Diagnosis of non-neoplastic endocervical diseases

Abstract

Endocervical pathology is commonly encountered in daily outpatient gynecological practice and is apparently simple to diagnose. Remote resonance of untreated endocervical pathologies, however, indicates difficulties in detection and perhaps even in treatment. The role of the endocervix is that of boundary between the lower genital tract and the upper genital tract, that is between an environment rich in microorganisms and the almost sterile endometrium and endosalpinx. The major barrier role belongs to the cervical mucus. Non-neoplastic pathology of the endocervix is systematically discussed, as follows: endocervicitis, Naboth cysts, endocervical polyps, cervical endometriosis, cervical fibroids, cervical stenoses, glandular preneoplastic lesions and adenocarcinoma in situ. Some notions of anatomy and histology are briefly reviewed. Endocervical pathology is varied. It can be correctly diagnosed starting from the clinical picture, completed with laboratory investigations, bacteriological examinations, exfoliative cytology, molecular tests for the diagnosis of HPV infection, colposcopy, but also by thorough ultrasound examinations. Ultrasound examination of the cervix should be part of the routine examination, because its systematic evaluation can make a significant contribution to refining the diagnosis.