Cervical erosion is a common disease associated with violation of the epithelial cover (mucous membrane) of the cervix. The meaning of this definition becomes clear if we remember that the uterus is composed of 3 main parts: a wide directional body, a ligament and a narrowed cervix. The cervix is a cylinder “inserted” (i.e. facing its tip) into the vagina. There is a channel inside the cervix that connects it to the uterus cavity. The outer part of the cervix facing the vagina is called the vagina. Inside, the canal of the cervix (cervical canal) is lined with a thin layer of special covering tissue – cylindrical epithelium. The vaginal part of the cervix is covered with a thicker, multilayer, flat epithelium. The same epithelium covers the walls of the vagina itself and serves as a barrier.
How does erosion occur?
When cervical erosion develops, the protective layer of the epithelium is damaged and slackened, which leads to the so-called “true erosion”. This is very rare. Pseudo-erosion or cervical ectopy is more common, in which the thick multilayer flat is replaced by a thin cylindrical epithelium, which normally covers the inner surface of the cervix (cervical canal). This condition is often found in young women. The epithelium is quickly infected with various viruses and bacteria. This creates a permanent area of smoldering or active infection. It gradually spreads upwards (cervical – uterine body – uterine tubes – ovaries) and this leads to the development of inflammatory processes. Among microorganisms that actively reproduce in the eroded area, a special role belongs to the human papillomavirus, with which the most terrible complication of erosion – cervical cancer – is associated. Cervical cancer is the most frequent cancer in women after breast cancer. Of course, not every erosion leads to the development of cancer, but its frequency in women with cervical pathology is increased, so erosion is commonly referred to the so-called background conditions in which various unfavorable factors particularly often cause the disease.
Who has cervical erosion?
Erosion is a fairly common disease. It occurs in 15-20% of women of childbearing age (age, years). The reasons leading to the development of ectopy include infections of various parts of the female genital system (vagina – colpitis (vaginitis); inner part of the cervix – endocervicitis and uterine body – endometritis), as well as hormonal status disorders. The development of true erosion is caused by adverse mechanical, thermal and chemical effects on the cervix, including traumatic intercourse, sloppy insertion of vaginal swabs, the use of some spermicides (chemical agents that kill sperm cells).
Clinical manifestations and diagnosis of erosion
In most cases, the disease goes unnoticed, so you can diagnose cervical erosion only with regular visits to the gynecologist. With extensive, long-lasting erosions may be bloody discharge from the vagina. However, very often contact bleeding secretions (eg, after intercourse) is a sign of already developed cervical cancer. Most often, erosion is detected in a standard gynecological study (examination of the vagina and cervical uterus with gynecological mirrors). In this case, the altered area can be easily distinguished from the surrounding tissues by its characteristic graining and pinkish-red coloring. Sometimes (e.g., with small amounts of erosion) more subtle studies are required: colposcopy (examination of the vagina and the cervix with the help of a special magnifying device) to distinguish true erosion from ectopy (congenital pseudoerosion) and to reveal other cervical pathology hidden under the mask of erosion, as well as biopsy (painless removal of a small piece of tissue with subsequent examination under a microscope). To determine the state of microflora, a doctor prescribes a vaginal and cervical smear, as well as an examination for urogenital infections. The obligatory stage of cervical pathology diagnostics is the cytological examination of a scrape from the cervix. Often, during the examination of the cervix may seem unchanged, and the cytological examination will help to identify existing disorders. Every woman should undergo a regular (every year) cytological examination of a cervical scrap. The smear for the cytological examination is taken with special instruments – a spatula and a brush. This procedure is absolutely painless. Doctor can offer you an examination for human papillomavirus. The fact is that there are highly carcinogenic types of this virus, which may contribute to the emergence of cervical cancer. For this analysis, using a special brush, just take an additional swab.