Cervical Erosion Research Articles

Pathogenesis and clinical significance of interleukin-8 and tumor necrosis factor-alpha in cervicitis

To investigate the relationship between local immune status of vagina and the occurrence of disease in patients with cervicitis. ELISA were used to detect the level of interleukin (IL)-8 and tumor necrosis factor (TNF)alpha in vaginal douche of patients with cervicitis due to ureaplasma urealyticum, mycoplasma hominis, chlamydia trachomatis, neisseria gonorrhoeae and cervical erosion. Compared with the control group, the level of IL-8 in vaginal douche of patients with mycoplasma hominis cervicitis, chlamydia trachomatis cervicitis and neisseria gonorrhoeae cervicitis was significantly higher and there was significant difference ng/L: 371 +/- 34, 369 +/- 31, 339 +/- 36, vs 341 +/- 32, 338 +/- 33, 316 +/- 24, (all P < 0.01). Comparing the level of IL-8 in vaginal douche of patients with ureaplasma urealyticum cervicitis and cervical erosion with that of control group, there was no statistical difference (all P > 0.05). The level of TNF-alpha in vaginal douche of each group was remarkably higher than that of control group except for patients with cervical erosion. And statistically significant difference was found between them (all P < 0.01). With regards to the pathogenesis of cervicitis, local immune mechanism of vagina plays an important role in the occurrence of cervicitis. The role of IL-8 in pathogenesis of mycoplasma hominis cervicitis, chlamydia trachomatis cervicitis and neisseria gonorrhoeae cervicitis is likely to be more important.

Clinical effect of thymopeptide and spectinomycin combined with carbon dioxide laser on cervical erosion

Objective To observe the Clinical effect of thymopeptide and spectinomycin combined with carbon dioxide laser on cervical erosion. Methods All 68 patients with cervical erosion were divided into two groups randomly. After treatment by carbon dioxide laser, therapy group (36 cases) was received thymopeptide enteric-coated tablet 20 mg orally twice a day and spectinomycin 2g intramuscularly for 10 days, and the other group was received Roxithromyein Capsules 0.15g orally twice a day for 10 days. All patients were followed-up examined and the effects of different groups on cervical erosion wore evaluated 4 and 8 weeks later. Results The efficiencies of the two groups were 75.00% and 91.66% after 4 weeks and 53.12% and 75.00% after 8 weeks, respectively. Conclusion Thymopeptide and spectinomycin combined with carbon dioxide laser is a safe,effective and convenient therapy for cervical erosion and could significantly shorten the length of treatment. Key words: Cervical erosion; Thymopeptide; Spectinomycin; Carbon dioxide laser; Clinical efficacy

Some minor female reproductive system disorders: findings in the Oxford-Family Planning Association contraceptive study

BackgroundThe Oxford-Family Planning Association (Oxford-FPA) contraceptive study has provided information on many serious diseases of the female reproductive tract. No information has been published about a number of common minor...

Bacterial vaginosis

Tracey's boyfriend was complaining that she ‘smelled’ and was accusing her of ‘playing away from home’. The atmosphere at home was fraught and she went to the surgery hoping her GP or nurse could back up her protestations of innocence. As far as she was concerned, the only problem was a slight excess of a greyish/white, slightly frothy discharge. On examination, apart from a cervical erosion and discharge, a ‘fishy’ smell was noticed. The pH level of the vaginal fluid was found to be greater than 4.5, which led to suspicions of bacterial vaginosis.

Cervical Tuberculosis Mimicking Cervical Malignancy

A 36 years old patient presented to us with a history of primary infertility and secondary amenorrhea since 2 years and postcoital spotting per vaginum since 3 months. There was no history of any foul smelling discharge per vaginum, or any urinary problems. Her past menstrual cycles were regular, moderate and painless and she had amenorrhea since 2 years. There was no past history of tuberculosis and no history of contact. On examination, general condition was good. Systemic examination, did not reveal any respiratory pathology and cardiac status was normal. Per abdomen examination was normal. Per speculum examination (Fig. 1), cervical erosion on the anterior lip of the cervix was noticed, and a growth on the posterior cervical lip which bled on touch. On per vaginal examination, the uterus was bulky, fornices were clear. On per rectal examination both parametria were free. Investigations done as follows: Complete blood count Hemoglobin 10.9 gm/dl, total WBC count 8560 × 103 platelet count 3.24 lacs, ESR was normal. Her chest X-ray was normal and HIV status was negative. Total proteins were normal and liver and renal functions were normal. A pelvic ultrasound (Fig. 2) was done which was suggestive of bulky uterus and a collection within the uterine cavity. A dilatation and curettage with cervical biopsy was done for this patient. On D and C, a liquefied cheesy material was CASE REPORT

Cervical erosion had negative effects on the outcome of intra-cervical artificial insemination (ICI)

Cervical erosion had negative effects on the outcome of intra-cervical artificial insemination (ICI)

Asymptomatic &lt;i&gt;Chlamydia trachomatis&lt;/i&gt; Infection and Predictive Criteria among Low-Risk Women in a Primary Care Setting

The aim of this study was to estimate the prevalence and predictors of Chlamydia trachomatis infection among young adult low-risk women attending either of two inner-city family planning clinics in Trabzon, the most densely populated city in Turkey's Black Sea region. The study group comprised 150 sexually active women attending either of two family planning clinics. Two endocervical swabs were collected from each woman and tested for the presence of C. trachomatis by tissue culture and a commercially available enzyme immunoassay (ELISA). Multivariable logistic regression analysis was used to identify the associations of clinical factors for predicting C. trachomatis infection. C. trachomatis was detected in 19 of the samples (12.7%) by cell culture and in 15 (9.9%) by ELISA. None of the demographic characteristics could be associated with the state of infection, but the women preferring the withdrawal method for contraception accounted for a significantly higher percentage of the C. trachomatis-positive cases than women who used other contraceptive methods. The most frequent signs of cervical infection were vaginal discharge (RR = 4.86, 95% CI 1.60 and 14.79, P = 0.005) and cervical erosion (RR = 3.26, 95% CI 0.97 and 10.90, P = 0.056).

Microwave treatment of cervical erosion effect of 170 cases

目的 利用微波治疗仪治疗宫颈糜烂的疗效.方法 采用广东珠海市经济特区医药科仪公司中英合作生产的CYP-I型微波综合治疗仪对170例宫颈糜烂患者治疗并随访观察.结果 经微波凝技术(MTC)治疗,宫颈糜烂一次治疗显效率达85.3%(145/170),有效率达94.1%(160/170).结论 用MTC治疗宫颈糜烂具有疗效好,无痛苦,价钱低.操作简单,安全;治疗时间短等优点,值得临床推广使用。

Evidence for benefits from treating cervical ectopy: literature review.

Uterine cervical ectopy (cervical erosion) is today considered to be a physiological condition, but there still seems to be a strong tendency towards treating it. The purpose of this study was to review the medical literature for evidence regarding benefits from treating cervical ectopy. The following databases were reviewed: Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica Database (Embase), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) and Cochrane Library databases. In addition, six medical textbooks were consulted. The review showed that: 1) there is probably an association between ectopy and higher risk of Chlamydia trachomatis, human papillomavirus and human immunodeficiency virus infection; 4) there is probably an association between ectopy and cervical intraepithelial neoplasia; 5) there is an association between ectopy and mucous discharge and nocturia; and 6) there is no evidence of an association between ectopy and cervical cancer, or of protection against cervical cancer associated with ectopy treatment. 1) No data were found in the medical literature to support routine treatment for ectopy; 2) Treatment could be recommended for symptom relief, but more symptoms are attributed to ectopy than could be demonstrated in a controlled study; 3) Further studies to test the hypothesis of protection against cervical cancer associated with treatment are necessary.

Assessment of Cervical Erosion in Hamedan City, Iran

The purpose of this study was to determine the role of socio-economic factors and cytology in cervical erosion. A cross-sectional study involving 410 females in the reproductive age group was conducted in urban health centers in Hamedan city, Iran. Data were collected through interviews with women, gynecological examination in the clinics in the health centers and laboratory tests. Cervical erosion was detected in 68 (16.6%) females. Out of these mild dysplasia was seen in (8.8%) females. High percentages of inflammatory smears (58.8%) were obtained in women with cervical erosion. Cervical erosion was more common in illiterate and women with low literacy status as compared to women with higher education. Majority of cases of cervical erosion were detected in women with high parity. A statistically significant relationship was found between lower socio-economic status and cervical erosion (p < 0.05). Regular cytological screening by Pap smear will help in early detection of carcinoma cervix.

Improvement of cervical microenvironment after treatment of chronic cervicitis with focused ultrasound in infertility women

To investigate the effects of focused ultrasound (FUS) treatment on cervical microenvironment in infertility women with chronic cervicitis. A total of 10 women treated in Infertility Clinic of Obstetrics and Gynecology Hospital of College of Medicine of Zhejiang University were assessed. The women aged from 25 to 34 with normal menstrual cycles had moderate or severe cervical erosion. Ultrasound showed they had normal ovulation. The sperms of their husbands had normal motility and number. The FUS they received had a focal depth range of 4 - 6 mm, a resonant frequency of 9 - 11 MHz, and an output power of 3.5 W. The follow-up time was three months. The changes of cervical mucus and the results of postcoital test were evaluated. The clinical effects on cervical erosion and complications were also evaluated. In 6 cases of severe cervical erosion, 2 were cured, 2 were improved significantly (more than 50 % reduction of erosion area) and 2 were improved (less than 50 % reduction of erosion area). In 4 cases of moderate cervical erosion, 2 were cured, 2 were improved significantly. After the treatment, the median of cervical mucus score during LH peak were increased from 11 to 13 (Wilcoxon test, P=0.014). Postcoital test showed that the median of highly motile sperm (grade III and grade II) of 5 high-power field were increased from 22 to 52 (Wilcoxon test, P=0.015). Mild side effects without medical intervention included vaginal fluid in all 10 women, vaginal spotting in 2 women. No serious side effects were observed. The focused ultrasound therapy can help to improve the cervical microenvironment for infertility women with moderate or severe cervical erosion without serious side effects.

Distinction between lymphoma-like lesions and lymphoma of uterine cervix: a clinicopathologic study of 26 cases

To study the clinicopathologic features and differential diagnosis of lymphoma-like lesions and lymphoma of uterine cervix. Clinical data and hematoxylin and eosin-stained slides of 10 cases of lymphoma-like lesion and 16 cases of lymphoma of uterine cervix were reviewed. Immunohistochemical study for B- and T-cell markers and light chains (kappa, lambda) were performed on paraffin sections. The rearrangement status of immunoglobulin heavy chain (IgH) gene was analyzed with semi-nested polymerase chain reaction in 4 cases lymphoma-like lesion and 4 cases of lymphoma of uterine cervix. The age of patients with lymphoma-like lesion ranged from 24 to 54 years (medium = 43 years). The lesion generally presented with cervical erosion or polyp. Microscopically, it is characterized by focal or diffuse superficial infiltration of immunoblast-like large B cells intermingled with a polymorphic population of inflammatory cells, including plasma cells, eosinophils and neutrophils. Maturation of the transformed large B cells was also noticed. On the other hand, the age of the patients with lymphoma of uterine cervix varied from 28 to 78 years (medium = 58 years). Cervical mass or diffuse enlargement of cervix were the commonest clinical findings. The cases included 12 examples of diffuse large B-cell lymphoma and 4 examples of follicular lymphoma. The former was characterized by a diffuse monomorphic population of large atypical lymphoid cells, while neoplastic follicles were identified in the latter. Neither polymorphic inflammatory infiltrates nor maturation phenomenon was found. The immunostaining for kappa and lambda light chains was inconclusive. Molecular study showed clonal rearrangement of IgH gene in all cases of cervical lymphoma, as well as 2 cases of lymphoma-like lesion. The distinction between lymphoma-like lesion and lymphoma of uterine cervix depends primarily on the clinical and histopathologic features. Assay for rearrangement of IgH gene may be helpful in differential diagnosis, though monoclonality can be detected in some benign lesions as well.

An Industrial Dental-Erosion by Chromic Acid: A Case Report

A case of uncommon occupational dental erosion was reported in an individual who had worked in the war industry for twenty years. This occupation involved daily, at least 8 hours, inhalation of chromic acid being used for cleaning of barrel of cannons. The erosion manifested as dental sensitivity with excessive cervical erosion even with pulpal exposure in certain teeth. Moreover, due to the adverse effect of the chemical against to gingival and/or periodontal tissues, the lesions were extremely harmful with respect to the exposed root-cementum. After proper periodontal therapy, cervical lesions were treated conservatively with a compomer based restorative material without cavity preparation. Although today it is not common due to the well-controlled working conditions, occupational combined dental and medical problems via airborne fumes and/or elements can be seen at workers in chemical factories. A cumulative biohazardous effect is generally seen as not only medical but also dental disorders.

Synchronous Occurrence of Primary Neoplasms in the Uterus with Squamous Cell Carcinoma of the Cervix and Adenocarcinoma of the Endometrium

Synchronous primary malignant neoplasms of the uterus are uncommon. Patients with synchronous cervical and endometrial cancers are even rarer. We describe a case of cervical squamous cell carcinoma and endometrial endometrioid adenocarcinoma occurring simultaneously in a 47-year-old woman presenting with massive menstrual bleeding. The concept of synchronous primary malignancies of the genital tract is also reviewed in this report. A 47-year-old overtly obese female presented with menometrorrhagia of over 6 months' duration. Pelvic examination detected a large cervix but apparently normal externals. Magnetic resonance imaging revealed a mass over the cervical region and endometrial lesions in the uterine cavity. Surgical exploration disclosed a cervical tumor and erosion of the endometrium. The pathologic findings were compatible with synchronous occurrence of primary neoplasms in the uterus with squamous cell carcinoma of the cervix and adenocarcinoma of the endometrium. Synchronous genital tract neoplasms are rare but cause more clinical problems than a single neoplasm. It is practical to pay more attention to the differential diagnosis of primary and metastatic tumors. The second primary cancer that occurs in an individual with endometrial cancer may offer an opportunity for early detection. The prognosis for a patient with synchronous gynecologic malignancies does not seem to be worse.

Seroprevalence and correlates of herpes simplex virus type-2 infection in a general gynecology clinic

Up to two-thirds of individuals acquire herpes asymptomatically and most infected persons shed the virus during latency periods. Genital infection is frequently associated with the presence of other sexually transmitted diseases. The objective of this paper was to assess the seroprevalence of HSV-2 in a low risk population and to validate the use of reported symptoms and clinical signs as a possible diagnostic tool to screen for HSV-2. One hundred and fifty consecutive women presenting for the first time to the Gynecology outpatient clinic with complaints of vaginal discharge, lower abdominal pain, genital warts or ulcers were enrolled over a period of 4 months. Samples were taken and laboratory tests were performed to evaluate the presence of common reproductive tract infections including HSV-2. In this study, using a validated type specific assay, we found an unexpected high prevalence of HSV-2 (35 subjects, 23.3%). Of the 147 women who presented with the symptom of vaginal discharge, 34 (23.1%) tested positive for HSV-2. On examination cervical erosion and tenderness was noted in 50 women, in 23 (46%) of whom HSV-2 tested positive. On univariate analysis, no significant association was found between selected demographic factors, STIs and NSTIs and HSV-2. The association between previous abortion and HSV-2 was however, statistically significant. Also, none of the women who had HSV-2 positivity tested positive for HIV. The high HSV-2 seroprevalence in this low risk population may indicate a high risk for future acquisition of HIV in this population. Cervical erosion and hypertrophy as a possible clinical marker for HSV-2 has low positive predictive value and cannot be recommended as a possible diagnostic tool to screen for HSV-2 in resource poor settings.

Papanicolaou smear abnormalities in HIV‐infected women in north India

AbstractBackground: Dysplasia on Papanicolaou (Pap) smears have been reported in 15–40% of HIV‐positive women. These rates are 10–11 times higher than those observed among HIV‐negative women. Both the Center for Disease Control and Prevention and the Agency for Healthcare Policy and Research recommend that HIV‐infected women have a gynecologic evaluation including a Pap smear and pelvic examination as part of their initial evaluation.Methods: We performed pelvic examinations and took Pap smears in HIV‐positive women who attended the immunodeficiency clinic of the Postgraduate Institute of Medical Education and Research, Chandigarh, India, from August 2002 to September 2004. The cytology results were followed by colposcopy and/or biopsy if needed.Results: There were 136 women included in the study, and the age range was 21–58·years. Fourteen patients were menopausal, two had lactational amenorrhea, and five were pregnant. All were married and the majority (121 women) were parous. None of these women had any gynecologic symptoms. Speculum examination was clinically normal in 44 women, 24 had vaginal discharge suggestive of monilial vaginitis, 24 had vaginal discharge suggestive of a mixed infection and 44 had cervical erosion (with or without vaginitis). Bimanual pelvic examination was normal in nearly all, and only two had adnexal tenderness due to pelvic inflammatory disease. Pap smears were reported as normal in 65% of women and as inflammatory in 20%. Dysplasia was seen in 14 smears with invasive carcinoma in one. Seven women underwent colposcopic examination with directed biopsies where indicated. Despite initial counseling for a need for follow‐up, about one‐quarter of the women did not return to collect Pap smear reports and among this group were seven women with dysplasia.Conclusion: The high incidence of dysplasia in HIV‐positive women supports the recommendation of regular gynecologic examination including Pap smears in all these women even if they do not have any gynecologic symptoms. However, there is a need to have a better follow‐up so that appropriate therapeutic measures can be taken.

Skull Base Osteomyelitis: Diagnostic and Therapeutic Challenges in Atypical Presentation

We sought to document the diagnostic and management difficulties in masked skull base osteomyelitis secondary to malignant otitis externa, with emphasis on establishing diagnostic criteria in recurrence. Retrospective analysis of 3 cases of inadequately treated malignant otitis externa in elderly diabetic individuals leading to recurrence and atypical manifestations of skull base osteomyelitis on contralateral side with or without multiple cranial nerve involvement. Two of the 3 cases died of the disease despite aggressive treatment. One case was treated successfully with combination of antipsuedamonal microbial drugs for 8 to 12 weeks and hyperbaric oxygen therapy. Major complications such as thrombosis of lateral sinus and internal jugular vein, meningitis, ophthalmoplegia, blindness, cervical spine erosion and paralysis of all cranial nerves with exception of Ist cranial nerve were observed. There is high morbidity and mortality associated with skull base osteomyelitis. In partially treated cases of malignant otitis externa, atypical symptoms and findings of unilateral severe otalgia, unremitting headache, and presence of high ESR, unilateral OME, constitute diagnostic clues of skull base osteomyelitis. Such cases require further investigation with CT, MRI, Technetium 99 and gallium 67 scintigraphy and aggressive management.

Clinical observation of 168 cases using α-interferon suppository for cervical erosion

目的 观察干扰素栓治疗宫颈糜烂的临床疗效.方法观察组168例,给干扰素栓阴道内用药,每天1粒,9次为1个疗程,连用2～3个疗程.对照组160例,用消糜灵栓,隔日1粒,10次为1个疗程,同样用2～3个疗程.于用药后1个月、2个月、3个月观察疗效.结果观察组宫颈糜烂痊愈率为22.62%,显效率为57.14%,有效率为13.10%,总有效率为92.86%.对照组总有效率为51.25%.结论干扰素栓治疗宫颈糜烂方法简便、易行,疗效可靠。

Explorations of Suitable Therapy and Nursing Methods for Cervical Erosion

为探讨宫颈糜烂适宜的治疗和护理方法,2000年7月～2003年9月,我院除对单纯型宫颈糜烂用CO2激光和冷冻治疗外,对宫颈糜烂的颗粒型、乳头型,采用射频消融治疗.对486例宫颈糜烂患者的疗效和副作用进行分析,现报告如下.

Use of cervical cytology, vaginal ph and colposcopy as adjuncts to clinical evaluation of ayurvedic vaginal Douche, Panchavalkal, in Leucorrhoea

The use of cytology, vaginal pH and colposcopy as adjuncts to clinical assessment of efficacy of traditional Ayurvedic douche alone in treatment of uncomplicated leucorrhoea, has been evaluated in this study. Forty two cases of uncomplicated leucorrhoea without pelvic inflammatory disease or associated gynaecological or systemic pathology formed the study group. History, clinical examination, Papanicolaou (Pap) smear, gram stain, vaginal pH, and colposcopy were carried out before treatment, at 2 weeks post treatment and monthly examination. Daily douches with modified Panchavalkal (decoction from barks of F bengalensis, F religiosa, F infectoria, F glomerata and Alebbeck 25gms each), were given for 14 days. Symptoms were evaluated by a diagrammatic visual grading score. Thirty six cases (85.7%) had clinical relief or cure (p < 0.001; Chi square test). The symptom score was reduced from 5.4 ± 1.9 to 2.2 ± 2.2 (Mean ± SD) at 2 weeks and 2.3 ± 2.2 (Mean ± SD) at 1 month (p < 0.001; paired ‘t’ test) at 2 weeks post treatment. Out of 29 cases who had cervical erosion, 20 cases showed reduction in area of erosion whilst no change was seen in 9 cases. Colposcopy (n=21) confirmed reduced vascularity, inflammation, discharge and epithelialisation of transformation zone in 19 cases. Vaginal pH (n=28) was reduced in 13 and remained normal in 7 and remained same in 4 cases. In 4 cases there was a nonsignificant rise. Pap smears (n=37) showed improvement in severity of inflammatory changes in 25 cases. Specific infections were seen in 24 cases initially, and in 15 cases at 1 month. Apart from symptoms and signs cervical cytology, colposcopy and vaginal pH were very useful in evaluation of the traditional Panchavalkal douche treatment of uncomplicated leucorrhoea. Multiple infections and resistant cases were identified. Panchavalkal provided symptomatic relief in 85.7% of cases.