Is surgery necessary for mild cervical erosion? What are the symptoms of cervical erosion in women?

Cervical erosion used to be a disease that troubled many women. When you go for a physical examination, you will almost certainly be diagnosed with cervical erosion. Generally speaking, mild to moderate cervical erosion does not require surgery, as surgery can easily affect reproductive function. The treatment of cervical erosion is mainly local treatment, of which physical therapy is the most commonly used. The treatment principle is to use various physical methods to cause necrosis and shedding of the eroded surface, and to cover it with new squamous epithelium. Physical therapy is not only safe, efficient, simple and painless. However, since there are many physical therapy methods, the specific treatment method needs to be determined by the doctor based on clinical symptoms and examination results.

Regular cervical examination is necessary, not to prevent cervical erosion, but to prevent cervical cancer. The occurrence of cervical cancer is related to infection with human papillomavirus (HpV). Some patients with high-risk HPV infection are prone to precancerous lesions and cervical cancer when they are persistently infected at the squamous-columnar junction of the cervix. Since the advent of cervical smears, the mortality rate of cervical cancer has dropped significantly. The key is early prevention and treatment. It is currently recommended that women over the age of 21 should undergo a cervical smear examination once a year. After the age of 30, an HPV examination can be combined. If three consecutive HPV and cervical smear tests are negative, the interval can be extended to once every three years, and screening can be stopped after the age of 65.

Symptoms of cervical erosion

After cervical erosion occurs, there is often an increase in vaginal discharge, which is sticky, milky white or light yellow purulent secretions, and sometimes bloody or mixed with blood. The vulva may be stimulated by increased vaginal discharge and may develop vulvitis or vaginitis, causing itching and pain. When the inflammation is severe, it can spread along the uterosacral ligament and cardinal ligament to cause pelvic connective tissue inflammation, causing pain in the lower abdomen or lumbosacral region, accompanied by a feeling of falling. When the inflammation spreads to the bladder triangle or around the bladder, frequent urination or difficulty urinating may occur, and sexual intercourse may also cause contact bleeding or odor.

Cervical erosion is not true erosion, but a pseudo-erosion compared to the normal smooth cervix. It has three manifestations: At the beginning of inflammation, the erosion surface is only covered by columnar epithelium and the surface is flat, which is simple erosion. Later, the erosion surface becomes uneven and granules appear on the surface, which is granular erosion. After that, the unevenness of the erosion surface becomes more obvious, and papillae appear on the surface, which is papillary erosion.

The eroded surface of the cervix has a clear boundary with the surrounding normal squamous epithelium. Clinically, it is often divided into three categories according to the area of ​​erosion: mild (Ⅰ°), moderate (Ⅱ°), and severe (Ⅲ°). If the erosion area accounts for 1/3 of the total area of ​​the cervix, it is mild cervical erosion. If the erosion area accounts for 1/2 of the total area of ​​the cervix, it is moderate cervical erosion. If the erosion area exceeds 1/2 of the total area of ​​the cervix, it is severe cervical erosion.

Is simple cervical erosion serious?

Simple cervical erosion is often seen in the early stage of inflammation. Because it is mild, it is often ignored. It is easy to cause moderate or severe cervical erosion. Due to the stimulation of inflammation, the epithelial cells covering the surface of the cervix fall off, and the columnar epithelial cells underneath protrude outwards and replace the fallen epithelial covering. Because the capillaries of the columnar epithelium are exposed, the inflamed area appears bright red.

The erosion surface is covered by a single layer of columnar epithelium, and the epidermis is relatively flat and smooth. Because there is only a thin layer of columnar epithelium on the surface, the typical "grape cluster" cannot be seen after applying 3% acetic acid, only a flushing area can be seen, sometimes accompanied by some well-branched hyperplastic blood vessels, and no obvious white scale-column boundary can be seen.

There are three main types of cervical erosion, which can exist alone or coexist alternately. The inflammation of simple cervical erosion continues to exist, causing excessive proliferation of the cervical epithelium, uneven erosion surface, and granular appearance, which is granular erosion. If the glandular epithelium and stroma proliferate significantly, the unevenness is more obvious, and it is papillary, which is papillary erosion. Local treatment is mostly used, and there are many methods, such as drug therapy, physical therapy, surgical treatment, etc. The purpose of the first two conservative treatments is to cause the columnar epithelium on the cervical erosion surface to necrotize and fall off, creating conditions for the covering growth of new squamous epithelium.

Therefore, the symptoms of simple cervical erosion are relatively mild and there is no obvious discomfort.