Why does chronic endocervicitis occur and how is it treated? Chronic endocervicitis: clinical picture, treatment Chronic endocervicitis symptoms and treatment

The inflammatory process in the cervical canal of the cervix, affecting mainly the mucous membrane, is called endocervicitis. As a result of this disease, the structure of the organ's epithelium is deformed and the natural outflow of mucus is disrupted. Transparent are replaced by purulent mucus with an unpleasant odor.

The chronic form occurs against the background of untreated acute endocervicitis. Sluggish pathology can provoke various complications, in particular:

• inflammation of the endometrium and uterine cavity;
• formation of cervical polyps;
• problems with conceiving and bearing a child.

Causes of development of chronic endocervicitis

Chronic endocervicitis develops against the background of the penetration of infections and pathological microorganisms into the area of ​​the cervical canal. These include strepto- and gonococci, chlamydia, trichomonas and others. Penetration of infection into the tissue of the cervix quickly spreads to the uterus and appendages.

Provoking factors for infection in the genital tract are:

• injury to the cervix due to childbirth;
• gynecological manipulations (abortions, curettage, etc.);
• inflammatory processes of the pelvic organs;
• sexual intercourse with an infected partner;

Indirect risk factors in this case are:

• hormonal imbalance;
• reduced immunity;
• presence (colpitis);
• non-compliance with the rules of genital hygiene, including unprotected sex with different partners.

What are the symptoms of endocervicitis in chronic form?

Acute endocervicitis is characterized by pronounced clinical symptoms - nagging pain in the lower abdomen, copious discharge, burning sensation when urinating. Upon transition to the chronic stage, clinical manifestations noticeably weaken. The pain subsides, the volume of discharge decreases, but in some cases the clear mucus is replaced by purulent mucus.

The danger of the chronic form of the disease lies in the hypertrophy (proliferation) of the cervical epithelium. During palpation, the gynecologist feels a strongly compacted and thickened organ.

The sluggish course of the inflammatory process in the absence of clinical manifestations is evidenced by hyperemia and swelling of the pharynx of the organ. The chronic form of the pathology can provoke cervical erosion.

Diagnosis of the disease

After a gynecological examination of the cervical canal using speculum and palpation, the doctor prescribes a clinical examination. It includes:

• general and specific blood tests;
• smear on flora.

However, these methods are not enough to confirm the diagnosis; the doctor also prescribes a detailed examination:

1. Cytology smears (taking samples from the cervical canal) are necessary to accurately identify the causative pathological infection.
2. Ultrasound (transvaginal).
3. Hysteroscopy is a visual examination of the cervical canal using a magnifying device.
4. – allows you to identify not only endocervicitis, but also other pathologies. This diagnostic method cannot be performed during an exacerbation of the disease.

Treatment of chronic endocervicitis

Treatment of chronic endocervicitis is complicated by the presence of concomitant diseases. The choice of methods entirely depends on the form of the pathological process, the presence of concomitant infections and inflammations. Full recovery of the patient is possible only using an integrated approach.

Drug treatment

1. Antibacterial therapy

Before prescribing any antibiotic, the doctor must test the patient’s sensitivity to the drug.

For the treatment of chronic endocervicitis, broad-spectrum drugs are usually used:

• ceftriaxone;
• metronidazole;
• azithromycin and others.

1. Local antifungal treatment

• vaginal suppositories and tablets;
• anti-inflammatory drugs;
• vaginal baths and irrigations;
• endocervical instillations (with Trichomonas origin of the disease).

1. Eubiotics (bifidobacteria and lactobacilli) are prescribed to restore normal vaginal microflora.
2. Vitamins and immunomodulators (for example, pyrogenal, cycloferon). Without strengthening the immune system, it is impossible to achieve a complete cure for chronic endocervicitis.

Physiotherapeutic treatment

These treatment methods are used exclusively in the remission stage of the disease. These include the following procedures:

• laser treatment;
• electrophoresis;
• magnetotherapy.

Forecast

The acute form of chronic endocervicitis has a favorable prognosis. But the progression of the disease into a chronic form threatens a lot of complications (ascending infection, adhesions and problems with conception) and a long treatment process. However, an adequately selected treatment regimen contributes to the complete cure of cervical pathology.

Chronic inflammation of the cervical canal mucosa is the most common disease among women of reproductive age. But in gynecological practice, there are cases of identifying the atrophic form of chronic endocervicitis.

The causes of the development of this disease, as a rule, are specific and nonspecific agents. Specific pathogens include infectious diseases that are predominantly sexually transmitted. Among all infections, chlamydia is the most common cause. When they enter a woman’s body, the disease does not appear immediately, which complicates diagnosis and further treatment.

Often, chronic cervicitis develops against the background of opportunistic flora, in which the causative agents are staphylococci, streptococci and fungi of the genus Candida. One pathogen is not enough for further development, so chronic endocervicitis progresses in the presence of predisposing factors.

The maintenance of the inflammatory process is facilitated by:

• decreased protective functions of the body's immune system;
• mechanical effect on cervical tissue;
• promiscuous intimate relationships;
• constant use of spermicides;
• the use of aggressive douching agents;
• prolapse of the pelvic organs (prolapse of the vaginal walls, prolapse of the uterus).

Chronic endocervicitis is classified according to prevalence:

• focal involvement in the process of individual sections of the cervical canal;
• diffuse is characterized by the involvement of the entire epithelium of the cervical canal in the process.

In addition, they are distinguished according to the activity of clinical manifestations:

• chronic inactive endocervicitis (what is it?) is manifested by a sluggish course of the disease without obvious clinical signs;
• chronic active endocervicitis is characterized by the appearance of pronounced symptoms in remission.

An important task in gynecology is the correct and timely diagnosis of the disease. In addition to the collected medical history and examination in the mirrors, it is necessary to conduct a number of laboratory tests. The most important and informative is a cytological analysis of a smear of the cervical canal.

The analysis determines the structural changes characterizing chronic endocervicitis. What it is? This is the presence of leukocytes in the smear, a large amount of epithelium, red blood cells, squamous metaplasia, as well as hyperkeratosis and dyskeratosis. All this indicates a long-term inflammatory process of the mucous membrane of the cervical canal of the cervix.

It often happens that chronic endocervicitis and chronic endometritis are mutually inverse concepts. These two nosological units can provoke the development of each other. For example, in the presence of provoking factors, chronic endocervicitis ascends through the ascending tract into the uterine cavity, causing endometritis. The situation with the development of endocervicitis in endometriosis is similar.

Symptoms

In the absence of adequate therapy, acute endocervicitis turns into chronic endocervicitis. Symptoms and treatment depend on the pathogen and the severity of the disease. The chronic course of the disease implies sluggish progression of the disease. In most cases, a woman has chronic inactive endocervicitis, which is asymptomatic. With chronic active endocervicitis, blurred symptoms appear that are not specific.

In gynecology, general clinical signs of chronic endocervicitis are distinguished:

• discharge that is mucous or purulent in nature and has a cloudy tint. In most cases, the secreted secretions are characterized by a specific unpleasant odor;
• pain syndrome, which is characterized by nagging pain in the lower third of the abdomen;
• a feeling of discomfort in the vagina that accompanies sexual intercourse;
• feeling of burning and itching in the genital area;
• contact discharge that occurs after sexual intercourse;
• urination problems, with a burning sensation.

On examination, a characteristic feature is a peculiar corolla around the external os of the cervix, red in color.

Treatment

Chronic endocervicitis: treatment

Treatment of the chronic form of the disease involves a set of measures aimed at eliminating the symptoms, as well as the cause of the development of the inflammatory process.

As a rule, the chronic form of the disease requires surgical treatment. These include methods such as: laser vaporization, radio wave therapy, cryodestruction and diathermocoagulation. But before using surgical methods, it is necessary to restore the vaginal microflora, eliminate the manifestations of the inflammatory process and remove the cause of the disease.

For viral etiologies, antiviral drugs are prescribed in combination with immunostimulating drugs.

In case of a hormonal disorder that has caused atrophic changes in the cervix, drugs containing estrogen are prescribed.

When an infectious agent is identified, it is advisable to use antibacterial and antifungal drugs. Since there are various forms of medications, the question arises which injections are allowed for chronic endocervicitis. Drugs from the group of tetracyclines, macrolides, etc. are allowed in injection form. In addition, anti-inflammatory and painkillers are prescribed in the injections.

To speed up the process of regeneration of cervical tissue, it is recommended to carry out some physiotherapeutic procedures as part of complex therapy. In addition, with the help of some physiotherapeutic procedures, the administration of anti-inflammatory drugs is prescribed.

For the diagnosis of “chronic endocervicitis”, auxiliary measures include treatment with folk remedies. These include douching with various herbal decoctions. The most commonly used decoctions are calendula, chamomile, and celandine. Sea buckthorn oil is widely used, both in candles and for wetting tampons.

Pregnancy

Currently, taking into account the existing ecology and many other factors, women are more careful when planning pregnancy. This procedure involves, first of all, a gynecological examination, during which chronic endocervicitis is detected. In some cases, this pathology is the reason for the lack of pregnancy. In addition, the lack of treatment of a chronic process during pregnancy has consequences for both the woman and the fetus. These are fetal growth retardation, intrauterine infection, as well as premature birth and postpartum endometritis.

Video: Treatment of cervicitis

Chronic endocervicitis is a constantly progressive disease, which is accompanied by inflammation of the mucous membrane of the uterine cervix. If left untreated, this disease leads to hypertrophy of the canal cells, and in some cases, to the development of metaplasia.

Chronic endocervicitis: causes of the disease

Inflammatory processes begin when an infection enters the female body. These can be streptococci, gonococci, staphylococci, trichomonas. Less commonly, the causative agent is a viral infection or fungi.

The fact is that in a normal state of health, the cavity of the uterine cervix contains a mucous plug that protects the body from the penetration of pathogenic organisms. Infection occurs when the integrity and functionality of this protective barrier is compromised for any reason. Most often this happens during gynecological manipulations, for example, installation of a spiral, abortion, trauma during childbirth, microscopic rupture of the cervix, etc. In some cases, chronic endocervicitis is the result of improper use of hormonal contraceptives, and also occurs in the presence of another chronic disease, for example, endometritis, erosion, colpitis.

Signs of endocervicitis

It is worth noting that chronic endocervicitis is one of those diseases that very quickly transition from acute to chronic form. The symptoms are not too pronounced. Sick women complain of uncharacteristic vaginal discharge. However, they can be abundant or released in very small quantities. Such discharge differs in its consistency - it can be liquid, purulent or mucous.

Another sign of the disease is pain that occurs in the lower abdomen and varies in intensity. In most cases, they are dull and drawing - somewhat reminiscent of pain during menstruation.

During a gynecological examination, the doctor may notice that a reddish corolla has formed on the tissues of the uterine cervix, which indicates the presence of inflammatory processes.

Chronic endocervicitis: methods of diagnosis and treatment

The presence of inflammation can be judged after a gynecological examination, as well as based on the results of colposcopy. In addition, it is necessary not only to make a correct diagnosis, but also to identify the causative agent - this will make it possible to speed up the treatment process. For this purpose, analyzes of vaginal smears are used, where pathogen cells can be detected, as well as bacteriological culture, which will determine the sensitivity of the infection to antibiotics.

Drugs for treatment are selected depending on the nature of the pathogen. For example, bacterial endocervicitis requires antibiotics to treat, while a fungal infection is treated with antifungals. Preparations can be presented as tablets, vaginal suppositories, ointments, etc.

Along with treatment, it is necessary to protect a woman from the development of vaginal dysbiosis, since antibiotics destroy not only pathogenic microbes, but also beneficial microflora. If necessary, a sick patient may be prescribed vitamins to improve the body's immune defense.

Endocervicitis: treatment with folk remedies

Traditional healers also know other methods of treatment. For example, sea buckthorn oil is considered a very effective remedy. This medicine should be used in the form of tampons. Treatment lasts no more than two weeks. Sea buckthorn oil is not toxic, but rather quickly heals the affected tissue. That is why it is often used along with conservative treatment. In addition, they can even treat pregnant women. But, in any case, you should not use this method on your own - it is better to consult a gynecologist first.

Chronic endocervicitis is an inflammation that occurs in the cervical canal of the cervix and lasts more than two months or often recurs. The disease is most often diagnosed in young and middle-aged women (during the reproductive period).

The development of chronic endocervicitis of the cervix leads to erosion, the formation of polyps, thickening and deformation of the cervix, while the epithelial cells change their structure and can no longer secrete normal cervical mucus (instead, purulent and foul-smelling discharge is released). But the main danger posed by the pathological process is infertility and the risk of tumors.

What causes the development of pathology

The main causes of the development of the disease are microorganisms that can enter the organ during sexual intercourse (if the partner is infected), during abortion, childbirth, diagnostic curettage, in the case of bacterial vaginosis. The body is most susceptible to bacteria entering the cervix if there is an intrauterine device. Particularly dangerous include:

• streptococcal and staphylococcal infections;
• chlamydia;
• Trichomonas;
• gonococci;
• coli.

The pathology can develop against the background of other female diseases: colpitis, endometritis. Prolapse of the cervix and the appearance of microtears also contribute to the disease, as does the onset of menstruation (this is the most convenient period for infection to enter the canal).

In the cervical canal there is a mucus plug that protects the uterus from bacteria entering the organ. Under the influence of certain medical procedures (abortion, installation of an IUD), it is destroyed and nothing prevents the penetration of pathogenic microorganisms into the organ, which leads to the development of chronic active endocervicitis.

Special attention is paid to immunity. This pathology and its consequences most often affect those women who have a weak immune system. In addition, carriers of human papillomavirus and herpes are most at risk of developing the disease.

Clinical picture of the disease

The chronic form of the disease occurs quite quickly after the acute phase, and is characterized by a decrease in the severity of all symptoms, but many of them persist.

The main symptom of chronic endocervicitis is pathological discharge with an unpleasant, fetid odor. They can be purulent, mucous and mixed (i.e. purulent-mucous). Both meager and plentiful in quantity.

The next sign is pain in the lower abdomen. They can be aching, pulling, and sometimes dull. In this case, different degrees of intensity are observed. What is typical, having passed into the chronic stage, the pain decreases and gradually disappears completely (which is why many women assume that it has passed).

In case of chronic inactive endocervicitis (when the inflammatory process is in the “quiet” stage), upon medical examination only a small red rim around the pharynx of the cervix is ​​detected (whereas in the acute form it is bright cherry and covered with small erosions), meanwhile, this does not indicate independent retreat of the disease.

The disease is also characterized by itching, which periodically occurs in the genital area.

Is this disease compatible with pregnancy?

A separate question that interests many women: is it possible to get pregnant with chronic endometritis or endocervicitis? In fact, the problem is not so much in the conception itself, but in the fact that these diseases of the mother can seriously affect the health of her child. The fetus is at risk of intrauterine infection or purulent lesions of the baby’s internal organs in the first days of life, and a delay in its development may occur.

With chronic endocervicitis for pregnancy, there is an increased risk of spontaneous abortion in the early stages. In addition, the risk of developing various complications and premature onset of labor increases.

Is it possible to get pregnant with chronic endocervicitis? A question that has a positive answer (despite the fact that with this disease, 30% of women experience infertility). But in order to carry and give birth to a healthy child, you should undergo a full course of treatment even before planning a pregnancy and completely get rid of a pathology that is dangerous for mother and baby.

Methods for diagnosing this disease

Symptoms and treatment of chronic endocervicitis are directly related to diagnostic procedures. A high-quality and complete examination will allow you to prescribe the most effective treatment program for the disease.

Diagnosis of chronic endocervicitis begins with a gynecological examination, which includes:

• thorough examination of the cervix;
• hysteroscopy, colposcopy;
• bacteriological cultures of smears taken from the canal and cervix (with their help, you can identify the causative agent of the disease and determine adequate therapy);
• collection of epithelial tissue for subsequent cytological examination.

After this, the patient is prescribed a transvaginal ultrasound, as well as an ultrasound examination of the pelvic organs. Specific studies (for example, enzyme immunoassay) may also be needed.

How is this disease treated?

Treatment of chronic endocervicitis is carried out using a conservative method, which requires a comprehensive selection of the most effective means. For this purpose medications are prescribed:

1. antifungal;
2. antibacterial;
3. antiviral;
4. immunomodulators;
5. vitamins;
6. eubiotics.

Endocervicitis is an inflammation of the mucous membrane of the cervical canal of the uterus. It is caused by various infections and other pathological microorganisms. These can be fungi, staphylococci, E. coli, chlamydia and trichomonas. When a woman does not receive effective treatment for such an illness, the inflammatory process becomes protracted, developing into chronic endocervicitis. It is dangerous because it can lead to complications, such as erosion of the cervix and even its deformation. Accordingly, this disease should be considered in as much detail as possible, studying the features of its manifestation and treatment.

Important! In addition to bacteria and other harmful microorganisms, the inflammatory process can be provoked by abortion, installation of an intrauterine device, curettage and other medical procedures. Injuries received during difficult childbirth may also be the cause.

Clinical picture

It is known that the success of recovery from any disease directly depends on the timeliness of its detection. So you should consider the signs of chronic endocervicitis in more detail. They will appear like this:

• dull pain in the lower abdomen;
• copious or too scanty vaginal discharge;
• purulent impurities in vaginal discharge;
• itching and burning in the vaginal area.

It should be noted that to a greater extent such symptoms are characteristic of the acute form of the disease, but can persist during its chronic course. Then we are talking about chronic active endocervicitis. In any case, if they occur, you should immediately contact a gynecologist. During a gynecological examination, swelling of the uterine mucosa, the presence of small erosions, as well as a whitish plaque similar to purulent will be revealed.

Diagnosis of the disease

In order for the doctor to accurately establish a diagnosis, identify the cause of the disease and prescribe its effective treatment, the patient must undergo a full examination. It consists of the following procedures:

• gynecological examination;
• colposcopy;
• taking a smear to test for the presence of various pathogens;
• transvaginal ultrasound examination.

These procedures will be sufficient to identify the symptoms of chronic endocervicitis and prescribe its effective treatment. The good news is that with a responsible approach to therapy, this disease can be quite easily gotten rid of.

Features of treatment

In this case, we will talk about complex therapy, which only in this form can give the desired result. It is carried out in several directions.

1. Antibacterial therapy. This involves fighting pathological microorganisms that provoke the development of the inflammatory process. Drugs will be selected depending on the characteristics of the pathogen. For example, if the cause is fungi, then the doctor will prescribe antifungal agents; when the inflammation is caused by staphylococci or streptococci, then you will have to take drugs that have a detrimental effect on these microorganisms. Only if the pathogen is eliminated will the treatment of chronic endocervicitis be successful.
2. Local therapy. Local drugs that have an anti-inflammatory effect will be used here. They are available in the form of vaginal suppositories and tablets and come in a variety of names, so they should only be selected by a doctor.
3. Physiotherapeutic procedures. The relevance of their implementation is assessed by the doctor in each case individually. In order to eliminate chronic endocervicitis of the cervix, the patient may be recommended magnetic therapy, electrophoresis or laser treatment.
4. Immunomodulators. These are medications that increase the body's resistance and strengthen the immune system. They allow the body to mobilize its own forces and direct them to fight inflammation. In addition, taking such medications allows you to avoid relapse, which may well happen if we are talking about chronic inactive endocervicitis.
5. Maintaining sexual rest. During treatment, the patient must abstain from sexual relations in order to make the therapy as effective as possible. As for the duration of this period, it will differ in each individual case. The average is two weeks.

Pregnancy with chronic endocervicitis

Many women are interested in one question - is it possible to get pregnant with chronic endocervicitis. Of course, pregnancy can occur in this case. But how healthy will she be? The disease helps to increase the tone of the uterus and loosen the mucous membranes. In addition, it can cause untimely discharge of amniotic fluid. What can we say about infections that can cause infection of the fetus and disturbances in its development. In addition, the delivery itself may be at risk. That is why you should not plan a pregnancy with chronic endocervicitis.

Initially, you need to undergo examination and treatment by a gynecologist, and only then begin planning conception and bearing a child. Thus, the likelihood of a healthy pregnancy and childbirth increases significantly, and now nothing interferes with the full development of the fetus. Reviews about the treatment of chronic endocervicitis indicate that the therapy is not delayed for too long, accordingly, pregnancy can be expected very soon.

Important! Once the therapy has been completed, you should definitely consult with your doctor regarding pregnancy planning.

The doctor will be able to give practical recommendations that will help the expectant mother implement her plans. You should not wonder whether it is possible to get pregnant with chronic endometritis or endocervicitis. You need to start treating these diseases, and only then think about fertilization and childbirth.