bubble_chart Overview

Depending on the degree of inflammatory stimulation, cervical erosion can manifest in different forms. When the columnar epithelium of the cervical mucosa grows slowly, the surface remains flat and smooth, resulting in simple erosion. If the columnar epithelium proliferates rapidly, forming glandular hyperplasia, it becomes glandular erosion. When the glands dilate, follicular erosion occurs. If accompanied by stromal hyperplasia, small protrusions form, covered unevenly by columnar epithelium, leading to papillary erosion. These types often occur in combination. Cervical erosion is one of the most common gynecological conditions.

bubble_chart Etiology

The causes of the disease include mechanical irritation or injury, such as sexual activity, late abortion, and childbirth lacerations, as well as bacterial invasion leading to cervicitis; pathogen invasion, commonly caused by general pyogenic bacteria like staphylococci, streptococci, gonococci, subcutaneous nodule bacilli, viruses, actinomycetes, trichomonads, and amoebae, can all result in cervicitis.

bubble_chart Clinical Manifestations

The main symptoms include increased leucorrhea, often purulent in nature. There may be a dragging pain in the lower abdomen and lumbosacral region, as well as bladder irritation symptoms. Patients with more severe erosions may experience varying degrees of bloody discharge, typically presenting with bloody secretions after sexual intercourse. The cervical mucus becomes thick and purulent, hindering sperm passage and leading to infertility.

bubble_chart Diagnosis

The diagnosis is not difficult based on clinical manifestations, but it should be noted that cervical erosion is difficult to distinguish from cervical intraepithelial neoplasia or early cervical carcinoma in appearance. Routine cervical smear, cervical canal aspiration, and if necessary, colposcopy and biopsy should be performed to confirm the diagnosis.

The eroded area of the uterine cervix has a clear boundary with the surrounding normal squamous epithelium. Clinically, it is often classified into three grades: mild (grade I), moderate (grade II), and severe (grade III). If the eroded area accounts for less than 1/3 of the total cervical area, it is classified as grade I cervical erosion. If the eroded area accounts for 1/2 of the cervical area, it is classified as grade II cervical erosion. If the eroded area exceeds 1/2 of the total cervical area, it is classified as grade III cervical erosion.

bubble_chart Treatment Measures

Drug Treatment: For small erosions with shallow inflammatory infiltration, the following drug treatment methods can be used:

1. 10-20% Silver Nitrate: Apply locally once a week, with 2-4 applications constituting one course of treatment.
2. Potassium Permanganate: Apply locally after menstruation, and repeat the treatment once after 1-2 months. When using the above medications, operate carefully to avoid burns to the surrounding vaginal walls, and ensure proper disinfection during application to prevent reinfection.

Physical Therapy: Used for cervical erosions with larger areas and deeper inflammatory infiltration:

1. Electrocautery: A specialized electrocautery device is used to burn the eroded tissue, causing it to necrotize and slough off. The treatment must reach a certain depth to be effective.
2. Cryotherapy: A specialized rapid-freezing device is used to freeze, necrotize, and slough off the diseased tissue of the cervical erosion. The commonly used cryogen is liquid nitrogen, which can lower the temperature of the cryoprobe to -196°C. When applied to the cervical surface, the eroded tissue freezes, necrotizes, and sloughs off, allowing new epithelial tissue to regenerate. One session is usually sufficient for a cure. Generally, there are no adverse reactions, though a few patients may experience mild dizziness or lower abdominal pain.
3. Laser Therapy: A carbon dioxide laser device is commonly used. A specialized laser probe irradiates the cervical erosion tissue, causing it to carbonize, scab, and slough off, allowing new squamous epithelium to regenerate. One session is usually sufficient for a cure. The procedure is generally comfortable, though a few patients may experience bleeding during scab detachment.
4. KS Device Therapy: This treatment uses a special band of light and heat, is painless, and highly effective.

During the above treatments, maintain vulvar cleanliness, abstain from sexual intercourse, vaginal douching, and sitz baths, and schedule regular follow-ups to monitor the healing of the erosion.

Surgical Treatment: For cases where drug and physical therapies are ineffective, the cervical erosion is deep or extensive, the cervix is hypertrophic, or cancer is suspected, a cervical conization or total hysterectomy may be considered.