Cervicitis and endocervicitis: diagnosis and treatment. Acute and chronic cervical endocervicitis - causes and diagnosis, signs and treatment

Endocervicitis is an inflammatory disease that affects the mucosa cervical canal. The main pathogens are various infections and pathogenic microflora.

Also, inflammation can begin due to various mechanical damage, injuries of the endocervix and exocervix (the lower part of the cervix protruding into the vagina).

Many women are mistaken confuse the concepts of exocervix and endocervix, considering it to be a disease. In fact, these are the main mucous membranes of the cervix, each of which performs its own functions.

Endocervicitis is one of the most common diseases in the field of gynecology and is observed in patients childbearing age(from 18 to 45 years).

The incidence rate depends on the trend of increasing frequency gynecological diseases, as well as the prevalence of hormonal disorders.

Causes of endocervicitis

One of the causes of inflammation is the defeat of various antigens of the exocervix and endocervix. Other causes inflammatory process are:

diseases of the pelvic organs:
- acute salpingo-oophoritis ;
- endometritis ;
- pelvioperitonitis ;
- purulent tubo-ovarian formations, etc.;
trauma to the cervical canal and ectocervix during invasive procedures, abortions, complicated childbirth, incorrect identification intrauterine device;
allergic reactions to chemical spermicides, vaginal douching, contraceptives from poor-quality material, contraceptive caps;
limited lesions of the exocervix and endocervix, the cause of which is low level sex hormones during menopause;
incorrect localization of the genital organs due to prolapse of the vaginal and uterine walls;
general weakness of immunity due to the presence of other infectious diseases;
unprotected promiscuity (promiscuity).

Symptoms of endocervicitis

The disease does not have any special symptoms. The main symptom of endocervicitis is a change in the amount and type of cervical discharge. At the beginning of the incubation period, the discharge becomes profuse, cloudy, white, yellow, thick or liquid (see photo above).

The woman has discomfort lower abdomen and tolerable pain in the lumbar region. Sexual intercourse is accompanied pulling pains. Sometimes redness of the genitals, unbearable itching and tingling is possible.

The most striking manifestations of the disease are multiple periglandular infiltrates and microabscesses. Such signs indicate the presence of another inflammatory process.

With a late start and improperly selected treatment, inflammation passes to chronic stage. Despite this, the main symptoms disappear and many patients think they are healthy, but they are not.

Chronic endocervicitis involves the irradiation of inflammation to healthy muscle fibers and support fabric. Initially, the cervix and ectocervix swell, and then they are rammed and hypertrophied. Due to the impact of regular discharge from the endocervix, pseudo-erosion can form on parts of the vagina.

Classification

The disease is classified based on the general course, the specifics of the manifestations, the stage of the prevalence of the pathology and the type of the main stimulus that provoked the onset of the inflammatory process. In gynecology there are the following types this disease:

acute - manifests itself sharply, has vivid symptoms and obvious changes that are noticeable during initial examination at the gynecologist;
chronic - symptoms are not expressed. Appear weak discharge and mild swelling cervix;
macular - inflamed areas are randomly located;
mixed - inflammation affects the entire cervical canal;
non-specific - caused by pathogenic microflora.

Atrophic endocervicitis, which occurs in women during menopause, is considered an independent disease. With this disease, thinning of the membrane of the cervical canal is observed.

Diagnostics

To diagnose and treat endocervicitis, you need to undergo full examination. The standard methods for diagnosing inflammatory diseases of the cervical canal are:

visual and instrumental examination by a gynecologist helps to identify edema in the area of the external lumen of the cervical canal, small hemorrhages, uncharacteristic discharge. An erosive surface is observed in advanced cases;
extensive colposcopy makes it possible to see the expansion of blood vessels extending from the cervical canal, as well as to verify the results of a gynecological examination;
microscopic analysis of cervical smear;
cytological examination helps to assess the structure, degree of damage to tissue cells and the effectiveness of treatment in dynamics;
biopsy. Taking a biopsy implies the exclusion of the acquisition of malignant properties by cells of healthy tissue;
bacteriological culture from the cervical canal is done to identify the main pathogen and determine the sensitivity of the antigen to bactericidal drugs;
polymerase chain reaction reveals the main causative agents of various diseases of an infectious nature;
linked immunosorbent assay - laboratory method, which determines the quality and quantity of various viruses, microorganisms, etc.;
ultrasound examination of the pelvic organs helps to see changes in the cervix, its size, density and possible naboth cysts. Also, thanks to ultrasound, an oncological process is excluded.

In some cases, cervical endocervicitis requires a comparative diagnosis with other diseases - ectopia, tumors, tuberculosis, etc. If necessary, it may be required consultation of a dermatovenereologist, phthisiogynecologist and oncogynecologist.

Treatment of endocervicitis

The goals of treating endocervicitis are to eliminate symptoms and stop the inflammatory process. Treatment methods are as follows:

immunotherapy helps to increase the overall resistance of the body to pathogens and normalizes the immune response;
therapeutic use of special physical means improves recovery processes and strengthens the anti-inflammatory effect of certain medications;
ultra-high frequency therapy (UHF therapy) and ultraviolet radiation panty zone shown at acute form endocervicitis;
in a chronic inflammatory process, the following methods are used:
- decimeter waves;
- magnetotherapy;
- the introduction of drugs through the mucous membranes using a small charge of electric current;
- laser treatment of the vagina;
- mud swabs.

If a woman has nabothian cysts that contain infectious agents, diathermopuncture is recommended.

Medical treatment

Treatment of the disease can be carried out with the help of some groups of medicines. Medicines are:

Plastic and other surgical interventions are required only in the presence of other gynecological inflammatory diseases.

Complementary home treatments

To additional methods treatment of endocervicitis involves a woman's compliance proper nutrition and general management healthy lifestyle life.

It also excludes ways traditional medicine as various decoctions and infusions. But still, you should not neglect medical help, since such a prolonged self-medication can lead to the development of serious complications.

Food

Proper nutrition plays one of the critical roles in treatment. During the entire treatment period, a complete rejection of strict diets, which do not allow to properly saturate the female body with useful substances.

Useful foods are:

turkey, chicken, rabbit;
processed cheese;
cereals (buckwheat, barley, oatmeal);
beans;
pumpkin seeds;
pistachios;
sour cream, natural cream, cottage cheese, butter;
fresh vegetables and fruits;
chicken eggs;
seafood, tuna, flounder, capelin.

All of these products are rich in many vitamins that are necessary for the female body during the treatment and prevention of endocervicitis. Refuse to use alcoholic beverages, flour, caffeine, spicy, smoked and fatty foods, preservation, etc.

Folk remedies

Treatment of endocervicitis with traditional medicine is not excluded. Folk ways are:

Propolis and calendula. Mix pharmacy calendula (20%) with three tablespoons of propolis and 55 grams of lanolin. In the resulting mixture, you can moisten a tampon and use it at night. The course is 7 days;
Sea buckthorn oil. It is considered the most effective in the treatment of cervical endocervicitis. Most commonly used for tampons. The course of treatment is 10 days;
Peony tincture. 4 tablespoons of crushed root pour 500 ml of vodka, insist for a month in a tightly closed container. After taking 1 tablespoon before meals three times a day. Duration of treatment 45 days;
Mummy. Take 0.2 grams orally every day;
St. John's wort. Pour 5 tablespoons with two liters of boiling water, simmer for 15 minutes. Cool and do douching 1 time per day.

All acceptable methods of traditional medicine must be agreed with the attending physician.

Prevention

Preventive measures of endocervicitis imply that a woman follows certain rules and recommendations.

The patient should be periodically examined by a gynecologist, if necessary, do colposcopy, bacteriological studies and other procedures prescribed by the doctor.

It is necessary to strictly observe personal hygiene, use high-quality contraceptives, streamline sex life and not get involved in self-medication.

Also, do not take medicines without a prescription, as taking certain medicines can interfere with subsequent diagnosis and the correct diagnosis.

Specialty: Cardiologist, Therapist, Doctor of Functional Diagnostics.

If inflammation prevails in the cervix and cervical canal, such unpleasant disease called endocervicitis - what it is, the district gynecologist will tell in more detail. Disease occurs due to increased activity pathogenic flora, worries the patient with alarming symptoms, internal discomfort. If the first signs of endocervicitis appear, a woman with characteristic complaints should consult a specialist. Otherwise, among the complications, doctors single out chronic gynecological diagnoses, among them - infertility.

What is endocervicitis

In fact, this is inflammation of the cervix of various etiologies, which disrupts the functionality of the urogenital area, reproductive system. The mucous membrane of the cervical canal and vagina is involved in the pathological process. At first, the specified disease prevails in an asymptomatic form, and the patient learns about its existence unexpectedly - during a planned visit to women's consultation. After the detection of endocervicitis, treatment should be immediate, otherwise the disease becomes chronic.

Symptoms

The attending physician answers questions not only about what endocervicitis is and how to treat it, but also how a characteristic ailment manifests itself in the female body. On the initial stage the activity of the pathogenic flora is moderate, but over time, the unpleasant symptoms only intensify, frightening with their intensity. Endocervicitis occurs in acute and chronic form, and the second stage develops in the absence of timely response measures to the symptoms of the first.

Acute endocervicitis

The disease worries unexpectedly, the patient may confuse endocervicitis with signs of classic thrush. It all starts with internal discomfort, burning sensation and itching in the vaginal area. Specific discharge from the genital organs, which have bad smell, mucous consistency, impurities of pus. Other characteristic signs of acute endocervicitis are presented below:

vaginal burning;
allocation of purulent masses;
emotional instability.

Chronic

If you ignore the acute stage of inflammation, the disease acquires a chronic modification with less severe symptoms. Endocervicitis of the cervix can be detected with a thorough examination, comprehensive study fluid in the cervical canal on the flora. Characteristic symptoms diseases are overtaken by periodic relapses and periods of remission, when a woman mistakenly believes that the pathology has receded forever. The deep layers of the mucous membrane of the cervical canal become foci.

Echo signs of endocervicitis

If a woman experiences internal discomfort after an abortion or long-term use of antibiotics, complains about the manifestation of thrush, it is possible that these are echo signs of endocervicitis, which, in the absence of a timely response from the patient, only progress. The process of inflammation begins when weakened defensive forces, under the influence of other provoking factors in the once healthy body. The disease is not a sexually transmitted disease, but is infectious and inflammatory in nature, sexually transmitted.

The reasons

Before treating endocervicitis, it is required to reliably determine the etiology of the pathological process, to assess the real condition of the patient. The diagnosis often prevails in adulthood, and it is preceded by the penetration and presence of a pathogenic infection in the pelvic organs. These can be streptococci, staphylococci, corynobacteria, E. coli, a fungal infection, or bacteroids. Other causes and prerequisites for the development of endocervicitis are detailed below:

chronic form of chlamydia, gonorrhea, trichomoniasis, others sexually transmitted diseases;
fungal infections of the urogenital area of a woman;
cervical injury after abortion, pathological childbirth;
the presence of an intrauterine device;
inflammation of the appendages;
endometriosis;
vaginal dysbacteriosis;
promiscuous sex life;
inflammation of the pelvic organs;
periods of menopause, menopause;
sexual contact during menstruation;
weakened immunity;
prolapse of the uterus.

Kinds

In order to successfully cure uterine endocervicitis with conservative methods, it is first important to determine the nature and specifics of the pathological process, to identify the main pathogenic factor. Abnormal changes in the structure of the cervix or cervical canal have the following conditional classification depending on the nature of the harmful pathogen:

Specific endocervicitis. Symptoms of a characteristic ailment occur with the pathogenic activity of pathogens that are predominantly sexually transmitted.
Nonspecific endocervicitis. Pathology progresses due to increased activity coli, streptococci, staphylococci, corynebacteria and other anaerobes, aerobes.

Diagnostics

Before being appointed effective treatment endocervicitis, it is necessary to determine the dependence of the pathogenic flora, the nature of the pathogen. For this, one gynecological examination of the patient is not enough; in addition, a number of laboratory tests are required, clinical examinations. Since endocervicitis can be sexually transmitted, both sexual partners are diagnosed. So, you need to pass the following examinations:

seeding tank from the cervical canal;
smear for atypical cells from endocervix and exocervix;
extended colposcopy;
examination for the presence of infectious agents;
Ultrasound of the pelvic organs;
blood and urine tests to detect inflammation;
PCR method for determining pathogenic flora.

Cytogram

This is the main examination of the inflammatory epithelium, carried out in a hospital, which determines the form of endocervicitis, the degree of neglect characteristic pathology. If the tissues of the cervical canal or cervix are pathologically compacted, the disease prevails in a chronic form. A cytogram in acute endocervicitis can confirm the fact that the area of the external pharynx is pathologically inflamed, covered with small erosions.

Treatment of endocervicitis

Recovery after infection is long and chronic endocervicitis Generally considered an incurable disease. Use of conservative methods intensive care provides stable positive dynamics, prolongs the period of remission. Required A complex approach to treatment, which is individually prescribed by a gynecologist. The main goal is to exterminate the pathogenic flora, eliminate the inflammatory process, normalize the hormonal background, and strengthen the immune system weakened by the disease with useful vitamins.

Preparations

If endocervicitis predominates in acute stage, the doctor first recommends broad-spectrum antibiotics for oral administration. The choice of a particular medication depends on the nature of the pathogenic flora, and the duration antibiotic therapy- from the neglect of the pathological process. On average, antibiotics and not only a woman will have to be treated for 2 weeks. Positive result it will definitely be if, when prescribing treatment, the doctor pays attention to the representatives of the following pharmacological groups:

With chlamydial infection, macrolides (Sumamed), tetracycline antibiotics (Doxycycline) are indicated.
Recommended for fungal infections antifungal drugs(Nizoral, Fluconazole, Diflucan, Fluciz).
When infected with Trichomonas, antiprotozoal drugs are indicated (Trichopolum, Metronidazole).
With the activity of staphylococci, streptococci, antibiotics are prescribed penicillin series fourth generation (Amoxiclav, Augmentin, Ampicillin).

In addition to the antibiotics described above, the patient with endocervicitis is also recommended other medications for oral and topical use in home environment. It:

Lactobacilli to restore the disturbed microflora of the vagina (Acidophyllin, Bifidobacterin.
Immunostimulants to increase the body's defenses (Likopid, Genferon, Interferon, Cycloferon, Timolin).
Natural preparations for the productive restoration of the vaginal microflora (Linex, Acilact, Vaginorm).
Antivirals for the extermination of pathogenic viruses (Valavir, Vairova, Valtrex).
Multivitamin complexes for the safe strengthening of immunity (Elevit, AlfaVit, Duovit, Pikovit).

Candles

At simultaneous application suppositories with antibiotics, the therapeutic effect only intensifies. Candles for vaginal use act locally, relieve inflammation and unpleasant signs of endocervicitis, and speed up the healing process. In addition, such a conservative method can eliminate other diseases of the genitourinary sphere of a woman that accompanies endocervicitis. It is necessary to highlight the following vaginal suppositories, which can be bought at a pharmacy without a prescription, but used strictly according to medical recommendations for up to 10 days:

Betadine;
Terzhinan;
Galangin;
Micramore;
Genferon.

Traditional medicine methods

Alternative medicine prescriptions give positive reaction in the treatment of endocervicitis, are helper method conservative therapy. To avoid dangerous consequences for the body, you must first consult with a gynecologist, jointly determine the most effective folk remedies. Below are a few recipes that help cure endocervicitis:

Combine half a vial of propolis and calendula tincture, add 60 g of lanolin. Mix the composition, use vaginally as homemade tampons at night. Course - 10 days.
Perform homemade tampons, moisten them with sea buckthorn oil, insert them into the vagina before going to bed. The course is 7-10 days.
4 tbsp. l. dried herb St. John's wort steam and insist in 2 liters of boiling water. Cool, insist, strain, and use as an evening douche.

Illness during pregnancy

When planning a pregnancy, a woman should perform a vaginal smear to rule out a characteristic pathological process. If endocervicitis is detected, a number of additional surveys and especially a cytogram for exclusion oncological diseases in a feminine way. To avoid serious complications during gestation and "scars on the heart" due to miscarriage or pathological childbirth, treatment of endocervicitis should take place earlier successful conception. Infection during pregnancy is dangerous, so the woman remains under medical supervision.

Prevention

Photos of patients and complicated clinical pictures can be found online. To avoid such health problems, you need to take care of the prevention of endocervicitis in a timely manner. Preventive measures are as follows:

timely treat diseases of the female reproductive system;
be selective in the choice of sexual partners;
regularly visit a gynecologist;
strengthen immunity;
avoid abortion.

Video

A fairly common pathology of the female reproductive system is endocervicitis, the treatment of which consists in a complex drug therapy. Endocervicitis is an inflammatory disease that affects the mucous membranes in the uterine cervical canal. Most patients experience the lesion in question in reproductive age(20-40 years).

Before treating endocervicitis, it is worth deciding on characteristic manifestations pathology. The main symptoms of the disease in acute form are:

the presence of mucous or purulent vaginal discharge;
discomfort, such as itching and burning, in the genital area;
possible pain manifestations, localizing in the lumbar region and groin.

In chronic forms of the disease, all manifestations that may disturb patients disappear. This is one of the main dangers of pathology. This phenomenon due to the fact that with the chronic nature of endocervititis, the inflamed areas of the mucous membranes begin to heal, and the symptoms are minimized. Healing tissues stop secreting symptomatic amounts of mucus, but pathological processes continue to cellular level continue to progress. In this case the only way identifying the disease is a thorough medical examination.

During a medical examination, the cervix affected by endocervititis turns out to be inflamed, characterized by profuse redness, often surface erosion. In the chronic form, discharge of a cloudy color, muco-purulent, is also possible.

Treatment of the disease

Treatment of cervical endocervicitis takes a long time, especially if the disease is associated with concomitant pathologies.

If the pathology is detected at an early stage, the duration of the treatment course may be limited to one week.

The dynamics and nature of the treatment is determined by a qualified specialist, based on the nature of the development of the disease, as well as the type of pathological pathogen that caused endocervititis.

The acute stage of the development of the disease is characterized by etiotropic treatment aimed at eliminating the impact of an infectious agent. Well medical measures may be based on the use of antibiotics, antiviral or antifungal agents.

The specificity of antibacterial treatment is based on the fact that it is formed based on the sensitivity of infectious crops to antibiotic drugs. When the acute progress begins to subside, it is time for topical treatment.

With endocervitis, treatment occurs in the following ways:

using a spectrum of antifungal drugs (fluconazole, diflucan, nizoral);
with the use of antibiotics-tetracyclines and macrolides (for chlamydial infections);
treatment with antiprotozoal agents (trichopolum, metronidazole) for trichomonas endocervitis.

If the pathology under consideration is accompanied by characteristic additional diseases, it is necessary to carry out appropriate therapy. In addition, it is necessary to carry out immunocorrection, drink a course of recommended vitamins and immunomodulators.

In order to restore the disturbed vaginal microflora, a course of lactobacilli therapy is prescribed.

In chronic endocervicitis, treatment can be complicated by the protracted process of pathology development, therefore, the only effective method remains surgery.

In this case, diathermocoagulation, cryotherapy, laser removal of affected tissue areas are used. It should be noted that after surgical intervention mucosal tissues regenerate.

Chronic form of the disease

Treatment of chronic endocervicitis, as a rule, is complicated by its late diagnosis.

If you have been diagnosed with endocervicitis, suppositories treatment can be quite effective. Application is possible only on prescription.

It is important to remember that the effectiveness of therapy for the disease in question depends entirely on the exact implementation of medical prescriptions. Self-medication is highly discouraged.

With a disease such as endocervicitis, treatment folk remedies Not recommended. It is possible to use some additional funds auxiliary nature, rinsing and washing, but doctors do not advise hoping for their exceptional effectiveness.

Prevention of endocervititis

In order to prevent, it is necessary, first of all, to adhere to the simplest recommendations in the field of personal hygiene and medical safety.

First of all, it is worth passing gynecological examinations at least twice a year.

In difficult childbirth or abortion, uterine ruptures must be sutured.

In the event of inflammatory diseases in the pelvic organs, it is worth going through a full course of therapy. For full recovery the body is recommended to take additional course vitamins and supplements.

Endocervicitis, according to the standard medical calculation, can be defined as an inflammatory-degenerative and at the same time dystrophic lesion of the cervix. The disease is considered quite common, according to the data medical statistics, a similar condition is observed in 15% of the fairer sex. There are certain risk groups, that is, women who are at greater risk of getting sick. A more common disease of a similar nature is vaginitis: inflammation of the vaginal mucosa. These diseases, like twin brothers, one follows the other. What you need to know about endocervicitis?

What is endocervicitis?

As already mentioned, endocervicitis is a disease in which the epithelium of the cervical canal (the vestibule of the uterine structures, endocervix) becomes inflamed. The disease is among the top five "leaders" in terms of prevalence. The main category of those suffering from this pathology is girls of childbearing age and representatives of the weaker sex over 40. Most often, the pathological process is diagnosed in the period from 18 to 45-50 years. It is noted that there are certain risk groups:

Women puberty. At this time, the vaginal microflora is not sufficiently stable, colpitis, vaginitis and other gynecological diseases that can lead to endocervicitis often occur.
Representatives of the weaker sex during other peak hormonal conditions: pregnancy, menstrual cycle, menopause.
Representatives of the weaker sex, often suffering from infectious viral diseases, especially if we are talking about the female genital area.
Girls and women who have undergone difficult childbirth, operations on uterine structures and the female genital area in general.
Women infected with the herpes virus. Most often, endocervicitis is provoked by the following strains:
- Herpes virus of the first type (often provokes the banal appearance of "colds" on the lips).
- Strain of the second type. Actually genital herpes. Most often it is the source of the problem.
- Strain of the third type. Causes shingles, also provokes the development of the notorious chicken pox.
- Epstein-Barr virus (aka herpes virus type 4).
- Cytomegalovirus.
Elderly patients.

In general, risk groups cause certain reasons the formation of the disease.

Causes of the disease in women

The direct factor that entails the formation of a disease-causing condition lies in the defeat of the cervical canal by microbacteria and viral agents. The most commonly provoked diseases are the following microorganisms:

Staphylococci. Particularly dangerous in this regard Staphylococcus aureus. It is resistant to most antibiotics, extremely adaptable, able to adapt to adverse conditions and creates whole conglomerates.
Streptococci (especially green ones).
Klebsiella.
Gardnerella.
Herpes viruses (as mentioned above).

However, viral and infectious lesions cannot appear on their own. A number of related factors are required:

Dysfunction endocrine system. The microflora of the vagina and mucous membranes of the internal genital organs, including the cervical canal, directly depends on cyclic changes in the hormonal background. If estrogen becomes low, protective function local immunity comes to naught, and secondary inflammation begins. The consequences of the transition of inactive viruses and infections into the active phase are very deplorable.
Displacement of the genital organs along exogenous and endogenous causes. As soon as the uterus or other organs of the female genital area descends, there is compression of the surrounding structures, a violation of their nutrition. This is fraught with a decrease in the intensity of the work of local immunity.
Dysbacteriosis of the vagina. As a rule, the bacterial composition of the vaginal microflora is in dynamic equilibrium. As soon as the number of pathogenic and opportunistic organisms grows, and the number of lactobacilli decreases, pathological changes begin in the entire female genital area. This is extremely dangerous and is fraught with the formation of exocervicitis or endocervicitis (developing for internal and external reasons, respectively).
Frequent sexual intercourse with different partners. They cause a shift in the microflora of the external and internal genital organs towards the conditionally pathogenic flora. In addition, damage and injury are possible with excessively active intimate relationships.
Traumatic lesions of the cervix and cervical canal. At surgical interventions on the female genital organs, including abortions and curettage. Such endocervicitis proceeds most aggressively. Severe purulent and atrophic changes in the uterus and cervical canal are possible.
Infectious and viral inflammatory diseases of the female genital area (vaginitis,). As already noted, they occur together and are rarely observed in isolation.

As a rule, most often doctors note a whole complex pathogenic causes and factors. Therefore, endocervicitis can be called a polyetiological and multifactorial condition.

Main signs (diagnosis)

The symptomatology of endocervicitis is not specific enough to make a diagnosis, as they say, "by eye". Required objective research. In general, the manifestations of the disease are as follows:

Pain syndrome in the projection of the cervical canal and uterus. The pains are intense, burning, aching. Localized in the pubic area, lower abdomen. Can radiate to the lower back, external genitalia. Pain is aggravated by mechanical action on the affected area: during sexual intercourse, diagnostic examinations etc.
Possible menstrual irregularities. It starts a little later than expected, or vice versa, too early.
Redness of the cervix is visually determined. It is noted. Endocervicitis is dangerous, including the likelihood of developing cancerous tumors in the region of the cervical canal.
Discharge from the vagina is purulent or mucous. It is considered an unfavorable sign.

These manifestations are typical for, vaginitis, colpitis. Therefore, objective research is needed.

First of all, it is recommended to contact a gynecologist for a thorough diagnosis. At the initial appointment, the specialist interviews the patient about complaints and their duration. Collects an anamnesis (that is, reveals what diseases the woman suffered or suffers from).

General blood analysis. Gives a picture of a typical inflammatory process.
General urine analysis.
A smear from the vagina, cervical canal for subsequent sowing on nutrient media.
. Inspection of the vagina and mucous membrane of the cervical canal.
PCR and ELISA diagnostics for the search for pathogenic genetic material.
. Echoes on ultrasound appear sufficiently to make a correct diagnosis.

Echo signs of chronic endocervicitis on ultrasound

If there is a suspicion of malignant degeneration of the cervical canal, it makes sense to conduct a biopsy followed by a cytogram, morphological and histological studies.

It is possible to conduct magnetic resonance imaging to assess the condition of the uterus and surrounding structures.
Contrast radiography is also practiced with the introduction of a coloring substance into the uterine cavity.

These studies are more than enough.

Classification of endocervicitis

There are three main types of endocervicitis, depending on the nature and intensity of the process.

Accordingly, the following types of the disease are distinguished:

Spicy

It develops with an excessively weakened immune system. As a rule, it does not exist in isolation, it manifests itself intense symptoms described above. Additionally, hyperthermia at the level of febrile condition and even more is possible. similar shape fraught with dangerous complications.

subacute

Subacute endocervicitis occurs with severe symptoms, but they appear to a lesser extent. The temperature rises rarely and only to subfebrile values. As a rule, in the subacute phase, treatment is still effective. The pain syndrome is moderately pronounced.

Chronic

Appears in most cases. It is not accompanied by severe symptoms, because women rarely turn to a gynecologist. So much the worse for patients, because endocervicitis is a harbinger of cancer. Especially if it flows for a long time.

In all three cases, competent therapy is required. Appointed vaginal suppositories(candles). Other drugs are also prescribed: anti-inflammatory, antibiotics. Before appointing medicines the patient must be carefully diagnosed. How - has already been said above. Antibiotics are prescribed with great care, only after receiving the results of bacteriological culture.

Endocervicitis and pregnancy

Endocervicitis does not rule out pregnancy, but fertility ( reproductive function) is significantly reduced. Therefore, the likelihood of getting pregnant is much lower.

Endocervicitis - painful and dangerous state. Required emergency treatment. So the prognosis will be favorable.

The main cause of endocervicitis is conditionally pathogenic microflora.

Its main representatives include:

coccal microorganisms - streptococci, staphylococci;
bacteroids;
coli.

These bacteria are present in the body of every woman, but during normal functioning immune system do no harm. With a decrease in general or local defenses, opportunistic bacteria begin to actively grow and multiply, damage the mucous membrane and lead to the development of an inflammatory process.

The second most common cause of endocervicitis is sexually transmitted microorganisms. This group includes gonococci, chlamydia, mycoplasmas, Trichomonas, fungi.

In addition to the immediate causes, scientists identify a number of predisposing factors. When exposed to them, the likelihood of developing the disease increases significantly.

The main ones include:

inflammatory diseases of the reproductive system (vaginitis, cystitis, colpitis, adnexitis, endometritis, cervical erosion);
artificial termination of pregnancy, diagnostic curettage, childbirth;
prolapse or prolapse of the pelvic organs;
immunodeficiency states;
the presence of intrauterine contraceptives;
decrease in the concentration of estrogen in the blood (menopause, ovarian dysfunction);
douching performed without appropriate indications;
sexual intercourse during menstrual bleeding.

Depending on the nature of the course, endocervicitis can be acute and chronic.

Signs and symptoms of endocervicitis

Symptoms of chronic endocervicitis depend on such points:

the nature of the course of the disease;
etiological factor;
individual characteristics of the patient, the state of protective mechanisms;
the presence of comorbidities.

The main symptoms of acute endocervicitis are:

intoxication syndrome;
pathological discharge from the vagina;
pain sensations.

Intoxication syndrome is manifested by general weakness, fever, sweating, loss of appetite, increased fatigue. In most cases, the syndrome occurs in the pathology of gonococcal and trichomonas nature. If endocervicitis is caused by nonspecific flora, these signs are mild or absent altogether.

A large amount of vaginal discharge is the most frequent, practically persistent symptom endocervicitis. By the nature of the discharge, they can be mucous, mucopurulent, purulent, bloody, sanious. By color - white, yellow, red, brown, dirty. Often there is an unpleasant odor.

The pain is localized in the lower abdomen, may radiate to the vagina. Sometimes the sign appears only during or after intercourse. Constant pain intensifies after intimate contact and excessive physical exertion.

Chronic endocervicitis is characterized by an undulating course. During periods of remission, the clinical picture is erased, there are no specific signs of the disease. During exacerbations, women notice a deterioration in their condition, and therefore seek medical help.

Diagnosis of endocervicitis

Diagnosis of endocervicitis is carried out in three stages:

study of complaints and collection of anamnesis of the disease;
gynecological examination;
laboratory and instrumental examination of the patient.

The first stage is, in fact, a conversation, during which the doctor finds out the patient's complaints, sets the time and order of their appearance, variability, severity, and a possible provoking factor. It is important to find out if the patient was treated before, with what drugs and what was the result. The doctor will also clarify the presence of other diseases, collect data on possible allergic reactions, injuries and surgeries.

The next stage is an examination in the gynecological chair. Conducted without special training. Immediately before the examination, the woman should empty bladder, and the gynecologist will tell you about the sequence of the procedure and possible sensations. First, the doctor will examine the cervix in the mirrors and take smears from the vagina, urethra, and cervical canal. They will be sent to a lab for further testing. This will be followed by a two-handed study, during which the condition of the uterus and appendages is assessed.

The data obtained depend on the nature of the disease and comorbidity, but usually they are enough to make a preliminary diagnosis of endocervicitis.

To confirm it, instrumental diagnosis of endocervicitis is necessary.

Most often, patients undergo such instrumental tests:

general analysis of blood and urine;
determining the level of hormones in the blood;
colposcopy;
bacteriological examination secretions;
ultrasound procedure;
biopsy followed by histological examination sample.

A complete blood count shows the general condition of the body and allows you to evaluate the functioning of the immune system. Since endocervicitis is a disease of bacterial origin, an increase in the level of leukocytes is observed in the blood, a shift leukocyte formula to the left, an increase in the erythrocyte sedimentation rate. AT general analysis urine, the appearance of bacteria and an increase in leukocytes are possible.

Determining the concentration of hormones allows you to confirm the lack of estrogen, which may be the cause of the pathology.

Colposcopy - instrumental method examinations, with the help of which not only endocervicitis is diagnosed, but also other diseases of the cervix. During a colposcopy, the gynecologist examines the mucous membrane of the cervix using a magnifying technique. The procedure is carried out in a regular gynecological office, without prior preparation. There are no contraindications to the test.

Colposcopy can be simple or advanced. A simple study is carried out as indicative.

It evaluates the following parameters:

the shape and size of the cervix;
diameter of the external pharynx;
the shape of the external pharynx;
color of the mucous membrane;
the presence of changes in the relief of the vaginal part of the cervix;
vascular pattern.

Extended colposcopy consists in examining the cervix after it has been treated with acetic or salicylic acid. Substance promotes vasoconstriction and improved visualization pathological changes. To confirm the data, the cervix is treated with Lugol's solution. Areas with pathological epithelium stain less intensely compared to normal mucosa.

In chromocolposcopy, the cervix is stained with hematoxylin or toluidine blue. In this case, normal cells stain worse.

To assess the condition of blood vessels, examination is used through green and yellow filters, as well as in ultraviolet rays.

A separate type of procedure is microcolposcopy. This is an intravital histological examination of the vaginal part of the cervix. It is carried out with or without staining, usually after the detection of pathologically altered areas during an extended examination.

Bacteriological examination of vaginal discharge is carried out in order to identify the pathogen and determine its sensitivity to antibacterial agents. This is a mandatory test before prescribing antibiotics, as it allows you to choose the most effective remedy.

Ultrasound is the simplest, cheapest, but at the same time highly informative method. instrumental diagnostics. With its help, you can identify signs of inflammation in the organs of the reproductive system, volumetric neoplasms, congenital malformations.

To date, two ultrasound techniques are used - transabdominal and transvaginal. In the first case, the inspection is carried out through the lower part abdominal wall. Before the examination, the woman needs to fill the bladder, as in air environment ultrasonic waves are scattered. In a transvaginal examination, a transducer is inserted into the vagina. The survey is carried out without prior preparation.

Biopsy followed by histological examination of the specimen is the most exact method examinations. During the examination, the doctor pinches off a small piece of cervical tissue on the border of healthy and pathologically altered areas. The sample is examined by a pathologist and draws up a conclusion.

In controversial cases, computed or magnetic resonance imaging, hysteroscopy are indicated. Their goal is to differential diagnosis and make a definitive diagnosis. As a rule, these procedures are shown when simpler ones are not informative. diagnostic methods, or when the data of previous research methods contradict each other, the clinical picture of the disease.

Treatment of endocervicitis

Treatment of endocervicitis is carried out on an outpatient basis. In severe cases or in the presence of complications, the patient is hospitalized in a specialized department.

Patients diagnosed with endocervicitis are recommended the following groups of drugs:

antibacterial;
anti-inflammatory;
eubiotics.

Antibacterial agents are prescribed according to the results of the sensitivity test. Their goal is to eliminate the cause of the disease. This is the main group of drugs used. According to indications, a combination of antibiotics and antiprotozoals is used, and antifungal drugs are also added.

Medicines from the anti-inflammatory group reduce the activity of the inflammatory process, reduce pain.

Eubiotics restore intestinal and vaginal microflora.

If necessary, accompanying therapy is prescribed - antiallergic drugs, drugs that improve liver function, hormonal replacement therapy. In each case, the treatment regimen is compiled individually. Doses of drugs, the duration of the course is recommended by the doctor.

During periods of remission, sanatorium and physiotherapy treatment of endocervicitis is indicated. Most often, ultrasound and electrophoresis with absorbable preparations are used. The procedures help prevent the appearance of adhesions, reduce inflammation, increase the activity of regenerative processes, and contribute to the patient's speedy recovery.

In general, the prognosis of the disease is favorable, but with an incorrect or untimely treatment complications of endocervicitis develop.

The main ones include:

cervical polyps;
ascending spread of infection, damage to the urinary tract;
erosion, dysplasia of the cervix;
malignant diseases.

One of the most unpleasant consequences of the disease is infertility. In such cases, couples are forced to resort to assisted reproductive technologies.

Prevention of endocervicitis

Prevention of endocervicitis is nonspecific. Since endocervicitis is an inflammatory disease, personal hygiene and regular preventive examinations by a gynecologist come to the fore. Diagnosed inflammatory diseases should be treated as early as possible, strictly following all the doctor's recommendations. Only in this way can chronicity of the process and complications of endocervicitis be prevented.

After an acute episode, women are shown secondary prevention endocervicitis. Such patients are in the dispensary. In addition to the usual preventive examination, they are shown regular histological, bacteriological examination, as well as colposcopy.

The AltraVita clinic employs gynecologists with extensive experience. The institution is equipped with everything necessary for your full examination and treatment. All procedures are carried out in one clinic, by appointment. You do not need to travel to other laboratories for testing and stand in long queues. All staff are extremely polite. If you wish, examination and treatment can be carried out with complete anonymity. To book an appointment, all you have to do is call the specified number phone or fill out an email form.