Cervicitis is a total infectious process in the cervix, including inflammation of the mucosa and inflammation of the vaginal mucosa of the cervix. Cervicitis rarely is isolated, in 75-80% of cases, the disease is accompanied by adjacent pathologies - vaginitis and endometritis. Running cervicitis can lead to erosion of the cervix, the formation of polyps in the uterine cavity, malignant degeneration of the cellular structures of the uterus, infertility.
Cervicitis: causes
It develops as a result of intrusion into the canal of the cervix of streptococci, staphylococci, E. coli, less often - viruses, trichomonads. An anaerobic microflora and chlamydia play a role in the occurrence of cervicitis. Cervicitis of syphilitic or tuberculous etiology is comparatively rare.
Predisposing factors:
- menopause;
- irritation of the cervix by chemical / mechanical contraception;
- weakening of immunity, omission of the uterus;
- traumatic delivery (numerous perineal / cervical ruptures);
- ectopia of the cervix, surgical termination of pregnancy.
Typical varieties of pathology
- Viral cervicitis. The causative agent is the existing virus in the body - HIV, herpes simplex, human papillomavirus. Viral cervicitis manifests itself particularly vividly - painful sensations during urination, severe itching in the external genital organs, cutting pains in the lower abdomen.
- Purulent cervicitis. "Starts" against the background of venereal diseases, characterized by the addition of subepithelial deformation of the cervical membrane and inflammation of the cellular material of the cylindrical epithelium. Purulent cervicitis provokes inflammatory processes in other organs of the reproductive apparatus, prevents the bearing of the fetus, and causes obstetric pathology.
- Bacterial cervicitis. It comes as a result of the activity of pathogenic bacteria. Pathologies are preceded by gonorrhea, trichomoniasis, vaginal dysbiosis.
- Atrophic cervicitis. It results from the penetration of the virus during unprotected coitus or develops after incorrect abortions and diagnostic curettage.
- Candid cervicitis. Disease associated with prolonged parasitism of Candida fungi in the cervix.
- Diffuse cervicitis. The pathology that spread throughout the vaginal section of the uterus.
Acute cervicitis: symptoms and treatment
At the first stage, the mucosa of the cervical canal is affected with further involvement in the pathological process of the stroma. The acute form of cervicitis is characterized by an expansion of the vascular pattern, the accumulation of leukocytes near the glands and vessels, perigendulary / perivascular juvenile abscesses. Patients are concerned about moderate pain in the lower abdomen, burning in the vagina, mucopurulent or purulent discharge from the genital tract, postcoital bleeding, frequent urge to urinate. When gynecological examination reveals puffiness, reddening of the mucosa of the vaginal segment of the cervix, signs of pseudo-erosion or "continuous erosion."
The diagnosis of "acute cervicitis" is based on a visual examination of the cervix with the help of a colposcope and vaginal mirrors, an anamnesis, a bacteriological examination of the canal separating the cervix. Postponed viral infection, conjunctivitis, fever - an occasion for virological research. Therapy is performed taking into account the stage of the disease, the accompanying pathologies, the nature of the pathogen. Assign vaginal douching with lactic acid solution, chamomile infusion, antibiotics or sulfonamides (bacterial C), tetracycline and Doxycycline (chlamydial C), metronidazole (anaerobic microflora), leukocyte interferon preparations (viral C).
Cervicitis - possible complications:
- recurrent infectious process in the organs of the genitourinary system;
- "Launch" of the pathological mechanism: cervical erosion - dysplasia - oncology;
- polyps on the cervix and in the uterine cavity;
- malignant degeneration (malignancy) of the cellular structures of the uterus;
- miscarriage, infertility.
Chronic cervicitis: symptoms, diagnosis, treatment
The chronic stage of the disease is a consequence of untreated acute cervicitis. Characterized by lean mucopurulent or purulent discharge from the vagina, edema and minor hyperemia of the cervix.
Morphological signs of chronic cirricitis:
- Muscular and connective tissue elements are involved in the inflammatory process;
- excretions from the genital tract are intensified 1-2 days after the end of menstruation;
- the cervical canal is re-infected, the rejection of the epithelium is not excluded;
- The cervix is ​​hypertrophied and compacted;
- flat epithelium partially replaces cylindrical epithelium; metaplasia of epithelium is likely;
- there are infiltrates and cysts.
Diagnostic measures
Diagnosis of chronic cervicitis is often difficult due to lubricated symptoms, which leads to untimely therapy and the transition of the disease to a long process that occurs with exacerbations, difficult to respond to drug treatment.
Stepwise differential diagnosis of cervicitis:
- careful analysis of anamnesis with obligatory account of the transferred labor and gynecological operative interventions;
- evaluation of the clinical picture;
- examination of the cervix and cervical canal with the help of mirrors;
- the study of the results of cytology, microbiological research.
Necessary tests:
- macroscopy of vaginal discharge, urethra, cervical canal on bacterial flora;
- smear on oncocytology;
- bacteriological culture with the isolation of the pathogen, the detection of its sensitivity to antibacterial drugs;
- general analysis of urine, blood;
- test for HIV and syphilis, sowing on gonococcus;
- colposcopy (detection of deformed segments that differ in vascular structure, color, structure from the rest of the surface);
- diagnosis of ureaplasma, mycoplasmal, chlamydial, papillomavirus, herpetic infections.
Treatment of chronic cervicitis
- Elimination (elimination) of the infectious agent. Complex preparations with antibacterial, antiprotozoal, antimycotic action (Tantum Rose, Terzhinan, Polizinaks) are used. In the presence of ureaplasma, chlamydial infection, trichomoniasis, candidiasis, local therapy is supplemented with oral medication.
- Removal of foci of ectopia (pseudo-erosion). Viral and chlamydial infections imply the use of physiosurgical methods of treatment (cryosurgical action, laseraporapisation, electroconjuration). When performing the destruction of the modified exocervix, the presence of inflammation is necessarily taken into account. If it is not possible to achieve a positive result after destruction, a normal epithelization will not be observed on the wound surface of the cervix for a long time, which can lead to scar deformation of exocervix, endometriosis of the uterus, and the appearance of multiple cysts.
- Correction of vaginal microbiocenosis. For immunocorrection use a combination of immuno-correctors (Imudon) and eubiotics (Hilak-forte).
Preparations for the treatment of cervicitis:
- Doxycycline (0.2 g per day throughout the course);
- Acyclovir (200 mg five times a day for 5 days);
- Sumamed (single dose, the dosage is determined by the attending physician depending on the type of pathogen);
- Valtrex (twice a day for 500 mg for 5 days);
- Terzhinan (one suppository per day, within 10-12 days);
- Tarium (once 2 tablets);
- Maksakvin (once a day for 400 mg, duration of admission is determined by the doctor);
- Erythromycin (duration of the course / dosage is determined by the doctor depending on the type of pathogen).
Candles from cervicitis
Preparations in the form of suppositories (suppositories) are widely used in the complex treatment of chronic cerebrovascular disease. Their use makes it possible to point to the immunopathogenesis of the inflammatory process by regenerating the disturbed homeostasis. The optimal ratio of components in suppositories ensures active absorption of the cervical mucosa and good tolerability.
Terzhinan. Antifungal and antibacterial candles of complex action, are active against pyogenic bacteria, trichomonads, anaerobic flora, Candida fungi. Have a local anti-inflammatory effect. Auxiliary components of the candles retain the integrity of the vaginal epithelium in infectious inflammatory diseases, maintain a normal pH balance.
Polizhinaks. Combined drug, characterized by antifungal, bactericidal, antibacterial effect. Active substances Polizhinaksa (polymyxin, neomycin) neutralize many Gram-positive / Gram-negative microorganisms, improve trophic processes in the mucous membrane of the vagina.
Betadine. Antimicrobial suppositories of a wide spectrum of action, are effective against viruses, fungi, bacteria, quickly restore the normal microflora of the vagina.
Macmirror complex. Candles are part of a group of antiseptics and antimicrobials. They have a pronounced antifungal, antibacterial, antiprotozoal effect. Do not violate the physiological flora, restore the normocenosis of the vagina.
Cervicitis in pregnancy
The problem of cervicitis becomes particularly important in pregnancy. The presence in the anamnesis of the diagnosis of "cervicitis" implies a high probability of premature births, purulent-septic complications, intrauterine infection of the fetus. In Russia, the percentage of intrauterine infections varies between 6-50%, reaching 75% among preterm infants. The incidence of perinatal mortality from this pathology varies from 3% to 65%. There are five ways of penetration of the infectious agent into the body of a pregnant woman: descending, ascending, mixed, transdecidual, hematogenous. The most dangerous is the ascending one, in which the infection enters the uterus through the cervical canal. The chronic focus of inflammation in the cervical canal serves as convenient "gates" for pathogenic viruses and bacteria. If intrauterine infection occurred in the early stages of pregnancy, embryopathies are formed provoking primary placental insufficiency and congenital malformations - this results in undeveloped pregnancies and miscarriages.
Infection at late stages is accompanied by delayed fetal development, generalized / local lesions of the fetus, formation of a repeated placental insufficiency. Generalized forms of infection most often develop in the first trimester of pregnancy, when the fetus is not yet able to localize the inflammation. In the third semester, inflammatory mutations cause obturation (blockage) or a significant narrowing of the openings / channels, which leads to anomalies of the already formed organ - hydronephrosis and hydrocephalus. During gestation (the number of full weeks of gestation), the cervix protects the fetal egg and the uterine cavity from exogenous pathogens, performing a barrier role. Cervicitis provokes premature termination of pregnancy due to infection of the embryo, placenta, amniotic fluid, the fetus itself.
Infection of water and shells is possible with ascending infection. Pathogenic organisms penetrate into the fetal fluid, migrate between the membranes and reach the basal plate, where they are countered by leukocyte infiltration. Parallel to the amniotic fluid, a foci of infection is structured, which causes fetal death.
Cervicitis: treatment during pregnancy
Cervicitis during pregnancy requires urgent detailed examination and complex therapy. Apply antiviral, antifungal, antibacterial drugs, given the type of infectious agent and its resistance to drugs. The safest and most effective drug for the treatment of cervicitis in pregnant women is Sumamed. It is well established in the treatment of mycoplasmal, ureaplasma, chlamydial infections. Sumamed (active substance - azistromycin) persists in the inflammatory focus of 5-8 days, which allows doctors to develop the shortest (3 days) and safe for pregnant medical courses. Timely and adequate therapy of the disease can neutralize the complications that are associated with pregnancy, and significantly increases the likelihood of normal delivery.
Treatment of cervicitis with folk remedies
Recipes of traditional medicine for the treatment of cervicitis can be used only "in conjunction" with traditional methods and only after consulting with the doctors. Self-medication can lead to serious complications.
Broths for douching:
- take in equal proportions grass spores, leaves of the three-leafed watch, the roots of elecampane, fruits of fennel, grass shepherd's bag. Two large spoons of a collection to fill in with 500 milliliters of boiled water, to sustain on weak fire of 10-15 minutes, to insist, to cool. Use in a warm form;
- take in equal proportions the bark of willow white, leaves of mother-and-stepmother, birch, bird cherry, grass of nettle, juniper roots, caraway seeds, straw of oats. Two tablespoons of the collection (large) pour 500 milliliters of boiling water, carefully strain, cool. Apply in a warm form;
- combine plantain, Icelandic moss, Goose's goatee, sage, woodruff, lilac flowers, chicory root. Pour two tablespoons of a dry mixture with a liter of boiling water, insist 10-15 minutes, drain. Use in a warm state.
Ointments:
- take the roots of the snake mountaineer, dandelion, flax seeds, birch leaves, kipreja, celandine grass, wormwood, sage, lilac flowers. Grind into powder 50 grams of collection, pour 500 milliliters of clean water, boil in a water bath in 2 times. Add melted butter to the broth (50 milliliters), boil for 20 minutes, add glycerin (50 milliliters), cool well;
- Icelandic moss, calendula, clover, juniper pine, plantain, flax seeds, sea buckthorn, field horsetail, chamomile. Ingredients chop, pour 500 milliliters of water, boil twice, add melted butter (50 milliliters) and glycerin (50 milliliters). Boil another 20 minutes, cool. Apply for bandage tampons.
Infusions for oral administration:
- take in equal proportions wormwood, lemon balm, flax grass, wormwood, triple leaf leaves, blueberries. Ingredients well grind, mix. A teaspoon of the collection to fill with 250 milliliters of boiling water, insist 2-3 hours, drain. Drink the infusion after 20-25 minutes after eating;
- to connect the goatee with goose, tansy, cumin seed, celandine leaves, guelder rose, geranium. Grind, dry, brew a tablespoon of collection 350 milliliters of boiling water. Use 1.5-2 hours after eating;
- take leaves of birch, raspberries, St. John's wort, field horsetail, mint, wormwood (in equal proportions). A tablespoon of herbs to brew 250 milliliters of boiling water, insist, filter. Drink three times a day for 20-30 minutes before meals.
Prevention of cervicitis:
- regular preventive examinations at the specialized specialist;
- treatment of urinary infections, venereal diseases;
- strengthening immunity;
- hormonal contraception during the menopause.
Cervicitis is a serious pathology that can lead to infertility, therefore it is impossible to ignore the "first bells" that indicate the presence of infection in the genitals. Adequate and timely treatment of the disease allows you to avoid many health problems and complications associated with conceiving and bearing a child.