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What is cervical endometriosis in accessible language?

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Endometriosis of the cervix uteri is a pathological, benign growth of the mucous membrane beyond the limits of the organ. Foci affect part of the cervix and cervical canal. Often the disease passes without symptoms. In rare cases, spotting (bloody) after intercourse, before and after the menstrual cycle.

Over the past 50 years, the increase in pathology has increased by an average of 1%. The disease affects women of reproductive age. In girls before puberty, endometriosis was not fixed. During postmenopausal disease progresses.

Diagnosing pathology in the early stages is difficult. Examination of the gynecologist does not always make it possible to determine the correct diagnosis. As a result, the disease progresses, leading to complications.

The growth of the endometrium is a hormonal, gynecological pathology. The disease belongs to ICD 10, to the interval under the number 80 - 98.

ICD is an international classification of diseases. The abbreviated medical term makes it easier for professionals to account for the reasons for the patient's seeking medical help.

Cervical Endometriosis: Causes

The exact cause of the occurrence of the disease today by specialists in the field of gynecology has not been identified. Experts are inclined to believe that the occurrence of endometriosis is associated with the introduction of endometrial cells into the damaged exo-or endocervix.

However, the occurrence of pathology is influenced by a number of factors:

  1. Reverse menstruation (retrograde). During the period of the menstrual cycle, a small amount of blood, passing through the fallopian tubes, enters the abdominal cavity. The immune system acts as a blocker, slowing the process of growth of the endometrium.
  2. Weakened immunity.
  3. Hereditary factor. The risk of developing the disease increases significantly if a close relative was diagnosed with endometriosis.
  4. Surgical interventions on the cervix. Endometriotic heterotopia occurs as a result of abortion, the installation of the Navy, curettage, hysteroscopy and hysterosalpingography.
  5. Hormonal background. With a decrease or increase in the level of hormones in the blood there is a sensitive response of endometrial cells. A sharp jump in estrogen leads to an increase in lesions.
  6. Chronic infectious diseases.
  7. Obesity.
  8. Ecology.

Endometriosis of the cervix is ​​a hormone-dependent pathology. The cause of the appearance depends on the amount of estrogen and progesterone in the blood.

Symptoms of the disease

In the early stages of endometriosis, the clinical manifestations are almost asymptomatic. For several years, the disease may not progress. The diagnosis is established during routine inspections or examinations of infertility. Often infertility is the only sign of endometriosis of the cervix.

The clarity of the clinical picture is affected by endometriotic foci - their number, size and depth parameters.

  • spotting that occurs two days before and after the beginning of menstruation,
  • highlighting dark red shades during intimacy,
  • painful symptoms in the abdomen during intercourse or during exercise.

To clarify the diagnosis, colposcopic examination is additionally performed. According to the results, the doctor prescribes treatment.

Complications

Non-treatment of endometriosis leads to deformation of the cervical tissue. The menstrual period is transferred painfully, the woman loses working capacity and mental balance. These clinical manifestations contribute to atresia of the cervical canal. Subsequently, the disease goes beyond the uterus.

What is dangerous endometriosis:

  • malignant tumors
  • infertility
  • unwanted termination of pregnancy
  • the formation of new pathologies,
  • chronic pain syndromes
  • violation of the menstrual cycle,
  • neurological disorders.

The neglected form of the disease will lead to prompt removal of the uterus, appendages and ovaries, and hormonal activity will be disturbed.

See a video about endometriosis, its symptoms and treatment:

Diagnostic methods

The beginning of the diagnosis consists in collecting complaints and anamnesis of the disease. The doctor takes into account all factors: heredity, the possibility of the presence of genital and extragenital abnormalities.

If the disease proceeds without symptomatic signs, gynecological examination is carried out using mirrors. The presence of "endometrioid ocelli" is a confirmation of the diagnosis. These are dark blue or red spots formed on the mucous membrane of the cervix.

It is possible to finally confirm the presence of the disease with the help of colposcopy and a biopsy of the endometrial focus. For examination of the organ using a microscope and all sorts of test procedures.

Histological examination of tissues examines the structure of the organ. Using cytological analysis, the cellular composition of the cervical canal is examined.

How to treat?

Therapy will depend on the dimensions of heterotypic growths, localization of endometrial foci, complications, age and reproductive criteria of the female body.

If there is a high indication of heterotopia, discharge (blood) and pain in the abdomen, medication is prescribed, which consists of taking:

  1. Hormonal medication. These drugs inhibit cell growth. Treatment is carried out by combined and progestin contraceptives. Therapy is carried out independently or in preparation for surgery.
  2. Symptomatic medication. Combined therapy is aimed at immunocorrection, stopping of symptomatic manifestations and complications. Painful symptoms are removed nonsteroidal, anti-inflammatory drugs. With reduced hemoglobin, iron medications are prescribed.

In the early stages of the disease and in order to prevent the use of folk remedies are allowed, after consulting a gynecologist. Treatment of folk remedies, is to take herbal tinctures, propolis and celandine. Under the supervision of a physician, therapy with clay and leeches.

For small foci of endometriosis of the cervix and the absence of clinical signs, the patient is shown dynamic observation, regular examination by the doctor.

What is the difference between endometritis and endometriosis? Read in the article about the symptoms of diseases and the causes of their development, the differences and similarities between pathologies, methods of diagnosis, methods of treating endometritis and methods of treating endometriosis.

How to drink Duphaston with endometriosis? Detailed instructions here.

Preventive measures

Measures for the prevention of endometriosis - one of the main, topical issues for women who have suffered a disease, and for those who have not yet encountered the disease.

Prevention is as follows:

  • regular visits to the gynecologist (1 time in half a year),
  • abstaining from sexual intercourse during the menstrual cycle,
  • timely treatment of gynecological pathologies,
  • struggle with excess weight (it is necessary to adhere to diets, regularly perform exercises),
  • choice of contraception,
  • avoidance of stress.

Effective treatment of endometriosis of the cervix is ​​active prevention.

The occurrence of endometriosis of the cervix can be avoided if with special attention relates to their health. It is recommended not to ignore preventive measures, to regularly visit medical institutions, to treat gynecological pathologies in a timely manner.

What are diseases?

To understand what constitutes endometriosis, it is necessary to understand the anatomical features of the female reproductive system. The entire internal cavity of the uterus is covered with a layer of endometrium - tissue, the thickness of which varies depending on the period of the menstrual cycle. If the growth of the inner membrane goes beyond the limits of the organ and is noticeable on the cervix, the doctors diagnose “suspected endometriosis” and recommend the patient to undergo an additional diagnostic examination.

The disease develops differently in each individual case. It is difficult for doctors to predict the dynamics of the progression of pathology. Moreover, in the early stages of the development of the disease it is difficult to diagnose only by visual inspection. After all, the focus of endometriosis is inside the uterus.

Causes and varieties

Gynecologists can not name the exact reasons for which develops subepithelial endometriosis of the cervix. But among the most likely factors provoking the development and progression of the disease, physicians distinguish:

  1. Menstrual flow into the uterus, tubes, or ovaries. This blood contains particles of the endometrium that can join the inner membranes of the organ and grow in the future.
  2. Frequent artificial penetrations into the uterine cavity (scrapes, abortions, miscarriages, gynecological operations). In this case, the growth of the endometrium is the result of scarring of the damaged tissues.
  3. Hormonal imbalance, namely the violation of the production of estrogen and progesterone. The main cause of excessive (or insufficient) production of biologically active substances are age-related changes in the body, frequent stressful situations, excessive exercise on the body. Also, hormonal imbalance is the cause of hormonal imbalance.
  4. The patient may have a genetic predisposition to the disease. Studies have shown that a woman whose relatives had cervical endometriosis has a higher chance of becoming ill with the pathology.

In gynecology, endometriosis of the cervix of the uterus is classified according to two main indicators - the degree and severity of the lesion. In the first case, these types of diseases are distinguished:

  1. Diffuse (uniform growth of pathogenic tissue).
  2. Nodular (focal thickening of the shell is observed, on the inner walls of the body, nodes of different sizes are formed).
  3. Mixed (tissues grow evenly, but with the formation of focal seals).

Gynecologists identify several degrees of progression of the pathology. They differ in the level of organ damage:

  1. Endometriosis of 1 degree is expressed in single superficial foci of pathogenic tissue changes.
  2. In the second degree of pathology, pathogenic changes in the inner lining of the uterus occur in deeper layers. There are several lesions of enedometry.
  3. The third stage of disease progression is characterized by a large area of ​​the spread of thickening. Pathogenic processes affect all muscle layers of the uterus.
  4. In the fourth stage of the development of the disease, tissue proliferation spreads to other internal organs. There were clinically documented cases where endometrium was found in the patient’s lungs.

In the first stage of the disease there are no pronounced symptoms. Therefore, to diagnose it at this stage is difficult.

Symptomatology

Worsening of well-being is one of the reasons to consult a doctor for examination. The main signs of endometriosis of the cervix uteri are accompanied by almost all gynecological diseases. The main symptoms of the disease are:

  1. Painful menstruation.
  2. Long periodic discharge (up to 14 days per cycle).
  3. Spastic pains in the lower abdomen and lower back.
  4. Loss of strength, depression.
  5. Painful urination (at 3 and 4 stages of pathology progression).

If the patient went to the doctor with such complaints, he should, in addition to the routine examination, prescribe additional diagnostic methods to confirm the diagnosis. The earlier the disease is diagnosed, the more effective the treatment will be.

What danger poses

The main negative effect of endometriosis for young women is infertility. According to statistics, more than 60% of patients undergoing pathology, faced with the difficulty of conceiving a child.

In addition, negative complications of this disease is miscarriages. Even if a woman manages to become pregnant, due to the thickening of the inner mucous membrane of the uterus, the fetus does not have enough space for full development in the womb.

Treatment methods

Today, treatment of endometriosis of the cervix is ​​carried out in two ways - surgery and medication. Drug pathology can be cured if it is diagnosed at an early stage of development. If the lesions of the organ of the pathogenic tissue are large, gynecologists recommend the use of surgical intervention. To the question whether cervical endometriosis can be treated with alternative methods, doctors cannot answer unequivocally. They recommend the use of herbs in combination with traditional therapy.

One of the root causes of the disease is hormonal imbalance. Therefore, the main task of drug therapy is the normalization of hormone production. After hormone therapy, the growth of the endometrium stops. But it can resume when you stop taking medications.

Surgical intervention

Surgical treatment methods are used in severe forms of pathology. The main surgical methods for cervical endometriosis are:

  1. Radiowave treatment. It is used for small lesions of healthy tissue. During the procedure, radio waves affect only pathogenically modified areas.
  2. Cauterization (diathermocoagulation) of the cervix. This method is used primarily for erosions, as well as bleeding during gynecological operations. Today diathermocoagulation is successfully used for endometriosis.

The method of laser removal of pathogenically modified tissues is particularly popular. Traditional surgery, during which the amputation of the uterus is performed, as a last resort.

Is pregnancy possible?

Endometriosis is not a sentence for young women. After successful treatment of the disease there is no threat to normal pregnancy and childbirth. But the woman will have to be constantly monitored by the gynecologist to avoid complications - premature birth or miscarriage.

According to patient reviews, endometriosis can be cured if treatment is started promptly. After therapy, the natural conception of a child is possible.

This is a very insidious disease. After hormone therapy there was a relapse. So insulting. We'll have to go on cleaning.

I was diagnosed with endometriosis. I did not want to treat hormones, I decided to try traditional medicine. Fortunately, due to the initial stage of the disease, the treatment went to Ura and I was finally able to give birth to a healthy baby.

You can not ignore the disease, as it is bad for the reproductive system. It is necessary to immediately seek qualified medical assistance, otherwise it is possible to provoke infertility. Only after surgical treatment was I able to bear and give birth to a child. Good luck.

Causes of endometriosis of the cervix

According to the majority of specialists in the field of gynecology, the main cause of endometrial growths on the cervical mucosa is the introduction of endometrial cells contained in the menstrual blood into the damaged exo-or endocervix. The risk of developing endometriosis increases:

  • Cervical Diseases. Endometrial cells are easier to attach to the diseased mucosa. Endometriosis can develop against the background of erosion and pseudo-erosion of the cervix, exo-and endocervicitis.
  • Invasive Interventions. The emergence of endometrioid heterotopias is facilitated by abortions, installation of the IUD, curettage, hysteroscopy and hysterosalpingography, and other therapeutic and diagnostic manipulations on the uterus and its neck.
  • Pathological or frequent labor. Traumatization of the epithelium during labor contributes to the invasion of endometrial cells in the endo-and exocervix.

Predisposing factors play an important role in the occurrence of the disease. Thus, endometriosis is more often detected in women with a weakened immune system and dyshormonal conditions, which are accompanied by hyperestrogenism. Hereditary burden is of great importance: in close relatives of patients with endometriosis, endometrial heterotopy on the surface of the cervix is ​​found 5 times more often than in the general population of women.

Endometrial cells that invade the epithelial layer of the cervix respond to cyclic hormonal changes in the female body. The same transformations occur in them as in the inner layer of the uterus. First, under the action of estrogen cells proliferate, and then under the influence of progesterone increases blood supply to tissues and gland secretion. The cycle ends with aseptic inflammation and rejection of the heterotopic endometrium, which coincides in time with menstruation. Endometrial cells growing in an atypical site are more likely to be damaged by contact effects, which forms a typical clinical picture of the disease.

Symptoms of endometriosis of the cervix uteri

Often endometriosis of the cervix occurs without marked clinical manifestations. Most characteristic bloody spotting on the eve and after menstruation, as well as after intercourse. Since in most cases of growth of the endometrium are located on the exocervix, the pain syndrome is not pronounced.If endocervix and pelvic organs are involved in the pathological process, the patient is bothered by a pulling pain in the lower abdomen, the intensity of which changes in different phases of the menstrual cycle. Dyspareunia is possible, bringing discomfort to the sex life of a woman.

Diagnostics

Given the scarcity of clinical symptoms in the diagnosis of endometriosis of the cervix uterus, the data of objective studies play a key role. In diagnostic terms, the most informative:

  • Inspection on the chair in the mirrors. Small reddish foci with a diameter of 2.0-5.0 mm are clearly visible against the background of pale pink healthy epithelium. Before menstruation, heterotopies become blue-purple and slightly increase in size.
  • Colposcopy. Under the microscope, a characteristic endometrioid tissue is revealed, the volume and color of which vary depending on the phase of the menstrual cycle. The survey is recommended in the last week before the month.
  • Cytomorphological diagnosis. Histological examination of materials obtained by a targeted biopsy of the cervix, reveals typical endometrial cells. If it is necessary to obtain the mucous membrane of the cervical canal, its diagnostic curettage is performed.

Ultrasound of the pelvic organs, endoscopic and x-ray techniques in the diagnosis of endometrioid heterotopy of the cervix play a supporting role and allow you to identify foci of endometriosis in other organs. Differential diagnosis of the disease is carried out with chronic specific and nonspecific cervicitis, nabot cysts with hemorrhagic contents, telangiectasias, extravasates, and cervical cancer. If necessary, the patient is prescribed an oncogynecologist and a dermatovenerologist consultation.

Treatment of endometriosis of the cervix

The choice of therapies should take into account the size of heterotopic growths, the prevalence of the endometrial process, the presence of complications, the age and reproductive plans of the woman. For patients with small foci of endometriosis in the absence of clinical manifestations and complications, a dynamic observation with a gynecologist's examination every six months is shown. With a significant amount of heterotopias, complaints of bleeding and pain syndrome, drug therapy is prescribed, which includes:

  • Hormonal drugs. Endometrial cell growth is inhibited by drugs that suppress the endocrine function of the ovaries. To do this, use combined or progestin oral contraceptives, agonists and antagonists of gonadoliberins, androgens. Hormone therapy is carried out both independently and in preparation for surgical treatment.
  • Symptomatic drugs. Comprehensive treatment is aimed at immunocorrection, reduction of symptoms and complications of the disease. For pain relief, nonsteroidal anti-inflammatory drugs are used. At decrease in level of hemoglobin and erythrocytes iron preparations are shown.

With the inefficiency of 3-4 months of conservative treatment, it is recommended to remove the endometriotic growths promptly. For this purpose, laser coagulation, cryodestruction, or radio wave destruction of foci of endometriosis is usually performed. A radical approach to the extirpation of the uterus and appendages is indicated only when the process is significant, involving other organs and a pronounced pain syndrome in women who are not planning to become pregnant.

Prognosis and prevention

With timely detection and adequate therapy, the prognosis is favorable. After removal of foci of endometrial tissue, the disease rarely recurs. The results of treatment are further improved with the appointment of hormone therapy before surgery and after it. In such cases, the frequency of complete clinical recovery increases 8 times. In the prevention of endometriosis, regular examination by a gynecologist for the detection and treatment of cervical diseases plays an important role. It is recommended to refrain from the unreasonable appointment of invasive procedures and consciously refers to family planning, refusing from abortions.

What is cervical endometriosis

Pathological proliferation of endometrial tissue occurs in women of any age, but more often after 30–35 years. Pathology of the cervix belongs to the external genital type of endometriosis, which affects the mucous membrane of the vagina (in the cervical area) and the cervical canal.

In European countries, this type of endometriosis occurs in almost 3 out of 100 women. In Russia, the rates are higher, which is facilitated by the widespread use of electrocoagulation of erosion instead of conservative treatment.

It is traumatization and mechanical impact, for example, during frequent examinations, cauterization, sexual intercourse, is the main prerequisite for the development of not only endometriosis, but also its dangerous complications, which include endometrial cyst on the cervix, female infertility.

Surgical methods

When using surgical methods, the abnormal areas of the overgrown mucosa are removed. Usually this is preceded by treatment with hormonal drugs. If during the 4-month period such therapy does not produce results, endometriotic growths are removed promptly.

The affected areas are eliminated in the following ways:

  • laser coagulation
  • the use of radio waves
  • cryodestruction

When localizing the pathological process on the vaginal part of the cervix, it is common to use endoscopic methods. In this case, cauterization or excision of foci is performed outside or through the vagina without incisions.

In rare cases, hysterectomy may be recommended by a doctor. Typically, this technique is used if the growth process covers neighboring organs, causes pronounced pain syndrome, and progresses rapidly.

Hormone therapy

In endometriosis of the cervix uteri, treatment with hormonal drugs is optimal if the growth is small and is at the initial stage. Use the following tools:

  • progestins,
  • antigonadotropins,
  • COC (combined contraceptives),
  • antiestrogens.

Usually, treatment begins with the use of small doses that give results. In parallel, an assessment of the effectiveness of therapy is carried out and, if necessary, the dose or combination of drugs is adjusted by the attending physician.

Sedation therapy

Sedatives are used to alleviate the symptoms of the disease. Usually they are assigned to reduce anxiety, PMS manifestations. The choice of medication depends on the severity of symptoms:

  • Phenazepam,
  • Tazepam
  • Apselan,
  • tincture of valerian, hawthorn.

Such tools are used only in complex therapy along with the use of hormone-containing and other drugs (anti-inflammatory, vitamin).

Physiotherapy

Physiotherapy techniques are aimed at strengthening the immune system, reducing the volume of the pathological growth of the endometrium, reducing pain. Apply the following types of procedures:

  • balneotherapy,
  • current therapy
  • laser and ultraviolet shortwave radiation,
  • magnetic therapy
  • hydrotherapy.

ATIt is impossible to cure the disease only with the help of such manipulations, but it is physiotherapy that allows to speed up recovery, restore the reproductive functions of a woman, and delay surgery.

Combined treatment

Combined methods of treatment of endometriosis involve the use of different treatment regimens, for example, a combination of:

  • intrauterine devices with a release device for dosed regular administration of drugs into the affected mucous membrane,
  • single-phase oral contraceptives for at least 9 months,
  • Depo-Provera injections once,
  • gonadotropin-releasing factor schemes for at least six months in a row.

In addition, in order for the endometrial tissue to stop its intense growth, anti-inflammatory drugs, vitamins and enzyme complexes are also prescribed in parallel.

Folk remedies

Traditional methods of therapy include:

  • tinctures
  • decoctions,
  • medicinal tampons based on plant materials.

In the recipes of traditional medicine use the serpentine root, Potentilla, calamus, nettle leaves, shepherd's grass bag, boron uterus, clay. As a monotherapy, this method of treatment does not apply, since it is only an auxiliary one. In addition, to take such funds on the basis of natural ingredients is possible only after the recommendation of the attending physician.

Effects

In the absence of treatment and the progressive pathological proliferation of cells of the mucous layer of the cervix, all the tissues are deformed. It is fraught with severe pain during menstruation, sexual intercourse, as well as sterility.

The cycle is broken, the appearance of acyclic blood discharge is possible. Other complications:

  • the risk of tissue degeneration into malignant,
  • miscarriage, spontaneous abortion,
  • neurological disorders
  • regular pain syndrome
  • formation of background pathologies.

With the development of the disease bleeding increases, the pain increases. The final point is the extirpation of the uterus, ovaries and appendages, which radically violates the hormonal balance, leading to early aging.

How is the uterus

The reproductive female system has a complex structure.. Its main organ is the uterus - a muscular organ that performs a large number of different functions, but based on carrying a child.

The genital organ consists of three parts - the bottom, the body and the neck. The region of interest in this case - the neck is the narrowest part, it is formed by narrowing the uterus towards the vagina.

A significant part of the cervical region adjacent to the body of the uterus, therefore, during a gynecological examination can not be visualized.

Inside the uterine cervix there is a cervical canal containing a large number of folds resembling a spindle. The function of the folds - stretching during childbirth.

The surface layer is rejected monthly and removed with menstrual blood, and the basal again restores it. The surface layer, growing to normal size, is necessary for the attachment of the ovum.

But subject to the pathological increase of this layer, the ovum cannot implant in the uterine wall - this is one of the reasons explaining infertility with endometriosis. Another reason - endometrial tissue leaves the uterine cavity, and affects the fallopian tubes, thereby preventing the normal passage of the egg.

The cervix performs the following functions:

  • natural barrier against penetration of foreign particles,
  • childbearing - stretching during the passage of the fetus.

On the part of the vagina, the cervix has a small depression, which is called the external pharynx.. In nulliparous women, it has a rounded shape, and after childbirth becomes slit-like.

What is dangerous?

Endometriosis of the cervix can lead to the following consequences.:

  • infertility,
  • possibility of generation in oncology,
  • adhesions,
  • anemia due to significant blood loss with heavy menstrual or intermenstrual bleeding.

In addition, the process is dangerous because of its rapid spread; in the absence of adequate therapy, endometriosis can affect adjacent organs, which leads to pathological processes in them..

Is it possible to cure without surgery?

Treatment medication appropriate in the initial stages of the disease, for surgical intervention should be the following indications:

  • severe stage of the disease,
  • combination of endometriosis with tumor processes,
  • rapid progression of the disease
  • infertility,
  • lack of positive dynamics after conservative treatment,
  • suspicion of a malignant process.

Drug treatment

Doctors prescribe:

  • Non-steroidal anti-inflammatory drugs, which stop pain, but do not affect the rate of development of the pathological process - Ibuprofen.
  • Hormonal drugs. It can be oral contraceptives - Janine, Utrozhestan, Diane-35 and others, or progesterone drugs - Norethisterone, Depo-Provera, Femoston, Zoladex, Buserelin and others.

In addition, drugs are prescribed that compensate for iron deficiency in the body, stop bleeding (if any), and also raise both general and local immunity.

Hormonal preparations inject a woman’s body into a state of artificial menopause, while the pathological growth of endometrial tissue stops and the existing lesions are regressed. After the abolition of drugs, all the reproductive abilities of the body themselves normalize.

In some cases, remove the cervix

A complete amputation of the cervix is ​​carried out only in the case of a running process, as well as in the event of suspected malignancy. Often, the cervix is ​​removed from women who have already left the child-bearing age.

Pregnancy

According to statistics, every fourth woman with endometriosis can not be a mother.

Conception is hindered by many factors.:

  • endometrial layer too thick,
  • adhesions,
  • overlapping endometrial tissue of the fallopian tubes,
  • ovarian atrophy,
  • increase in viscosity of secretion in the cervical region, and others.

However, to say with a 100% guarantee that pregnancy and cervical endometriosis are not compatible.

In some cases, after the course of treatment, the woman became pregnant, and after giving birth the diagnosis “endometriosis” was canceled. But this is not always the case, more often, even with the possible conception, a woman can not bear the baby.

Therefore, it is necessary to plan pregnancy with endometriosis together with your doctor.

How common is cervical endometriosis?

The cervix connects the uterus with the vagina. Endometrial implants rarely appear in this area.

The prevalence of any form of endometriosis is difficult to estimate due to the fact that a significant proportion of women with this condition do not experience symptoms and do not go to doctors.

American scientists suggest that 6 to 10% of women have endometriosis. It is known that among the total number of patients complaining of symptoms, women of reproductive age constitute the largest part.

Cervical endometriosis is a rare condition. In the study, the results of which in 2011 were published by the Journal of Obstetrics and Gynecology, 13.5 thousand women with endometriosis took part, and only 33 patients had cervical endometriosis.

Due to the fact that the symptoms often do not appear, many women are not aware of the presence of endometriosis until the next gynecological examination or a Pap smear test, the results of which show the presence of unusual formations.

Causes of Cervical Endometriosis

The medical community does not know what causes the appearance of endometrial implants outside the uterus, including the cervix.

However, it is known that various medical procedures that can cause scarring of tissues increase the likelihood of developing endometriosis.

These procedures include:

  • cryotherapy,
  • biopsy,
  • loop excision,
  • laser therapy.

Classification

The following forms of the disease are distinguished:

  • endocervical (the mucous membrane covering the neck of the organ is involved in the process),
  • exocervical (the vaginal part of the neck is affected),
  • diffuse,
  • focal,
  • nodal.

There are 4 stages of the disease. At the 1st stage, endometriotic foci are localized shallow and extend no further than the muscle layer. At stage 2, less than half the thickness of the myometrium is involved in the process. At stage 3, the functional epithelium of the uterus grows into the entire muscle layer of the cervix. At the 4th stage, neighboring organs are often involved in the process. Often formed fistulous passages.

Operative intervention

Indications for the removal of lesions are:

  1. The ineffectiveness of drug therapy for 3-4 months.
  2. Concomitant hyperplasia (proliferation) of the endometrium.
  3. Nodal form of the disease.
  4. 3rd and 4th degree of the disease.
  5. Concomitant endometriotic cysts.
  6. Common posterior endometriosis.
  7. The inability to use hormonal drugs. Many drugs are contraindicated in thromboembolism, thrombophlebitis, atherosclerosis, coronary heart disease, migraine, liver failure, bleeding of unknown origin, diabetes, jaundice, depression, migraine, high blood pressure and varicose veins.

In endometriosis, a hysterectomy can be performed (removal of the organ with appendages). This is an extreme measure that is required with a strong spread of the pathological process. Most often for endometriosis the following minimally invasive interventions are performed:

  1. Laser coagulation (burning of pathological areas with a laser). Such treatment is carried out on an outpatient basis after local anesthesia. The advantages of laser therapy are small blood loss, low risk of complications, rapid tissue regeneration and the absence of coarse scars.
  2. Radio wave therapy.
  3. Cryodestruction (tissue freezing).

Causes and mechanism of development

Each menstrual cycle of a healthy woman is accompanied first by maturation and growth, and then by rejection of the endometrium (uterine lining). Rejection occurs directly during menstruation, when, in the absence of conception, tissues are simply removed from the body. During menstruation, the uterus undergoes contractions during which menstrual blood can penetrate the abdominal cavity through the fallopian tubes.This happens quite often, and there is nothing to worry about. However, scientists have not yet managed to find an explanation for the fact that endometrial cells are able to settle on the outside of the female genital organs, hitting the fallopian tubes, ovaries, vagina, on the cervix, etc. Endometrium begins to grow with the formation of foci that respond to hormonal changes occurring throughout the cycle.

Pathological lesions on the cervix can reach sizes larger than two centimeters in diameter. Externally, these tumors resemble polyps, so when determining endometriosis of the cervix uteri, histological examination is usually required, excluding the presence of the latter.

The exact circumstances of the occurrence of endometriosis of the cervix not studied, however, there are a number of factors contributing to the development of the disease:

  • reduced immunity
  • disturbances in the ratio of hormones,
  • mechanical damage to the cervix during abortions, scraping, surgery, etc.
  • genital infections
  • heavy exercise
  • constant stress
  • genetic predisposition.

It is worth noting that of all the above factors, the most common mechanical damage. If the resulting wound does not have time to heal by the time of the onset of menstruation, the particles of the endometrium contained in the menstrual blood can attach to the wound surface. Only this happens not at all.

Possible complications of cervical disease

If you detect any characteristic signs of disease, you must immediately see a doctor, because in the absence of therapy, endometriosis of the cervix may lead to serious complications. Among them, the most common following:

  • development of adhesions of the pelvic and abdominal organs,
  • Iron-deficiency anemia,
  • impaired reproductive function - infertility
  • the occurrence of endometriotic ovarian cysts,
  • transformation of a pathological focus to a malignant tumor.

Diagnostic measures

In order to diagnose endometriosis of the cervix, the woman is assigned a number of studies:

  • gynecological examination in mirrors,
  • colposcopy
  • hysteroscopy
  • Ultrasound of the pelvic organs and abdominal cavity,
  • diagnostic curettage of the endocervix
  • biopsy and subsequent histological examination,

It should be noted that the mirror examination and colposcopy are most effectively carried out in the premenstrual period, when the pathological foci become brighter under the influence of hormones and increase somewhat in size.

Treatment of the disease

The tactics of treatment of endometriosis of the cervix uteri will depend on the results of the research, the stage of development of the disease and the physiological state of the patient. So, The doctor may prescribe:

Hormone therapy is the main treatment for endometriosis of the cervix when there is a need to suppress hyperestrogenism. To do this, prescribed drugs with a content of histogenic components (Norkalut, Non-Ovlon, Triziston, etc.). Contraceptives may also be prescribed (Zoladex, Gonozol). These drugs will block the further growth of the endometrium.

Surgical treatment of endometriosis is much more effective and consists in the removal of pathological foci. Removal can be done by several ways:

  • the imposition of applications of chemical solutions (drug Solkovagin),
  • electrocoagulation,
  • radio wave method
  • using a laser
  • cryodestruction method.

Whichever of the above methods are chosen, hormone therapy will be required for several months after the operation to prevent recurrence of the disease.

Surgical method

Decades ago, endometriosis of the cervix was regarded as a neoplastic disease, so the choice was made in favor of surgery.

For this reason, many young women have lost their reproductive function. Modern gynecology applies surgical treatment only for certain indications:

  • if a conservative treatment for 3-4 months did not give an effect,
  • when there is a spread of the disease beyond the uterus and appendages - on the pelvic organs, abdominal cavity, retroperitoneal space, with severe pain, impaired bowel function,
  • if the patient is not going to give birth anymore or has already gone out of childbearing age.

A rare case is interesting: the parents of a 12-year-old girl treated her for back pain, blood in the urine. An examination revealed endometriosis with spread to the kidney, the child was operated on.

Among surgical methods, preference is given to minimally invasive organ-preserving interventions - endoscopic, laparoscopic, which do not require incisions, and the removal of nodes is performed under the control of a video camera through a probe.

Laser vaporization (evaporation) of foci, as well as cryodestruction (cold removal), ultrasound and radio wave coagulation are widely used and give a good effect.

Complete removal of the uterus with the cervix and appendages is performed in advanced cases of the disease, as well as in women who have gone out of fertile age.

Hormonal effects

Therapeutic tactics for newly diagnosed endometriosis is to correct the hormonal background in order to suppress the process of active growth of the endometrium under the influence of an excess of estrogens.

Hormonal treatment today is the leading method of dealing with endometriosis. The choice of drugs and their dosage is based on laboratory determination of the content of sex hormones in the blood.

Among the estrogen antagonists, Tamoxifen, Leuplerine, as well as progesterone antagonists (Gestrinone), sex hormone synthesis antagonists (Danol, Nafarelin) are prescribed.

In mild cases of endometriosis, the course begins with the appointment of pill contraceptives, which normalize the proportions of hormones (Janine, Novinet, Lindinet and other analogues).

When estrogenic activity is too pronounced, they resort to the appointment of male sex hormones - androgens (Methyltestosterone and analogues).

Patients who have already been treated in the past with the help of hormones that have a relapse of the disease are subject to the removal of lesions on the cervix by one of the methods.

Additional conservative methods

Regardless of whether the patient is operated on or receives hormonal treatment, it is mandatory to take remedies to eliminate the symptoms of the disease, increase the protective properties of the woman’s body, and improve tissue repair processes.

These include:

  • painkillers and anti-inflammatory drugs (naproxen, Nurofen), also prescribe candles with indomethacin or diclofenac, but not vaginal, but rectal,
  • immunity stimulants - of plant origin, Interferon, Cycloferon, Pentaglobin; the RESAN anti-cancer vaccine gives a good effect, which causes the body to produce antibodies against the proliferation of endometrial cells,
  • iron preparations - are prescribed for bleeding to increase hemoglobin level (Aktiferrin, Ferropleks, Ferrum-lek, Maltofer, Hemoheller),
  • vitamin-mineral complexes, which necessarily include vitamins A, C, D, E, folic acid, magnesium, calcium, zinc, iron, selenium (Menopace, Multitabs, Multicentrum, Duovit, AlfAVIT).

Conclusion

Cervical endometriosis is a rare abnormality, and in terms of its characteristics it resembles many other medical conditions, which is why it is not always easy to diagnose.

However, it must be understood that the correct diagnosis is extremely important. If a woman experiences symptoms that may indicate endometriosis of the cervix, she should see a doctor for a pelvic exam and subsequent diagnostic procedures.

With cervical endometriosis, the need for treatment does not always arise. However, if a woman is worried about pain or discomfort, an operation to remove endometrial implants will help alleviate the symptoms.

How to eat with cervical endometriosis

Since the main cause of cervical disease is an increase in the synthesis of hormones - estrogen due to metabolic disturbances, nutrition is recommended to be balanced and dietary.

In the diet, the following products predominate:

  • vegetables and fruits, bran bread, unrefined grains, flax seeds - they all strengthen the immune system, ensure the activity of the digestive system, containing fiber and vitamins.
  • sea ​​fish (salmon, mackerel, herring, mackerel) - regulates the synthesis of estrogen and reduces the production of prostaglandins, which reduces pain,
  • legumes and cereals, celery, garlic, parsley - being phytoestrogens, they reduce the production of these hormones by the body,
  • Cauliflower, broccoli - activate the liver, relieve the body of excess estrogen.

It is recommended to limit the following foods in the diet:

  • alcoholic beverages that additionally load the liver,
  • products that increase the synthesis of estrogen - all fat and fried, limit meat, pastries, sweets,
  • Coffee, carbonated drinks increase pain.

Preventive measures

With regard to the prevention of endometriosis of the cervix, it should be said that first of all it is necessary to exclude the factors contributing to the development of endometriosis. In order to avoid artificial interruption of pregnancy, women are recommended to be protected. You should also pay attention to the state of your immune system, you may need to take vitamin complexes to restore it.

Other mandatory preventive measures can be called a cautious attitude to ultraviolet radiation and heavy physical exertion, which can also trigger the development of endometriosis pathology. In addition, each woman is recommended to regularly visit the gynecologist even in the absence of any complaints.

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