Cervical Ectropion/ Erosion Flashcards
What is a cervical ectropion?
The state whereby the columnar epithelium is present on the vaginal surface of the cervix
It is a normal physiological state when?
Under normal influence during puberty
During pregnancy
With the COCP
What are ectropions prone to?
As columnar epithelium is soft and glandular, it is prone to bleeding, excess mucus production and to infection
What does it look like on examination?
Red area around the os of the cervix - endocervical epithelium extended its territory over the paler epithelium of the ectocervix
Why may it cause post coital bleeding?
Due to the presence of delicate blood vessels in the columnar epithelium
Factors which increased the risk of cervical ectropion are related to…
Increased levels of oestrogen e.g oral oestrogen containing contraceptive and menstrual age
What treatment is there?
Usually none required if asymptomatic, pregnant or pubertal.
If taking hormonal contraception, consider consider changing to non hormonal methods
Can have the columnar epithelium ablated - cryotherapy or electrocautery (sig vaginal discharge until healing complete)
What is a cervical erosion?
Means the same thing as an ectropian (no erosion of cells actually occurs)
What should be excluded?
Cervical intraepithelial neoplasia and cervical cancer
Pregnancy
What is the endocervix?
The inner part of the cervix
Lined by mucus secreting simple columnar epithelium
What is the ectocervix?
The part of the cervix that projects into the vagina - normally lined by stratified squamous non-keratinised epithelium
What happens to the stratified squamous cells of the ectocervix in a cervical ectropian?
They undergo metaplastic change to become simple columnar epithelium - induced by high levels of oestrogen
Is it common or uncommon in post menopausal women?
Uncommon
If there is discharge, is it usually purulent?
No
What investigations should be done?
Cervical ectropian = clinical diagnosis
Main role of investigations is to exclude other potential diagnoses:
Pregnancy test
Triple swabs - if any suggestion of infection
Cervical smear - rule out CIN
If a frank lesion observed, a biopsy should be taken (not performed as routine)
