BENIGN DISEASES OF
CERVIX
SUJATHA MENON
ACUTE CERVICITIS
In septic abortion,puerperal sepsis & gonorrhoea
Examination through a vaginal speculum-cervix
reddened & swollen with edema,mucopurulent
discharge
Sometimes tenderness can be elicited by
palpation of the cervix
Gonococcal cervicitis – backache & a feeling of
fullness in the lower abdomen
Symptoms & clinical course are often
overshadowed by those of the associated lesions
of the disease
CHRONIC CERVICITIS
Very common-seen in 80% of women with any
gynaecological complaint
Causes
Infections during abortion or childbirth
Lacerations of cervix during childbirth
Instrumentation
Gonococcal infection
a/c infection tend to persist as c/c infection
If the organism penetrates into the depth of the
gland,it is difficult to eradicate by local treatment
Mucous membrane of cervix is not exfoliated
during menstruation- no natural method of
overcoming infection
ECTROPION
Seen in a cervix which has been badly lacerated
by childbirth
Tends to evert the endocervical canal,the lining
mucosa gets exposed
Detected by digital examination
As the ext os is patulous,so that the lower part of
the cervical canal can be felt
Usually accompanied by chronic cervicitis
Treatment- excision of scar tissue &suturing the
edges of torn cervix(trachelorrhaphy)
CERVICAL POLYP
Endocervical & ectocervical polyps are the most
common benign lesions of the cervix
Causes
c/c inflammation
Abnormal response to increase in estrogen levels
Congestion of blood vessels in the cervical canal
Many types –
adenomatous,cystic,fibrous,fibromyomatous &
inflammatory
Mucous polyps-from mucous membrane of
cervical canal
Size ranges from the size of a pea to rare cases as
big as 2cm in diameter
Red vascular swelling,bleeds easily on
touch,covered by smooth glistening epithelium
Pedunculated; pedicle attached t mucous
membrane of cervical canal
Detected by palpation,but small sessile polyps
can be detected only by speculum examination
Usually in women of childbearing age
Symptoms-increase in vaginal discharge,irregular
& post coital bleed
HISTOLOGY
Surface epithelium-columnar
Glands in the stroma are racemose type& lined
by tall columnar epithelium
stroma-highly vascular;round cell infiltration at
the lower pole
Surface epithelium at the lower pole-well marked
squqmous metaplasia
TREATMENT
Polypectomy-outpatient procedure
Microscopic examination of polyp
Myomatous polyp may be mistaen for a mucous
polyp
Fibroadenomatous polyp-removal by torsion of
pedicle
Recurrent polyp removed under GA
Hysteroscopic avulsion – if polyps are multiple
Endocervical polyps must be differentiated from
endometrial polyps-endometrial polyps have a
long pedicle & the base is not accessible
CERVICAL STENOSIS
aetiology
Congenital
Traumatic- cauterisation & conization
Infection-chronic cervicitis
Cervical cancer
Menopausal atrophy
Congenital stenosis
Rare; causes primary amenorrhoea &
hematometra
Surgery – to drain hematometra,establish
menstruation & restore reproductive function
But restenosis is very common
Traumatic stenosis
Dilatation of cervix prior to cauterisation &
conization avoids stenosis
Causes secondary amenorrhoea or
dysmenorrhoea, infertility & sometimes
hematometra
Infection and chronic cervicitis require cervical
dilatation under anaesthesia
Stenosis due to CA cervix – require treatment of
cancer
MICROGLANDULAR
HYPERPLASIA
Usually seen in women using OCPs or depot
preparations of medroxyprogesterone acetate
Exaggerated epithelial response to
hormones;clinically 1-2cm polyps
On cytology & histology,it is mistaken for
malignancy
NABOTHIAN CYSTS
During reproductive years,columnar epithelium
of cervix is replaced by squamous epithelium
Metaplastic squamous epithelium occludes the
mouth of some of the glands & retention cysts
are formed
Seen in the adult cervix
MYOMAS
Similar to those seen in the uterus,but arising
from the smooth muscle of the wall of the cervix
Usually small & can be left alone
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