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RISK FACTORS FOR CERVICAL EROSION AND MODERN CLINICAL
DIAGNOSTIC METHODS
¹Abduraximova Adiba Abdurashit qizi
Yunusova Aziza
²Scientific supervisor.
¹Samarkand State Medical University
1st year clinical resident of the Department of Obstetrics and Gynecology No. 3
²Samarkand State Medical University
Assistant of the Department of Obstetrics and Gynecology No. 3
https://doi.org/10.5281/zenodo.14873165
Relevance of the problem:
Cervical ectopia also makes the reproductive system more
vulnerable to various infections. This is because the normal vaginal environment is acidic.
Normally, lactic acid bacteria and fungi live in a woman's vagina. They produce lactic acid, which
serves as a kind of barrier for various foreign microorganisms. If there are few pathogenic or
opportunistic bacteria and fungi, they cannot survive in the acidic environment of the vagina. This
means that they do not have time to reach the cervical canal, penetrate the uterine cavity, and then
spread to the uterine mucosa, fallopian tubes and ovaries. However, the mucous membrane of the
cervical canal - the columnar epithelium - produces alkaline mucus and is usually adapted to an
alkaline environment, not an acidic one. The displacement of the cervical mucus beyond the
boundaries of the cervical canal makes it alkaline to enter - and therefore "opens the door" for
many pathogens to enter the cervix. The most common sexually transmitted infections that can
accompany erosion and ectopia include, for example, gonorrhea, trichomoniasis, and
ureaplasmosis. Inflammation in ectopia can be caused by damage to the columnar epithelium of
the cervix or by infection.
Research methods and materials:
Along with cytology, the doctor can take biomaterial
for analysis human papillomavirus. The fact is that HPV has a high oncogenic property and serves
as a marker of predisposition to cervical cancer. HPV, 14 types (genotype determined 16 and 18;
genotype not determined 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68), PCR DNA (shearing, qual.)
HPV, 12 types (with genotype determination 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59), PCR
DNA (shearing, qual.) A convenient option for the patient is the combination of liquid cytology
and HPV testing in one study. This can be done on one sample of biological material obtained by
scraping. Liquid cytology of the cervix and cervical canal scrapings with the detection of HPV
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types 16/18 (genotyping), 31/33/35/39/45/51/52/56/58/59/66/68 (without genotype detection,
Abbott) HPV testing is especially important for women over 30 years old.
If the virus is not detected, the test should be repeated every 5 years. If it is detected, you
should be under the supervision of a doctor, and also undergo cytology and HPV testing annually.
This allows for timely detection of dangerous changes and their treatment before cancer develops.
Results
: All women aged 21 to 65 are recommended to undergo a cytological examination
of the cervix and cervical canal every 3 years. The analysis can be performed earlier if the girl has
been sexually active for 3 years.
Cytology is a special diagnostic method that allows you to detect atypical cells. Their
presence may indicate malignant processes in the cervical epithelium. Cytology is divided into
conventional and liquid. Conventional cytology is a less accurate method. With this examination
method, the doctor scrapes and transfers the collected material to a glass and removes the
cytobrush - a tool for scraping. As a result, part of the collected cells is not included in the sample
and is not analyzed. The average sensitivity of such a study is about 60-70%.
Liquid-based cytology is considered the gold standard for diagnosing precancerous
changes in the cervix. Its difference is that after sampling, the biomaterial with a cytobrush is
placed in a container (vial) with a special liquid. As a result, more cells are included in the sample
and the sensitivity of the analysis increases - when using modern technologies, it can reach 96%.
Discussion
: Cervical ectopia also makes the reproductive system more vulnerable to
various infections. This is because the normal vaginal environment is acidic. Normally, lactic acid
bacteria and fungi live in a woman's vagina. They produce lactic acid, which serves as a kind of
barrier to various foreign microorganisms. If there are few pathogenic or opportunistic bacteria
and fungi, they cannot survive in the acidic environment of the vagina. This means that they do
not have time to reach the cervical canal, penetrate the uterine cavity, and then spread to the uterine
mucosa, fallopian tubes and ovaries. However, the mucous membrane of the cervical canal - the
columnar epithelium - produces alkaline mucus and is usually adapted to an alkaline environment,
not an acidic one.
Conclusion
: To prevent true cervical erosion, it is necessary to take precautions during
sexual intercourse - avoid movements that cause discomfort and pain in the genitals and vagina.
When using a hygienic tampon, it is important to insert it strictly according to the instructions and
remove it from the vagina in a timely manner. On average, it is recommended to change tampons
every 4 hours. Some experts advise giving preference to pads. They are considered safer. There is
no special prevention for congenital ectopy and ectropion. To prevent acquired forms of the
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disease, you should use contraceptives (condoms), avoid promiscuous sexual intercourse,
regularly (at least once a year) undergo an examination by a gynecologist and undergo prescribed
tests. In addition, the use of hormonal contraceptives should be carried out under strict medical
supervision. In this case, the doctor can timely detect ectopy during the examination and
recommend other medications or methods of contraception.
REFERENCES
1.
Gynecology: national guidelines / ed. GM Savelyeva, GT Sukhish, IB Manukhina.
GEOTAR-Media, 2013.
2.
Cervical intraepithelial neoplasia, cervical erosion and ectropion: clinical guidelines /
Ministry of Health of the Russian Federation. 2020.
3.
Aggarwal P., Amor A. Ben. Cervical ectropion / StatPearls. 2022.
4.
Chang A R. Cervical "erosion"; an anachronism // Aust NZ J Obstet Gynaecol. 1991. vol.
31(4). P. 358–362. doi: 10.1111/j.1479-828x.1991.tb02822.x
5.
Goldacre MJ, Loudon N., Watt B. et al. The epidemiology and clinical significance of
cervical erosion in women attending a family planning clinic // Br Med J. 1978. Vol.
1(6115). Pp. 748–750. doi: 10.1136/bmj.1.6115.748
