1. Acute cervicitis.
2. Chronic cervicitis.
3. Cervical ectopy.
Definition: acute inflammation of endocervical glands.
Aetiology: * Gonococci & chlamydia.
* Puerperal sepsis: infection of cervical laceration.
General: fever, anorexia, headache & malaise.
Local: backache & mucopurulent discharge.
General: fever & tachycardia.
Local: cervix is red, swollen with marked tenderness on mobility.
Antibiotics should be given in full doses & full course.
Definition: Chronic inflammation of endocervical glands.
1. Chronic specific cervicitis e.g. TB & bilharisiasis.
2. Chronic non-specific cervicitis.
Aetiology: follows acute cervicitis due to:
1. Racemose nature of endocervical glands so, drainage is difficult.
2. Absence of monthly shedding of the cervical mucosa.
♦ May be asymptomatic.
– Mucopurulent discharge.
a) Backache: spread of infection along uterosacral ligament.
b) Dysmenorrhea: due to pelvic congestion.
c) Dyspareunia: spread of infection to parametrium.
d) Dysuria & frequency of micturition: cystitis caused by lymphatic spread.
– Bleeding: menorrhagia & contact bleeding.
♦ Complications; infertility -hostile cervical mucous- & septic focus.
Signs (clinico-pathological types):
♦ Chronic endocervicitis: manifested by excessive cervical discharge.
♦ Nabothian follicles: blocked ducts affect glandular drainage resulting in small bluish
cysts projecting into portiovaginalis.
♦ Cervical ectopy.
♦ Cervical ectropion: eversion of cervical lips due to bilateral fibrosed cervical tears.
♦ Chronic hypertrophic cervicitis.
♦ Mucous polyp.
1. Cervical smears; to exclude cervical malignancy in patients with suspicious cervix.
2. Culture & sensitivity of discharge: with little benefits -mixed flora environment-.
A. Medical treatment:
– Antibiotics are of little value if used alone.
– Clindamycin can be used -Clindam 300 mg oral-.
B. Surgical treatment:
– Trachelorraphy: in cases of ectropion.
– Conization: in old patients with marked lesions.
C. Cautery treatment: the main line of treatment.
1. Done postmenstrual to allow healing before next menses.
2. Vaginal discharge ↑ for some days after the procedure (hyperemia).
3. No intercourse or douching during this period.
4. Regeneration of sq. epithelium takes 4– 6 weeks covering cauterized area.
1. Anesthesia: not needed except in nullipara if cervical dilatation is needed.
2. Take 3 linear burns in anterior & posterior lips extending to edge of ectopy.
3. Depth of cauterization: 2 mm.
4. Avoid lateral edge to avoid injury of cervical branch of uterine artery.
Cautery reveals infection by opening deeply seated glands & draining them.
It also deals with the superficial epithelium covering cervical canal.
1. 2ry hemorrhage: occurs at 10th day (expholiation of epithelium and infection).
2. Ascending infection and upper genital tract spread.
3. Cervical stenosis: due to excessive fibrosis.
2. Cryo-cautery= freezing:
Idea: freezing of tissues to -60º c with 2 mm depth.
Advantages: better healing + less complications.
Disadvantages: excessive vaginal discharge for 3 weeks.
3. Laser cauterization :
Idea: CO2 laser used to destruct superficial layer of tissues by vaporization.
Advantages: as cryo-cautery.
Disadvantages: expensive & require training.
Idea: Coagulation & necrosis of tissues without charring.
5. Chemical Cautery: no longer used.
N.B.: erosion is an old name.
Definition: red area surrounding external os of cervix covered by columnar epithelium instead of stratified squamous epithelium.
(The underlying vessels give this area the red colour through thin columnar epithelium).
1. Congenital ectopy: persistence of an intra-uterine condition.
2. Hormonal ectopy: – Excess estrogen provokes creeping of columnar epithelium to
outside external os.
– Occurs during pregnancy also with OCP users.
3. Inflammatory ectopy: – Infected discharge of chronic cervicitis.
– Devitalization and denudation of area around external os.
– Columnar epithelium (instead of stratified squamous) rapidly
cover the denuded area.
Symptoms: like chronic cervicitis (mainly discharge and contact bleeding).
Signs: * like chronic cervicitis.
* Types of ectopy (flat, papillary & follicular).
* Cervical smear to exclude possibility of associated malignancy.
* No symptoms no treatment.
* Hormonal ectropion left to spontaneous recovery within 3 months.
* Cautery done only in:
– Symptomatic cases.
– Hormonal ectopy persisting > 3 months.
Ultrasound Video showing a Polyp in the uterus with cervicitis.
Cervicitis PPT (power point presentations):
Cervicitis Prof. Aboubakr Elnashar Benha University Hospital, Egypt