an external pharynx and an eversion of an endotserviks.
Symptoms of an ektropion of a neck of a uterus
At the ektropiyena of a neck of a uterus of the complaint can be absent as the disease has no specific symptoms.
In case of development of the inflammatory, dystrophic or atipichesky processes accompanying an ektropion of a neck of a uterus strengthening mucous transparent and dairy color of allocations from a vagina, emergence of pains on a bottom of a stomach and in a waist, violation of a menstrual cycle (menorragiya), contact bloody allocations can be observed.
Diagnostics of an ektropion of a neck of a uterus
Recognition of an ektropion of a neck of a uterus is carried out according to gynecologic survey by means of mirrors, an expanded kolposkopiya, cytologic or histologic researches. Gynecologic survey allows to find deformation of a neck of a uterus: existence of an eversion of an endotserviks in a vagina cavity, cicatricial changes in places of injuries. If necessary carry out a material intake for carrying out the cytologic, bakterioskopichesky and bacteriological analysis, PTsR-diagnostics.
For a research of character of a surface and type of folds of the site of an eversion of a mucous membrane of the tservikalny channel, identification of complications of an ektropion of a neck of a uterus carry out an expanded kolposkopiya. At a congenital ektropion of a neck of a uterus of a fold of a mucous membrane are located evenly; at acquired – it is chaotic. Detection of abnormal kolposkopichesky signs, zones of transformation is the indication to performance of an aim biopsy of sites of damage of a neck of a uterus with a histologic research of bioptat. At a congenital ekstropion of a neck of a uterus investigate the hormonal status of the patient, carry out tests of functional diagnostics.
Treatment of an ektropion of a neck of a uterus
Treatment of an ektropion of a neck of a uterus consists in its destruction or removal, elimination of the accompanying inflammatory process with the subsequent correction of anatomy of a neck of a uterus and microflora of a vagina and aims at restoration of barrier and reproductive functions of a uterine pharynx, prevention of pretumoral and tumoral processes in an endotserviksa. The clinical gynecology approaches the choice of a method of treatment of an ektropion of a neck of a uterus individually depending on age, a condition of reproductive system of the patient and the revealed kolposkopichesky and cytologic changes.
Expeditious treatment of an ektropion of a neck of a uterus includes destructive methods (a diatermokoagulyation, laser vaporization, cryodestruction) and surgical (a radio wave konization or an ekstsiziya of a neck of a uterus). Destructive methods of treatment of an ektropion are shown at moderately expressed deformation of a neck of a uterus and allow to destroy pathological fabric. Surgical methods give the chance to conduct a morphological research of remote samples.
Congenital necks of a uterus destroy by a cryodestruction method, and at inefficiency apply surgical treatment. Radiokonization or a radioekstsiziya are carried out at expressed to the ektropiyena, existence of a dysplasia and other precancer processes and allow to remove the struck fragment of a neck of a uterus and a part of the tservikalny canal. Also the medicamentous therapy applied in treatment of an ektopiya of a neck of a uterus and including antibacterial, antiviral, hormonal, immunomodulatory medicines is appointed.
At considerable deformation of a neck of a uterus owing to gaps and cicatricial processes carry out reconstructive plastic surgeries. During the rehabilitation period after surgical treatment of an ektropion of a neck of a uterus sexual rest the first 4-6 weeks, restriction of physical activities, the ban on syringings, use of hygienic tampons, acceptance of bathtubs, visit of a bath, sauna, the pool are shown.
Forecast and prevention of an ektropion of a neck of a uterus
The forecast at the ektropiyena – favorable, however the asymptomatic course of diseases of a neck of a uterus dictates need of annual routine inspections at the gynecologist.
Measures of prevention of development of an ektropion of a neck of a uterus are rational conducting childbirth, timely and adequate contraception for the prevention of abortions.