Cervical ectropion Flashcards
What is cervical ectropion
Benign condition where there is eversion of the endocervix, exposing the columnar epithelium to the vaginal milieu
Who is cervical ectropion commonly seen in?
Adolescents
Pregnancy
Women taking oestrogen containing contraceptives
What needs to be excluded in cases of cervical ectropion
Cervical cancer
Cervical intraepithelial neoplasia (CIN)
Name the two parts of the cervix
Endocervical canal
Ectocervix
Describe the endocervical canal
More proximal and inner part of the cervix
Describe the ectocervix
Part of the cervix that projects into the vagina
Which cells line the ectocervix?
Stratified squamous non-keratinized epithelium
Which cells normally line the endocervical canal
mucus secreting simple columnar epithelium
What happens in cervical ectropion?
The stratified squamous cells of the ectocervix undergo metaplastic change to become simple columnar epithelium - same as endocervix
What is thought to cause ectropion?
High oestrogen levels
List some risk factors for cervical ectropion
COCP
Pregnancy
Adolescence
Menstruating age
What are some clinical features of cervical ectropion?
Asymptomatic
Post coital bleeding
Intermenstrual bleeding
Excessive non purulent discharge
Describe what is seen on speculum examination in cervical ectropion
Everted columnar epithelium - reddish appearance and usually arranged in a ring around the external os
What are some investigations for cervical ectropion
Clinical test - exclude other possible causes
Pregnancy test
Triple swabs if any suggestion of infection - endocervical and high vaginal
Cervical smear - rule out CIN and biopsy if a frank lesion is observed
Describe the management of cervical ectropion
Normal variant and so does not require treatment unless symptomatic
- stop any oestrogen containing medications - commonly COCP
- Ablation of columnar epithelium by electrocautery or cryotherapy
- Medication to acidify vaginal pH such as boric acid pessaries have been suggested
