CERTIFICATE DISEASES
CERTIFICATE WOUNDS (EREZION CERVITIS) (CERTIFICATE WOUND) (CERTIFICIAL INFECTIONS)
Erosion cervicitis, popularly known as a wound on the cervix, is one of the most common gynecological disorders. The literal meaning of chronic cervicitis is a persistent inflammatory disease of the cervix. Wound (cervical wound), that is, erosion, is an infected tissue area around the cervix.
Why do cervical wounds (wound in the cervix) (eroded cervicitis) occur?
1-Frequently due to gonorrhea, chlamydia, trichomoniasis and HPV infections,
2-After frequent and traumatic sexual intercourse,
3-Condoms Chemical agents on it and tampons placed in the cervix,
4- Cervical tears that were not repaired and missed during birth,
For these reasons, the superficial layers of the multilayered squamous epithelium (skin) of the cervix are lost. causes the endocervical canal to change its area outwards. This area appears red because it bleeds more. And since this tissue is much more affected by infection, it causes cervical wounds (eroded cervicitis). Sometimes the thinned epithelial (skin) tissue disappears, causing the stroma to become infected. This is also called cervical ulcers. Another discomfort that develops due to these reasons is the formation of naboti cysts in the cervix. Naboti cysts are caused by the narrowing of the channels in the endocervical glands due to repair (epithelialization) that occurs during the inflammatory process. Thus, the secretion (mucus) and fluid in these glands cannot drain out. It pools backwards and forms naboti cysts.
What are the symptoms of a cervical wound?
1-Vaginal discharge: yellow, white, thick and sticky. The time of this discharge is different from the changing consistency of the discharge during the ovulation period.
2-Spotting-like bleeding after intercourse
3-Extra-menstrual bleeding: due to excessive swelling and edema of the epithelium in the internal canal of the cervix. Its fragility increases and it becomes easily traumatized. Thus, it causes spotting-like bleeding after vaginal douche or sexual intercourse.
4-Coccyx Back pain affecting the mucous membrane
5-Burning while urinating, frequent urination and difficulty in retaining urine are observed. The reason for this is the infection in the cervix; It spreads to the urinary bladder via lymphatic circulation (via neighbourhood). Honeymoon cystitis, which occurs in newlywed couples, also occurs for these reasons. Frequent sexual intercourse and excessive stimulation and trauma to the cervix lead to the formation of these urinary complaints.
6-Infertility: Cervical factors, which appear to be 10% of the causes of infertility, are mostly caused by wounds in the cervix. Infection and structural changes here prevent the sperm (male seed) from passing into the uterus.
How are cervical wounds diagnosed?
It can be easily seen with a normal gynecological examination. can be diagnosed. Before starting treatment, a smear should be taken to check whether there is any underlying malignancy. If suspicious areas are seen, a biopsy can be taken. In suspicious cases or HPV positive cases, colposcopy should be performed, the condition of the vascular vessels should be observed and a biopsy should be taken. It is necessary to wait for the test results before starting treatment.
What should be done to protect from cervical wounds?
1-Do not have sexual intercourse with suspicious or unknown people. Especially with men suffering from gonorrhea
2- It is necessary to wait for the cervix to open spontaneously at birth and not allow it to rupture. Here, healthcare personnel (doctor or midwife) have a great responsibility. If there is a tear in the cervix, it is necessary to repair it even if there is no bleeding. By the way, when we say to some of our patients that there is a tear in the cervix, they say, "Doctor, I remember it was sewn at birth." However, what they say is the incision (episiotomy) made in the vagina and perineum (the area between the entrance of the vagina and the anus) to facilitate the emergence of the head during birth. It should also be noted that this is not related to the cervix.
3-Infections should be treated in the best way possible in the acute period, without neglecting them.
4-Tampons containing chemicals should not be used.
5-Do not wash the vagina with soap and water. Because this process disrupts the normal PH (acid) of the vagina and prevents opportunistic microbes. It causes infection.
6-HPV vaccine: HPV vaccination is absolutely necessary between the ages of 9-26. In case of frequently recurring wounds and in women with multiple partners, vaccination is recommended as a preventive measure to eliminate the risk of cancer after the age of 26.
What are the treatment methods for cervical wounds?
1-Cauterization:
The heat obtained by applying electric current from the tip of a pen-shaped probe cauterizes the eroded (wound) area and kills the wound cells. The process takes 5-6 minutes. It is a painless procedure. It usually does not require anesthesia. After this procedure, there will be a dirty yellow discharge for 15 days, which is the desquamation period. After 15 days, the renewal (reparation) period begins. Therefore, sexual intercourse is prohibited for 1 month after cremation. Cremation is not performed on women who have not given birth. Because it causes narrowing in the cervix. These women undergo freezing (cryotherapy).
2-Freezing (cryotherapy):
Carbon dioxide is released from a special gun-shaped probe with tips adjusted according to the size of the wound in the cervix. It is the process of destroying the wound (erosion) by freezing it between minus 45 and minus 60 degrees by passing nitrogen oxide gas or nitrous oxide gas. The process takes 5-6 minutes. It is a painless procedure, there is no need for anesthesia. Since there is no narrowing of the cervix during the freezing process, it can easily be applied to women who have not given birth. After the process, clear water comes for 15 days during the shedding phase. Recovery takes 2 months. Sexual intercourse is prohibited for 1 month. It is necessary to go to the doctor for a check-up 2 months after both the burning and freezing process.
3-Loop (leep) operation:
If the smear result is not resolved by freezing or burning, the smear result is questionable. It is applied to patients who are diagnosed with HPV and are HPV positive. Here, it is treated and the part is removed at the same time. The process is carried out as follows; The wound (erosion) area is removed in the form of semicircles, the upper and lower cervix area, with a thin cautery with a special cutting tip. It is a bloodless and stitchless operation. The removed tissue piece can be easily sent to pathology since there is no necrosis (since the cells do not die).
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