Etiology of Cervix Ectropion
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Etiology of Cervical Ectropion
Introduction to Cervical Ectropion
Cervical ectropion, also known as cervical erosion, is a condition where the glandular columnar cells from the cervical canal extend onto the ectocervix, the outer part of the cervix. This condition is often observed during routine pelvic examinations, particularly in women of reproductive age3. While it is generally considered a benign and normal physiological state, it can sometimes lead to various symptoms and complications.
Developmental Aspects and Hormonal Influence
Cervical ectropion is a normal feature of cervical development, particularly influenced by hormonal changes. During fetal development and adolescence, the cervix undergoes significant changes due to hormonal stimulation and deprivation, which can lead to the presence of ectropion4 10. The condition is often seen in women who are pregnant or using hormonal contraceptives, as these hormones can cause the glandular cells to proliferate and extend outward3.
Association with Symptoms and Complications
While cervical ectropion is often asymptomatic, it can sometimes cause symptoms such as abnormal vaginal discharge, postcoital bleeding, and vulvovaginal discomfort1 3. In some cases, it has been associated with desquamative inflammatory vaginitis, a condition characterized by copious yellowish discharge and dyspareunia. Treatment of the ectropion in such cases, such as through cryotherapy, has been shown to alleviate these symptoms1.
Risk Factors and Associations with Other Conditions
Several risk factors have been identified for cervical ectropion, including the use of intra-uterine contraceptive devices (IUCDs) and previous hormonal contraceptive use3. Additionally, cervical ectropion has been associated with an increased risk of acquiring certain sexually transmitted diseases (STDs) such as human papillomavirus (HPV) and bacterial vaginosis, although it is not associated with chlamydia, gonococcal infection, or herpes simplex5.
Treatment Approaches
The decision to treat cervical ectropion remains controversial. Some studies suggest that routine treatment may be beneficial in preventing complications such as squamous metaplasia and squamous cell carcinoma of the cervix3. Treatment options include topical applications, such as gentian violet and antibiotics, and surgical interventions like electrosurgical treatment (LEEP biopsy) and cryotherapy2 3. A two-stage complex therapy involving microbial and viral pathogen elimination followed by electrosurgical treatment has shown promising results in reducing recurrence and accelerating epithelialization2.
Conclusion
Cervical ectropion is a common and often benign condition influenced by hormonal changes and developmental factors. While it is usually asymptomatic, it can sometimes lead to symptoms and complications that may require treatment. Understanding the etiology and associated risk factors is crucial for effective management and prevention of potential complications. Further research is needed to fully elucidate the benefits and risks of various treatment modalities.
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Most relevant research papers on this topic
Cervical Ectropion May Be a Cause of Desquamative Inflammatory Vaginitis
Cervical ectropion may be a cause of desquamative inflammatory vaginitis, and cryotherapy may provide long-lasting relief for patients with this condition.
Case Report
Rigorous JournalNew possibilities of complex ttreatment of cervical ectropion
The developed method effectively treats cervical ectropion, with a shorter reparative process and lower recurrence rate compared to traditional surgical treatment.
Observational StudyCervical Ectropion and Intra-Uterine Contraceptive Device (IUCD): a five-year retrospective study of family planning clients of a tertiary health institution in Lagos Nigeria
Routine pelvic examinations can help detect and control latent reproductive health problems like cervical ectropion, potentially preventing potentially lethal conditions and guiding appropriate treatment.
Observational StudyRigorous JournalThe Cervical Epithelium From Fetal Age to Adolescence
Congenital ectropion is a normal feature of cervical development, with its occurrence and persistence depending on cervical tissue growth in response to hormonal stimulation, deprivation, and systemic growth.
Observational StudyAssociation of Sexually Transmitted Diseases With Cervical Ectopy: A Systematic Review.
Cervical ectopy is likely associated with increased acquisition of certain sexually transmitted diseases, but not with chlamydia, gonococcal infection, or herpes simplex.
Systematic ReviewAbnormal cervical appearance: what to do, when to worry?
Abnormal cervical appearance, such as ectropion, Nabothian cysts, and small polyps, may not require immediate concern, but those associated with a history of diethylstilbestrol, inflammation, abnormal cervical cytology, and postcoital bleeding should prompt further evaluation.
Association of nivolumab and niraparib in the management of neuroendocrine cancer of the cervix
Nivolumab and niraparib show promising results in the management of neuroendocrine cervix cancer, with potential for future clinical trials.
Case ReportTopographic Relation of Cervical Ectropion and Vaginal Adenosis to Clear Cell Adenocarcinoma
Tuboendometrial epithelium, in the ectocervix or vagina, provides the bed from which clear cell adenocarcinoma develops in women exposed to diethylstilbestrol prenatally.
In Vitro StudyAtypical vaginal adenosis and cervical ectropion. Association with clear cell adenocarcinoma in diethylstilbestrol‐exposed offspring
Atypical vaginal adenosis and cervical ectropion of the tuboendometrial type are precursors of clear cell adenocarcinoma in diethylstilbestrol-exposed offspring.
Observational Study