What does the doctor actually see?
The cervix is covered with two types of epithelium. On the outside, on the vaginal side, it is multi-layered flat, resistant to acidic environments. Inside the cervical canal it is cylindrical, more tender and reddish. The boundary between them is called the transformation zone.
If the cylindrical epithelium extends to the outer surface of the cervix, upon examination the doctor sees a red spot around the external pharynx. This is what is traditionally called erosion, although the correct term is ectopia. There is no wound or defect.
- Ectopia often occurs in young women, during pregnancy and while taking hormonal contraceptives - this is due to hormonal influences
- True erosion—a true mucosal defect—is rare and is usually associated with trauma, inflammation, or atrophy
- Leukoplakia, polyps, dysplasia are fundamentally different conditions that require a different approach
Symptoms
- Most often, no symptoms - ectopia is detected upon examination
- Increased amount of clear or mucous discharge
- Bloody discharge after sexual intercourse - so-called contact bleeding
- Discomfort during sexual intercourse
- When inflammation occurs - discharge with odor, itching, burning
Please note: spotting after intercourse is a symptom that should not be ignored. It is possible with ectopia, but also occurs with polyp, dysplasia and cervical cancer, and therefore requires a full examination.
Mandatory examination
- Inspection in the mirrors
- Pap test or liquid cytology - evaluation of cervical cells; main screening method
- Test for high oncogenic risk HPV
- Video colposcopy - examination of the cervix under magnification with treatment with solutions; allows you to see the transformation zone and suspicious areas
- Cervical biopsy - if there is a suspicious colposcopic picture or altered cytology
- Flora smear and PCR for infections
- Express test CIN-DIAG for suspected dysplasia
It is this set that distinguishes the modern approach from the outdated one: first we find out whether there are HPV and cell changes, and only then decide on treatment. Cauterization “just in case”, without cytology and colposcopy, is today considered unjustified.
When treatment is really needed
- Cervical dysplasia was detected based on cytology and biopsy results
- There are suspicious changes during colposcopy
- There is constant contact bleeding that interferes with life
- Heavy discharge that does not respond to conservative therapy
- Recurrent inflammation due to ectopia
- True erosion is a defect in the mucosa
- Cervical polyp, leukoplakia
- Cervical deformity after childbirth, ectropion
Treatment methods
- Electrocoagulation - cauterization with electric current; available method
- Radio wave treatment
- Laser vaporization
- Cryodestruction
- Chemical coagulation with special preparations
- Conization of the cervix - with confirmed dysplasia; is performed not as “cauterization of erosion”, but as a treatment for a precancerous condition
- Anti-inflammatory treatment for identified infection - often this already normalizes the picture
- Removal of a cervical polyp if present
In nulliparous women, the choice of method is approached especially carefully: aggressive interventions can lead to scar deformation and narrowing of the cervical canal, which subsequently complicates childbirth. This is another reason not to treat something that does not need treatment.
Prevention and surveillance
- Regular examination by a gynecologist and Pap test according to the schedule recommended by the doctor
- Testing for high-risk HPV as part of screening
- Vaccination against HPV is the most effective prevention of cervical cancer
- Using a condom with a new partner
- Timely treatment of inflammatory diseases
- Quitting smoking - it reduces the body's ability to get rid of HPV
- Treatment for bleeding after intercourse
Where to get examined in Tashkent
A full examination of the cervix is required: cytology, HPV analysis, video colposcopy and, if necessary, biopsy.
In Tashkent, such examination and treatment for confirmed indications is carried out at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
If you were offered cauterization immediately after the examination, without cytology, HPV testing or colposcopy, this is a reason to clarify the rationale or get a second opinion. The correct order is: first examination, then decision. Clinic contacts are below.
