Erosion of the cervix, according to the results of studies, affects up to 44% of women of childbearing age. The fact that erosion of the cervix in case of a dysfunctional course is capable of leading to the development of cervical cancer has been proven.
Erosion is a superficial defect in the epithelium. Initially, when it was not possible to examine the cervix with colposcopic equipment, erosion was called any defect in the vaginal part of the cervix, expressed in the appearance of an irregularly shaped pale pink mucous red spot.
When the colposcope appeared, it was found out that in the overwhelming majority of cases the defect in the cervix was not real erosion, but the spread of the cylindrical epithelial tissue of the cervical canal to the vaginal part. Therefore, in modern gynecology, the term "erosion of the cervix" is used very rarely, and it was replaced by the term " cervical ectopia " or "pseudo-erosion".
What is the erosion of the cervix?
There is a true and false erosion of the cervix. In size, the erosion of the cervix varies from 0.2 centimeters to 2 centimeters or more.
- The true erosion of the cervix is a superficial defect in the cells of the epithelium (resembling a small sore), prone to self-healing after elimination of the causative factor. The true erosion is defined as spots of bright red color on the vaginal part of the cervix.
- False erosion of the cervix ( pseudo-erosion , ectopia) is the appearance on the multilayered epithelium of the vaginal part of the cervix of cells of the cylindrical epithelium, normally located only in the cervical. With this pathology, there is no defect in the epithelium itself. Normal cells are "not in their place."
In colposcopy, pseudo-erosion is defined as a patch of irregular shape, a bright red color, covered with long or round papillae (has a peculiar "velvety appearance"). The bright red color is acquired by the blood vessels radiating through the layer of the cylindrical epithelium. Around pseudo-erosion, as a rule, areas of light gray color (multilayered flat epithelium) are observed.
Cells of the cylindrical and multilayered planar epithelium are normal formations for the cervix, but in a number of cases pathological: iodine-negative zones, white areas (leukoplakia), structures resembling mosaic may appear. Pathological formations are an unfavorable sign and can undergo malignant degeneration.
The appearance of erosions differs depending on the size of the defect:
- small erosion (no more than 1 centimeter in diameter);
- medium (diameter from 1 to 2 centimeters);
- large erosion (more than 2 centimeters).
Classification of erosion by size is of the greatest clinical importance, because the choice of method of treatment depends on this. Small ulcers of the mucosa can pass independently, and erosion of medium and large size often require complex treatment, including surgical excision of the eroded part of the cervix.