Rupees ectopia. Cervical ectopia: causes and treatment. What diagnostic procedures are needed?

Ectopia refers to the abnormal position of the columnar epithelium, which is usually found inside the cervical canal. That part of the cervix that borders the vagina is usually covered with ordinary flat cells.

If the disease is not complicated in any way, then usually no clinic is given; if the disease is complicated, itching and various discharges appear.

Almost half of all women on the planet suffer from this disease, and 10% of them have ectopia from birth. It is worth remembering that such an anomaly does not develop into malignant tumors, but against its background the likelihood of such processes increases.

The diagnosis of ectopia is made after examining the cervix with a special colposcope and after taking a biopsy. Treatment depends on the form of the disease.

Classification of pathology and causes of epithelial displacement

Below are several principles for classifying this pathology:

When such erosion heals, the abnormal epithelium is replaced by a normal one.

Gynecologists identify a number of main reasons for the appearance of ectopia:

Thus, almost all processes occurring in the female body can lead to ectopia - from childbirth to various infections.

Manifestations of the disease, its diagnosis and therapy

If a woman has uncomplicated ectopia, there are usually no clinical manifestations, and the disease is detected only during examination by a gynecologist.

Unfortunately, in almost one hundred percent of cases, ectopia is complicated and combined with inflammatory processes and precancerous pathology.

If there are such violations, then clinically strong discharge, vaginal itching, and bleeding will be observed. Changes of a primary nature can even lead to menstruation disorders and infertility.

Identification of the disease

As mentioned above, such a problem, if it is congenital, is detected only when contacting a gynecologist. Visually, this is manifested by the presence of a bright red area with jagged edges on the overall normal background of the cervical epithelium. If you touch such an area, bleeding may occur.

If the doctor discovers such a defect in the mucous membrane, you should immediately perform a colposcopy. With this manipulation, the cervix is ​​stained with an iodine solution. After which, pockets of mosaics or unpainted areas are found on it. Such signs make it necessary to conduct a full examination of the patient.

In addition to colposcopy, diagnostics include:

Cytological diagnostics are also important, making it possible to detect altered epithelium. If abnormalities are detected at all stages of diagnosis, curettage followed by histology is recommended.

To confirm ovarian dysfunction, a hormonal blood test may be performed. After all the measures taken, it remains to differentiate ectopia from erosion and cancer.

Basic methods of treatment and prevention

Treatment of this pathology, as well as its diagnosis, depends on the form of the disease. If the pathology is uncomplicated, then treatment is not carried out at all. The patient is simply observed and all changes occurring with pseudo-erosion are noted.

Treatment of a complicated form comes down to several main steps:

As for prevention, with this diagnosis it is one of the main methods of combating pathology:

As for the prognosis, it is impossible to give a definite answer. Ectopia can occur again, even after full treatment, for example, after a second birth. But in general, if all preventive measures are taken and caution is exercised, the disease has a fairly favorable prognosis.

is a pathological condition in which the cylindrical epithelium extends into the vaginal part of the cervix. Externally, ectopia of the cervix looks the same as erosion, and therefore ectopia is called pseudo-erosion.

The cause of ectopia of the cervix is ​​hyperestrogenism - an increase in the level of female sex hormones, due to which the columnar epithelium creeps onto the vaginal part of the cervix. In women 23-45 years old, the border of the two epithelia is localized at the level of the external opening of the cervical canal, and after 45 years old it shifts towards the cervical canal.

Cervical ectopia is the entry point for chlamydia, herpes simplex virus and other infections, as well as human papillomavirus (HPV), which causes diseases. Ectopy itself does not cause cancer, but it does increase the risk.

Symptoms of cervical ectopia

As a rule, congenital ectopia is detected in girls at the first visit to the gynecologist, shortly after the start of sexual relations. This type of ectopia has no symptoms. The main thing is to regularly come to scheduled appointments to monitor the situation.

Recurrent cervical ectopia of the cervix at an early stage of development is diagnosed two months after treatment during control colposcopy. Late - manifests itself six months later using the same research method.

If we talk about the uncomplicated form of the disease, then this type of ectopia does not manifest itself in any way, but is detected during a routine gynecological examination.

Complicated ectopia is diagnosed, as a rule, after other diseases and inflammations. Sometimes ectopia is combined with precancerous manifestations and is subject to mandatory treatment. The following symptoms appear regularly:

• abdominal pain;
• dysmenorrhea;
• problems with conception;
• spotting, including during sexual intercourse;
• discharge of variable intensity that changes color and smell;
• burning and itching sensation;
• redness and swelling of the labia.

Treatment of cervical ectopia

Cervical ectopia is treated conservatively with the use of anti-inflammatory drugs and physiotherapy. A number of methods are also used to destroy the ectopic epithelium.

The goal of treating cervical ectopia is to remove the columnar epithelium and allow the squamous epithelium to gently return to its place and cover the outside of the cervix. To “destroy” columnar epithelium, use:

The procedure for treating cervical ectopia is usually painless. Although some women experience pain, this is due to the individual sensitivity of the cervix.

Which doctors should I contact for cervical ectopia?

Causes of cervical ectopia

The causes of cervical ectopia are divided into external and internal.

External factors include the following:

1. viral and infectious:
   • early onset of sexual activity;
   • frequent change of sexual partners;
   • infectious and inflammatory processes of the genital organs.
2. traumatic:
   • injuries during childbirth or abortion;
   • use of barrier or chemical contraceptives.

Among the internal causes of ectopia are:

• hormonal imbalances;
• decreased immunity;
• hereditary disposition.

Complications of cervical ectopia

Cervical ectopia of the cervix is ​​dangerous due to complications. Sometimes women, due to the lack of painful symptoms, do not want to treat ectopia. Then complications are possible in the form of inflammatory processes in the vagina, uterus and appendages, which causes infertility, miscarriage and hormonal disorders.

Against the background of ectopia, the following pathological processes sometimes occur on the cervix:

• cervicitis;
• leukoplakia;
• flat condylomas;
• dysplastic processes.

Women are interested in whether it is possible to get pregnant with such a pathology. If ectopia is not complicated by any other inflammation of the genital area, the menstrual cycle is not disrupted, there is no reason for concern: pregnancy will occur without problems.

Cervical ectopia and pregnancy

In a woman's body during pregnancy, changes occur in the cervix. As a result of hormonal changes, the cervix of expectant mothers increases in size, softens, and prepares for childbirth. Against this background, cervical ectopia appears.

If pseudo-erosion is small in size and arose due to hormonal changes in the body (there were no other reasons), then ectopia disappears after childbirth on its own. But more often pregnancy occurs with untreated ectopia.

Cervical diseases cause the following complications:

• threat of miscarriage;
• premature rupture of amniotic fluid;
• cervical ruptures.

Therefore, if an ectopia is detected in an expectant mother, the woman undergoes an examination and, if necessary, a course of anti-inflammatory treatment for infections. But it will be possible to treat pseudo-erosion 6-8 weeks after birth. Childbirth with ectopia usually occurs through the natural birth canal.

Classification of cervical ectopia

The following types of cervical ectopia are distinguished:

Congenital ectopia of columnar epithelium of the cervical canal

When examined in a mirror, congenital erosion looks like a rounded formation of bright red color. Occurs in adolescence and young adulthood. This is the only type of erosion capable of spontaneous self-healing.

True cervical erosion

Defect of stratified squamous epithelium of the cervix. When examined using mirrors, a bright red spot up to 1 cm in diameter is visible around the external os of the uterus with clearly demarcated edges. True erosion lasts 1-2 weeks after which it passes into the next stage (type) of the disease - ectopia.

Ectopia (pseudo-erosion)

A pathological change in which the normal stratified squamous epithelium is finally replaced by columnar cells. When examined in mirrors, ectopia looks like a red area located next to the external pharynx, usually on the back lip. Pseudo-erosion goes unnoticed for months and years. As a rule, erosion does not go away without appropriate treatment.

The risk of degeneration of ectopia into oncology is low in the absence of cell atypia. Patients with the presence of the human papillomavirus HPV (type 16, 18, 31, 33) are wary.

Diagnosis of cervical ectopia

When examined by a gynecologist, it is impossible to establish an accurate diagnosis. If bright red spots are detected in the cervical area, the doctor resorts to additional studies.

First of all, this is colposcopy, which helps to differentiate squamous epithelial cells from cylindrical ones. To exclude malignancy, a biopsy is also performed (at the doctor’s discretion) with a cytological examination of the selected material.

The presence of infections is checked by examining a swab taken from the vagina, as well as the cervix. In addition, laboratory tests are performed to check for the presence of sexually transmitted diseases and sexually transmitted diseases.

Differential diagnosis

To diagnose and confirm the diagnosis of cervical ectopia, as well as to differentiate from true erosion and oncological processes, the Schiller test is performed. When performing the Schiller test, areas of ectopia turn light brown. This is done with 3% acetic acid and iodine.

First, acetic acid is applied to the epithelium of the cervix so that the vessels narrow and the doctor sees the processes on the cervix. After this, the epithelial cells are stained with iodine solution. In this case, pathologically changed cells will not be stained. Only through extended colposcopy can an accurate diagnosis of erosion or pseudo-erosion (ectopia) be made and inflammatory or oncological diseases of the cervix refuted.

Prevention of cervical ectopia

It is much easier to prevent cervical ectopia than to treat and eliminate the consequences of the disease.

• undergo regular preventive examinations with a gynecologist;
• monitor deviations in the body’s hormonal and immune levels;
• treat inflammation, HPV and sexually transmitted infections;
• practice safe sex;
• do not use hormone-containing contraceptives or intrauterine devices;
• strengthening the immune system.

Questions and answers on the topic "Cervical ectopia"

Question:Hello! 1.5 years after giving birth, I went to the gynecologist for an examination. Nothing worries me. During the examination, colposcopy was performed and ectopia of the cervix was detected. They also wrote me cervicitis, viral infection, subclinical HPV infection. I was prescribed a test for STIs, HPV and HSV, and then a biopsy and cauterization of the cervix with Surgitron are planned, since according to the doctor, the ectopia itself will not go away with pills. But several years ago I was already treated for HPV and had tests done 2 times and everything was fine, but at an appointment with a gynecologist at the clinic, she said that my cervix seemed normal and there was no inflammation, but my ectopia was congenital and did not need to be treated. So I’m very, very worried, who to believe? I'm breastfeeding, maybe this has reduced my immunity? Do you recommend cauterization? Should I contact an immunologist? An ultrasound also revealed something on my left adrenal gland; adrenal hyperplasia is in question. Is this all connected somehow? Where to go, where to start?

Answer: Hello. Pseudo-erosion of the cervix or ectopia of the cervix - outwardly looks like a red spot around the external opening of the canal, which is often interpreted by doctors as erosion of the cervix, while the latter is extremely rare and is a defect in the epithelium due to an inflammatory process. Cervical ectopia is a normal physiological state of the cervix, occurs in half of women of reproductive age and does not require treatment. Regular cytological studies, colposcopy, as well as immunotherapy (in the presence of a viral infection) are the basis for the prevention of cervical cancer. In this regard, I recommend discussing with your doctor the possibility of using the drug Groprinosin, which has an immunostimulating and antiviral effect, in the complex therapy of human papillomavirus infection (HPV infection). Treatment must be carried out under the supervision of a doctor. Self-medication is unacceptable.

This disease occurs quite often - in 40-50% of women, and in 11.3% this pathology is congenital. So what is cervical ectopia - a danger or a slight inconvenience?

What such cervical ectopia

Cervical ectopia is also called pseudo-erosion, false erosion, endocervicosis, glandular-muscular hyperplasia. Ectopia is an atypical arrangement of the epithelium, when the cylindrical (prismatic) epithelium, which normally covers the inner part (cervical canal) of the cervix, is transferred to the outer part, replacing the flat one - so-called epithelization occurs. The ongoing displacement of the border of ectopic columnar epithelium and squamous epithelium is characterized by the fact that this border shifts to the zone of the external pharynx, localizing along its circumference (ectopic columnar epithelium - ECE occurs), and the ectocervix during embryogenesis is covered with multilayered squamous epithelium (MSE), which leads to reactive changes.

This pathology occurs in a large number of women under 30 years of age (about 40-50%), and in a certain number of patients this pathology is congenital. In itself, this disease does not degenerate into, but against this background the risk of developing a tumor process may increase.

The process of degeneration can occur due to the fact that in the transformation zone (which are divided into types 1 and 2), flat epithelial cells clog into the glands and form plugs, and this interferes with the release of mucus. Cysts form in the membrane, and their contents suppurate. This kind of process provokes the formation of atypical cells with an abnormal structure - squamous metaplasia occurs. If this condition progresses, then malignant formations occur.

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Classification

By origin, one can distinguish between congenital and acquired ectopia. According to the nature of its course, it can be recurrent; according to its clinical form, it can be uncomplicated or complicated.

Note! The uncomplicated form of cervical ectopia is regarded as a variant of the physiological condition.

Here, only the movement of cylindrical cells into the flat zone is observed, without complications. This form does not require treatment; only periodic gynecological examinations are recommended.

The complicated form is associated with colpitis and chronic cervicitis (inflammation), which are caused by infection in the area of ​​cell movement. Because of this, the ectopic area becomes swollen, damaged and true erosion or inflammatory diseases of other organs of the reproductive system occur.

According to histology, ectopia is divided into:

• Glandular, which has a large number of inflamed glands of the epithelium of a cylindrical structure;
• Papillary (papillary), which is diagnosed when cylindrical cells are grouped into papillae;
• Epidermising, in which squamous epithelial cells can penetrate between columnar cells and displace them. There is no need for treatment, since self-healing of the cervical pharynx coating can occur.

The disease is also divided into congenital and acquired:

Causes occurrence of the disease

The reasons why pseudo-erosion may occur are:

• Changes in hormonal levels, namely, the amount of female sex hormones in the blood increases. This can happen at the beginning of the reproductive period (because of this, the age of onset of the pathology is 20-30 years;
• The use of hormonal contraceptives (the balance of sex hormones is disrupted);
• Endocrine diseases;
• Multiple sexual partners;
• Pregnancy (in this state there is a surge in the amount of hormones);
• Injury to the mucous membrane of the cervix during childbirth, abortion, and this leads to a failure in the formation of cells;
• Infectious and inflammatory diseases of the genital organs, as a result - destruction of the structure of the mucous membranes due to their irritation by pathological secretions;
• Early sexual activity and early childbirth, when the mucous membranes of the cervix are immature and are easily injured.

Failures in the immune system can also be attributed to the causes of ectopia.

Symptoms

Uncomplicated cervical ectopia has no symptoms and is more often diagnosed during examination by a gynecologist.

In most cases (80%), complicated forms are diagnosed, which are combined with inflammation or precancerous conditions (dysplasia, polyps, leukoplakia).

The main symptoms observed with ectopia:

Diagnosis diseases

Congenital ectopia of the cervix can be detected during an initial examination by a gynecologist. If acquired pseudo-erosion is detected, then its formation on the unchanged surface of the cervix is ​​taken into account. When touching the ectopic lesion (usually bright red and irregular in shape) with a gynecological instrument, slight bleeding may occur.

If cervical ectopia is diagnosed, then an extended colposcopy is performed, during which an atypical area is identified. With the Schiller test, a colposcopic picture is determined: iodine-negative zones (in gynecology), mosaic, punctation, leukoplakia. If this is present, then an in-depth study of the patient is prescribed.

For this purpose, the following are carried out: telescopic examinations - transvaginal ultrasound, PCR examination of cervical discharge (analysis to determine the type of infection), bacterial culture. It is also necessary to analyze the scraping for cytology, which makes it possible to identify the presence of squamous and columnar epithelial cells, as well as to see signs of inflammation.

If an abnormal picture is revealed by colposcopy and cytology, then a cervical biopsy is performed. Tests are also performed to study hormonal status (the functions of the ovaries are studied).

Differential diagnosis is carried out with erosion and cancer.

Treatment

Is it necessary to treat cervical ectopia? If uncomplicated ectopia is diagnosed, then no treatment is required; the patient simply remains under the supervision of a doctor in order to see deviations in the maturation of pseudo-erosion in time. This type of ectopia often goes away on its own; it can become epithelialized.

When diagnosing a complicated form, all existing complications and consequences are taken into account. Prescribe etiotropic antiviral and anti-inflammatory therapy, prescribe a suitable type of contraception, and correct hormonal and immune disorders. After treatment of the infectious process, a procedure is carried out to destroy the ectopia using cryogenic exposure, laser or chemical coagulation, radiosurgery, and diathermocoagulation.

If there are cysts, they are opened - D-puncture with removal of the contents, and then cauterization of the damaged surface.

They are especially careful when choosing treatment for nulliparous women, since it is necessary to use the least traumatic methods so that scars are not left.

This is an atypical position of the cylindrical epithelium covering the inside of the cervical canal of the uterus; the norm is the presence of squamous epithelium. Clinical symptoms appear only in a complicated form: white discharge, discharge mixed with blood, itching and burning of the vulva, dyspareunia. Diagnosis of cervical ectopia of the cervix is ​​carried out using a gynecological examination, colposcopy, and in individual cases - biopsy. Treatment of ectopia is necessary only in a complicated form; the uncomplicated form does not require treatment, but only requires control of the disease.

Cervical ectopia of the cervix: what is it?

Modern medicine uses such definitions as pseudo-erosion, endocervicosis, false erosion to designate the disease ectopia. Ectopic columnar epithelium of the cervix occurs in 40% of women, while more than 11% of all cases are congenital anomalies. Patients of childbearing age are at risk (up to 50% of all cases). A history of ectopia in women increases the risk of the formation of malignant tumors, as well as the development of various inflammations of the vulva.

During a gynecological examination without the presence of ectopia, the cervix is ​​covered with squamous epithelium in several layers. Using mirrors and internal examination, the cervical canal, which is covered with columnar epithelium, is revealed. In the presence of cervical ectopia, the photo demonstrates that the line between the epithelia is deformed and moves closer to the outer cavity of the vagina, being located either locally or in a circle, the picture is completely different.

Classification of cervical ectopia of the cervix

Modern medicine defines several forms of ectopia, both by origin and localization, and by the course of the disease. Ectopia can be either a congenital disease (about 11% of all cases) or acquired. Signs of ectopia may be uncomplicated, which is the norm on an individual basis and does not require treatment; complicated ectopia is often caused by inflammation inside the genital organs, which also involves diseases such as colpitis and cervicitis. These diseases are infectious, their complete cure is necessary first of all. In the future, the prognosis of ectopia may not have any signs and a relapse may occur.

1. When the structural and skin elements of the cervix change, as well as when their relationship is dysfunctional, cervical ectopia is ectropion.
2. Based on histological characteristics, they are distinguished:
   • pseudo-erosion;
   • papillary - structural formations of the cylindrical epithelium of the uterus;
   • glandular - ectopia with inflammation, abscess of glands with branching is noted.

Scarring during ectopia is accompanied by the transformation and renovation of the epithelium from cylindrical to flat. The process involves additional cells, which, through division, turn into an immature form, and then acquire a mature stage.

With colposcopy, it is possible to differentiate changes in the skin. Under negative conditions, cellular transformation may not have a logical conclusion. In this case, a relapse of ectopia occurs. It is also possible for a retention cyst of the cervix to appear if the pharynx has a skin growth of a metaplastic type.

Causes of cervical ectopia of the cervix

Cervical ectopia can develop in conditions of changes in the functional systems of the body, including:

• hormonal disorders;
• inflammatory processes;
• presence of injuries and damage to the genital organs;
• general decrease in immunity due to chronic diseases.

The causes of ectopia of the uterus are diseases of the reproductive system that occur in the patient’s history and which have relapsed. Such diseases include chlamydia, mycoplasmosis, vaginitis, endocervitis. Changes in the microflora of the vagina, a quantitative increase in opportunistic flora due to bacteria such as streptococcus, staphylococcus, E. coli, etc. - all this can lead to the development of ectopia. In addition, vaginal discharge provokes changes in the squamous epithelium of the cervix, where erosion forms. Subsequently, erosion is differentiated as ectopia.

Injuries and mechanical damage can cause ectopia. Difficult childbirth, surgical termination of pregnancy, douching, placement of an IUD also increases the risk of pseudo-erosion and the development of the inflammatory process.

Hormonal imbalance in the body is also one of the causes of ectopia. Very often it is a concomitant disease with ovarian dysfunction, endometriosis, fibroma.

A decrease in the immune system and protective properties of the body can develop as a result of diseases such as diabetes and obesity.

The following conditions play an important role:

• early sexual life;
• frequent change of partners;
• unprotected sex;
• multiple births;
• multiple abortions.

All this is fertile ground for the occurrence of pseudo-erosion.

Symptoms of cervical ectopia

Symptoms and manifestation of ectopia are observed in a complicated form. As a rule, it is accompanied by diseases such as dysplasia, leukoplakia, and polyps. There may be a discharge that is whitish or mixed with blood in the presence of colpitis or endocirvicitis.

At the initial stage of a complicated form of ectopia, the patient may complain of changes in the nature and timing of the menstrual cycle, as well as the inability to become pregnant for a long time (1 year).

The uncomplicated form of cervical ectopia of the cervix does not have any special signs. During a gynecological examination, it is easily detected by a specialist.

Diagnosis of ectopic columnar epithelium of the cervix

Diagnosis of pseudo-erosion at the initial stage includes a primary gynecological examination by a specialist, thanks to which it is possible to identify the nature of ectopia - congenital or acquired. If the form is congenital and there are no complaints from the patient, further diagnosis and special treatment are not required. In the acquired form, it is necessary to evaluate the previous nature of the columnar epithelium of the cervix and compare it with changes in the vagina at the time of diagnosis.

Diagnostics using gynecological speculum and instruments reveals a violation of the epithelial line, the presence of a red inflammatory focus of the uterus, which can bleed when pressed.

Colposcopy and Schiller tests are mandatory measures to identify ectopia of the columnar epithelium of the cervix. These methods reveal the following indicators of the disease:

• transformation of uterine tissue into new structural compounds;
• the presence of a cylindrical zone of skin and a displacement of the connection line closer to the exit of the uterus;
• leukoplakia;
• punctuation;
• mosaic.

With the listed signs of ectopia, further diagnosis consists of:

• bacteriological culture;
• PCR diagnostics;
• microscopy;
• cytological examination;
• in some cases, a biopsy is indicated.

Additionally, studies of the ovaries are carried out, their functionality and the presence of possible hormonal disorders are determined. If any violations are detected, consultation with a gynecologist-endocrinologist is mandatory.

Treatment of cervical ectopia

The complicated form of pseudo-erosion has several treatment options, depending on the nature of the identified disorders. Anti-inflammatory drugs must be prescribed. An individual contraceptive program is selected together with a gynecologist-endocrinologist. Hormonal imbalances in the body are also treated.

Treatment of cervical ectopia involves the possibility of undergoing various therapies:

• laser therapy;
• cryotherapy;
• radiosurgery;
• diathermocoagulation, thanks to which the internal inflammatory process of the cervix stops and ectopia recurs.

When diagnosing diseases of the genital organs, further treatment occurs on an individual basis, depending on the specific disease, nature and location.

Uncomplicated ectopia does not require treatment. A patient with a history of this disease should simply be under the supervision of a doctor and follow his recommendations, which should contribute to the regression of the disease. If signs of ectopia are detected, the woman needs to undergo an examination as soon as possible to identify pseudo-erosion of a complicated form.

Prevention and prognosis of cervical ectopia

Cervical ectopia of the cervix has a positive prognosis when the disease is detected. The disease is monitored through colposcopy every six months, even in the absence of complaints about health.

Carrying out preventive measures consists of timely diagnosis and further treatment of any diseases that the patient has. Women who have endocrine disorders are at risk; they need constant monitoring by a gynecologist-endocrinologist to monitor the condition of the body and timely identify disorders.

Also, to prevent ectopia, constant examination by a gynecologist is necessary to detect infectious diseases of the genital organs.

Proper management of intimate life, properly selected contraception, avoidance of unwanted pregnancy - all these are the main preventive measures that must be observed.

Cervical ectopia is a pathological condition in which the columnar epithelium spreads beyond the cervical canal. The uncomplicated form of the disease is asymptomatic. The development of consequences is accompanied by the appearance of pain during sexual intercourse, burning in the labia minora, and bleeding. Ectopia is detected during a gynecological examination, the final diagnosis is made based on the results of colposcopy. Treatment in the early stages is usually not carried out; if there are dangerous consequences, the affected areas are removed.

Cervical ectopia is often called pseudoerosion or endocervicosis. Normally, the external pharynx is covered with squamous epithelium, while the cervical canal is lined with cylindrical epithelium. With ectopia, the second type of tissue appears in the vaginal area. Pathology is detected in every second woman; in some cases, the deviation is congenital. Most often, the disease is diagnosed in girls. Ectopia is not capable of malignant degeneration, but if it is present, the risk of developing cervical cancer increases.

By origin, pathology can be primary or acquired. It can have an acute or recurrent course. Simple and complicated forms of pseudo-erosion are identified. Currently, uncomplicated ectopia is considered to be a variant of the norm. The development of dangerous consequences is facilitated by the addition of infections, leading to the development of colpitis or cervicitis. When the ratio of stromal and epithelial tissues is disturbed, ectopia of the cervix is ​​called ectropion. According to histological characteristics, papillary, squamous and glandular forms of pathology are distinguished.

In the latter case, an accumulation of glands with branched excretory ducts is detected, as well as symptoms of the inflammatory process. With papillary pseudoerosion, the growth of stromal elements and the formation of growths covered with cylindrical epithelium are observed. Regression of the pathological process is characterized by the replacement of these tissues with mature flat cells. The process involves reserve cells, which first degenerate into undeveloped, then into mature metaplastic epithelium. Under the influence of unfavorable factors, this process can be disrupted, which is why ectopia occurs again. When the excretory ducts of the cervical glands are blocked, cysts form.

Causes of the disease

At a young age, ectopia is considered as an anatomical feature associated with excess estrogen production. The occurrence of pseudo-erosion during pregnancy is also considered a variant of the norm. This is due to the cessation of ovarian function. In other cases, the development of ectopia can be caused by inflammatory processes, improper functioning of the immune and endocrine systems, and injuries. Pseudo-erosion can occur against the background of bacterial vaginitis caused by opportunistic microorganisms and STI pathogens (chlamydia, ureaplasma, gardnerella). Pathological discharges that fall on the vaginal part of the cervix contribute to the destruction of squamous epithelium and the occurrence of true erosion. After a few days, it is covered with columnar epithelial cells, forming an ectopic area.

The development of inflammatory processes is facilitated by damage to the cervix during childbirth, abortion and surgical interventions; use of chemical methods of contraception and installation of an intrauterine device. It is believed that the occurrence of ectopia is associated with hormonal imbalance. This condition often accompanies endometriosis, ovarian cysts, uterine fibroids and other pathologies associated with hyperestrogenism. Proponents of the immunological theory take a decrease in the body's defenses as the basis for the mechanism of development of ectopia.

The acquired form of pathology develops with early onset of sexual activity, frequent changes of partners, the presence of chronic diseases, frequent childbirth and smoking.

Clinical picture

Uncomplicated forms of ectopia do not manifest themselves in any way; they are discovered during a routine medical examination. However, in most cases, the development of inflammatory and precancerous processes is observed - dysplasia, polyposis and leukoplakia. When colpitis or endocervicitis occurs, profuse discharge, itching and pain appear. The causes of ectopia can lead to reproductive dysfunction.

The presence of congenital forms of the disease is confirmed at the first visit to the gynecologist. Acquired cervical pseudoerosion usually develops in a previously unchanged area of ​​the cervix. During a gynecological examination using speculum, areas of hyperemia of the mucous membranes are detected. Touching them leads to minor bleeding. To make a final diagnosis, extended colposcopy is used. During the examination, a changed area consisting of columnar epithelial cells is separated. The Schiller test allows you to detect pathological processes such as leukoplakia and dysplasia. In this case, the patient needs additional examination.

It is necessary to carry out bacteriological tests to help determine the causative agent of the infection and its sensitivity to antibiotics. Cytological examination of samples is mandatory, revealing the presence of columnar epithelial cells and signs of inflammation. If test results deviate from the norm, a biopsy or diagnostic curettage may be prescribed, followed by histological examination. Functional tests help diagnose ovarian dysfunction. Additionally, a blood test for hormones is prescribed. A gynecologist-endocrinologist will treat hormonal disorders. When making a diagnosis, it is necessary to exclude diseases such as cervical cancer and true erosion.