CervicitisÂ – inflammation term that includes allÂ cervix, is very common in clinical pathology.Â Due toÂ inflammatory damageÂ of theÂ vagina,(vaginitis)Â in most cases accompanies inflammation of the cervix and many doctors prefer the term colpitisÂ – which means cervico-vaginalÂ inflammation of. Therefore colpitisÂ represents the reason ofÂ approximately oneÂ thirdÂ of gynecological appointments. About 50 % of all women had aÂ colpitisÂ at some point in life. According to evolution cervicitis can be acute or chronic.
Top cervix is the lower uterine segment, which is visible through the vagina. It is an important part of the genital tract, fulfilling several functions such as:
- Menstrual function:Â the cervixÂ is a channel through which blood flows from the uterus in the first quarter, in cases of congenital absence of the cervix or from its obstruction,Â the menstrual blood stagnates in the uterus.
- Static function:Â through its situation between the uterus and vagina,Â it maintains a normal position of theÂ pelvic organs
- Sexual function: with a rich innervation, theÂ cervixÂ stimulates secretion of someÂ hormones andÂ cervical gland secretion
- Fertilization function: endocervicalÂ gland secretions (cervical glere) by composition favors the rise of sperm
- Pregnancy:Â the cervixÂ is very important both during pregnancy, being a barrier between the vagina and uterus,Â also during labor.
Considering all these functions, preventing and treating diseases of the cervix may have numerous beneficial effects on women’s health.
The causesÂ of cervicitisÂ are veryÂ variable, most often being determined by:
- Infection withÂ Chlamydia trachomatisÂ –For Chlamydia Cure –Â Click Here!
- Infection with trichomonasÂ vaginalis
- Trichomoniasis association with CandidiasisÂ – Find out if you Have Bacterial Vaginosis – Take The Quiz
- Gonorrheae Neisseria (Gonorrhea) – Â At-Home Gonorrhea Test Kit –Â Â Click Here!
- Herpes simplex virus Â – For The Herpes Miracle – Click Here!
- Human papilloma virus (HPV)
- Other less common causes are: mycosis, syphilis, tuberculosis, mycoplasma.
Factors that can change the consistency and appearance of secretions
CervicitisÂ Risk Factors
Cervicitis appearance is favored by the following factors:
- Cervico-vaginal infections
- Obstetric trauma – occurring during birth (cervix trauma)
- Local trauma secondaryÂ to sexual contact, use ofÂ internal buffers
- Intrauterine device (IUD)
- EctopicÂ congenitalÂ defects (glandular epithelium of the cervical canal slipps off the external orifice of the cervix)
- Local maneuvers: curettage, hysteroscopy, etc..
Cervictis Signs AndÂ Symptoms
The main symptom of chronic cervicitisÂ is leukorrheaÂ – a vaginal discharge, constant, philantheÂ not very abundant, which can sometimes contain blood grooves.Â The color and its appearance varies with the etiologicÂ agent involved. Usually the presence of cervicitisÂ does not cause pain, fever and menstrual disorders and can evolve for years. But ifÂ the ligaments that support the pelvic organs are asloÂ inflamed, back pain, dysmenorrhea, dyspareunia (painful intercourse), menorrhagia (heavy menstruation) may occur. Local inflammation causes changes in cervical mucus that may affect sperm and their ascent,Â leading toÂ infertility.
CervicitisÂ Investigations And Diagnosis
The methods used for investigating diseases of the cervix are:
- Clinical examination: vaginal exams,Â by which the doctor notes pathological changes and possibly cervical secretions presenceÂ at this level
- BacteriologicalÂ examination of the cervical secretion, and possibly culture and sensitivity to antibioticÂ test are needed to determine the etiology of infection.
- Pap smear: cytological changes reveal (cellular) cervical
- Colposcopy: a method of inspection of the cervix using an optical instrument that enhances the image, called colposcope, during colposcopyÂ the LugolÂ test is also performed (a solution is appliedÂ to the cervical mucosa)
- AnatomopathologicalÂ examination: a piece of mucosa is takenÂ for biopsy by conizationÂ orÂ endocervical curettage (curettage inside the cervical canal).
Chronic cervicitisÂ is suspected after theÂ clinical examination highlights inflammatory changes, ulcerative lesions, deformities or secretions from the cervix. The certainÂ diagnosis of chronic cervicitisÂ is determined by colposcopyÂ andÂ a Pap smear test. Citobacteriologic examination of secretions is useful to detect the etiology ofÂ the cervical infection.
CervicitisÂ may progress for years, with a more or less Â abundantÂ leucorrheaÂ with that the womanÂ gets used often without pain, fever, menstrual disorders or impaired sexual life. SometimesÂ cervicitis can be complicated by inflammation of the neighboring pelvic organs:
- Inflammation of the ligaments that support the uterus and pelvic organs that can causeÂ abdominal pain, dysmenorrhea, dyspareunia, menorrhagia
- Salpingitis (inflammation of the fallopian tube) which can cause infertility, tubal obstruction secondary to theÂ inflammatory processes
- Chronic urinary tract infections.
Chronic inflammation of the cervix can cause cervical stenosis which can be followed by infertility.
Also theÂ chronic irritation can have a contributing role in causing cervical cancer. Chronic cervicitisÂ isÂ not theÂ cause cancer but may promoteÂ its appearance. Therefore, treatment of chronic cervicitis can be considered a prophylactic measure in the fight against cervical cancer.
Treatment of chronic cervicitisÂ is madeÂ upÂ ofÂ two stages. The first stage consists of medical treatment that is etiologic, which aims to eradicate the infection. The next step is using a surgical procedureÂ which can be one of the following:
- Laser therapy
- Loop excision (electrorezection)
- Amputation of the cervix.
All these methods destroy or removeÂ theÂ modified tissues. It is important to note that symptoms improve after several days of medical treatmentÂ and thisÂ does not coincide with the disappearance of tissue changes, so treatment must be complete.
Medical treatment aims, firstly toÂ eradicate theÂ infection, depending on the etiologicÂ agentÂ and theÂ sensitivity of theÂ etiologicÂ agent found the resultÂ can be a local treatment (with eggs) and if necessary aÂ treatment with antibiotics or oral antifungal drugs. Next a treatment for healing the muocasa it is recommended, butÂ in mostÂ cases it failsÂ to achieveÂ completeÂ remission of lesions,Â thus the patient willÂ require a surgical treatment.
Only after about 2 months after theÂ eradication of infection and if the cervical changes persist, surgery is indicated.
Surgery is done in the first days after menstruation, to let timeÂ for the scar to heal untilÂ the next menstruation and prevent infection. BeforeÂ the procedureÂ a gynecological examinationÂ is requiredÂ to exclude an acute inflammation of the cervix, a condition which requires to postpone the procedure, due to the risk of inflammation extending.
Depending on age, lesion depth and surface, the appearance of colposcopic and cytological changes, one of the following procedures may be performed:
- Cryotherapy is the method by which the pathological tissue is destroyed to a depth of 3-4 mm, by freezing, using carbon dioxide, nitrogen and liquid freon
- Laser therapy: a modern method by which cells are vaporized, without causing tissue necrosis,Â no bedsores and therefore no subsequent secretion as in the case of electrocauterization
- Loop excision usingÂ an eletric current,Â the modified area is removed with the possibility to perform biopsies.
- Conization:Â a portion of cervix mucosa is excised. This method is used for old injuries, recurrent and dysplastic lesions
- Cervical amputation: surgical removal of the cervix, in case ofÂ cervical dysplasia associated with hypertrophy.
ElectrocauterizationÂ is the procedure that isÂ usedÂ most often and is aÂ procedure in which tissues are coagulated (burned) under the caloric effect of an alternative current. It isÂ carried outÂ in theÂ first few days after menstruation. No local anesthesia is required because there are very few nerve endings in the cervix.Â Before performingÂ anÂ electrocauterizationÂ a pelvic examination is required in advance to exclude states that contraindicate this procedure such asÂ pregnancy, acute or sub-acute inflammation and feverishÂ states in general. In the first 48 hours following the procedureÂ bed rest is recommended,Â and in the first 5 days an oral antibiotic to avoid reactivation ofÂ a latent infection.
On the cervix, the place where the electrocauterizationÂ was performed will formÂ a crustÂ which will be removed in 3-4 weeks, during which a dirtyÂ vaginal discharge will persist which can be followed by aÂ bloody discharge, not very abundant, which may take 10-15 days. Full healing is achieved in about 6 weeks, during which sexual rest is recommended. To promote healingÂ vitamin C can be administered orally.