Tservitsit – inflammatory process in a vaginal segment of a neck of a uterus. The current is characterized muddy (mucous or purulent) by the allocations pulling or dull aches in the bottom of a stomach, a painful urination and sexual intercourse. Long chronic tservitsit leads to development of an erosion, a hypertrophy (thickening) of a neck of a uterus, spread of an infection on the top departments of the sexual device. Under ekzotservitsity understand an inflammation of a vaginal segment of a neck of a uterus or an ekzotserviks. Endotservitsit - it is an inflammation of an internal cover of the tservikalny channel of a neck of a uterus – an endotserviks.
Tservitsit – inflammatory process in a vaginal segment of a neck of a uterus. The current is characterized muddy (mucous or purulent) by the allocations pulling or dull aches in the bottom of a stomach, a painful urination and sexual intercourse. Long chronic tservitsit leads to development of an erosion, a uterus neck hypertrophy, spread of an infection on the top departments of the sexual device.
The neck of a uterus is the barrier interfering penetration of an infection into a uterus and the top departments of a genital tract (the narrow tservikalny channel, a mucous stopper, a protective secret). At certain factors there is a violation of its protective function, penetration of alien microflora and development of inflammatory process – the tservitsit including is ekzotservitsit and endotservitsit. Under ekzotservitsity understand an inflammation of a vaginal segment of a neck of a uterus or an ekzotserviks. Endotservitsit - it is an inflammation of an internal cover of the tservikalny channel of a neck of a uterus – an endotserviks.
Tservitsit can arise at the nonspecific infection caused by opportunistic microflora: staphylococcus, colibacillus, streptococcus, mushrooms and specific (hlamidiya, mycoplasmas, gonokokka, syphilis, trichomonads, viruses), some parasitic and protozoan infections (). Opportunistic microflora, defiant tservitsit, gets into a uterus neck in the contact way from a rectum or through blood and a lymph, specific – sexually.
Development of a tservitsit is promoted by certain factors: patrimonial injuries of a neck of a uterus, during diagnostic vyskablivaniye, termination of pregnancy; use of contraceptive means (installation and removal of Naval Forces). To provoke tservitsit cicatricial deformations and good-quality formations of a neck of a uterus, decrease in immunity can.
Tservitsit seldom develops separately, usually it is accompanied by other diseases of a reproductive system: vulvit, vaginit, bartolinit, uterus neck pseudo-erosion, (a uterus neck eversion). Tservitsit more often meets at women at reproductive age (to 70%), is more rare in the period of a menopause. Tservitsit is the frequent reason of not incubation of pregnancy and premature birth. Polyps and erosion of a neck of a uterus, an inflammation of the top departments of a genital tract are a consequence of a tservitsit.
Symptoms of a tservitsit
On a current distinguish sharp and chronic tservitsit, on extent of defeat – focal tservitsit and diffusion tservitsit. Sometimes tservitsit can initially proceed in the erased form. At a sharp tservitsit plentiful mucous or purulent allocations are noted, dull ache in the bottom of a stomach is more rare. Hypostasis and hyperaemia of an external opening of the tservikalny channel, protrusion mucous, small hemorrhages and ulcerations are observed.
Tservitsit has various manifestations depending on character of the activator and a condition of immunity. Tservitsit the gonorrheal nature usually proceeds sharply, with distinctly expressed signs, at a chlamydial infection signs are less noticeable. At a herpetic tservitsit a uterus neck brightly red, friable, with sites of ulcerations (a symptom of "a continuous erosion"). At a trikhomonadny tservitsit small hemorrhages ("strawberry "), atypical cages in dab come to light. At defeat by actinomycetes observe a symptom of "a yellow granular spot". The virus of papilloma of the person can cause formation of condylomas and an ulceration of a neck of a uterus of various sizes.
Tservitsit, undetected or not cured in a sharp stage, turns into long chronic process. Allocations become muddy and mucous, is observed pseudo-erosion on a vaginal part of a uterus (growth of a cylindrical epithelium). In a chronic stage of a tservitsit inflammation signs (hyperaemia, hypostasis) are expressed more weakly. There can be a replacement of a cylindrical epithelium with flat. The inflammation can extend to surrounding fabrics and glands, with formation of infiltrates, cysts, there is a consolidation of a neck of a uterus.
Diagnostics of a tservitsit
Tservitsit often proceeds asymptomatically that does not force patients to see a doctor. The majority of tservitsit is found at planned professional surveys incidentally or at the address of women on consultation of the gynecologist concerning other diseases. Diagnostics of a tservitsit is directed first of all to identification of the reasons which caused a uterus neck inflammation.
The diagnosis of a tservitsit is established on the basis of the following data:
- survey of a neck of a uterus by means of mirrors
- result of a kolposkopiya that allows to detail pathological changes of an epithelium of a neck of a uterus at a tservitsita (hyperaemia, puffiness mucous, existence of vascular loops, an ektopiya, an erosion, diffusion or focal character of an inflammation).
- laboratory methods (microscopy of dab, a bakposev on microflora and sensitivity to antibiotics, PTsR – diagnostics, a cytomorphological research)
At a sharp current of a tservitsit dabs contain many leukocytes (more than 30), and also lymphocytes and gistiotsita, a cylindrical epithelium with a hypertrophied kernel also a flat epithelium with dystrophic changes. At a chronic tservitsit cages of a cylindrical epithelium of different size, sometimes the phenomenon of a tsitoliz (destructions of cages) are visible.
The bacteriological research allows to reveal a sort and a species of microorganisms, and also to pick up the corresponding antibiotic. Dab cytomorphology at a tservitsita shows structural damages of cages and dynamic changes in treatment process. Detectability of some infections (gonorrhea, clamidiosis, mycoplasmosis, , herpes) at a tservitsita is impossible without carrying out PTsR - diagnostics and the immunofermental analysis (IFA).
Treatment of a tservitsit
The modern gynecology uses rather large number of various methods of treatment of a tservitsit in the practice. But first of all treatment of a tservitsit has to be directed to elimination of the contributing factors (hormonal, exchange, immune violations) and associated diseases.
Treatment of tservitsit includes application of antibacterial, antiviral and other means and depends on the revealed activator, its sensitivity to this medicine, a stage of inflammatory process. So, at a chlamydial tservitsit antibiotics of a tetracycline row (doxycycline, ), macroleads (erythromycin), hinolona (, ), azaleads are appointed (). At a kandidozny tservitsit application of a flukonazol is shown. In therapy of tservitsit widely use the combined local medicines. Medicines can be in the form of candles and creams.
Local treatment of a tservitsit is recommended when subsiding sharpness of process and 1-2% solution of a hlorofillipt, silver nitrate solution consist in processing of a vagina and neck of a uterus of 3% solution of a dimethyl sulfoxide.
Difficult gives in to treatment virus tservitsita. At genital herpes the long therapy including antiviral medicines (an acyclovir, ), application of specific antiherpetic Ig, vitamins, immunostimulators is required. In treatment of a human papillomavirus infection use inteferona, cytostatics, carry out removal of condylomas. At treatment of atrophic tservitsit locally apply estrogen, in particular, which promotes restoration of an epithelium mucous vaginas and necks of a uterus and natural microflora. At specific infections in parallel treatment there undergoes a sexual partner.
Conservative treatment is less successful in a chronic stage of a tservitsit therefore apply surgical methods – a diatermokoagulyation, cryotherapy, laser therapy; an indispensable condition is absence of infections. At the same time treat the accompanying pathology (, the colpitis, salpingoooforit, functional violations), restore natural microflora. Treatment of tservitsit is carried out under control of a kolposkopiya and laboratory analyses.
Prevention of tservitsit consists in observance of rules of personal hygiene, an exception of sexually transmitted infections, the prevention of abortions, the correct conducting childbirth, treatment of endocrine violations.