In what cases is it necessary to cauterize cervical erosion, and what is the best way to do this? How is the procedure performed?

Indications and contraindications

It is necessary to cauterize cervical erosion in the presence of the following pathological conditions:

• erosion began to grow;
• discomfort occurs during sexual intercourse;
• bleeding appeared;
• a large lesion on the cervix;
• there is a decrease in immunity;
• there is pain when using tampons;
• HPV virus detected;
• pregnancy planning, etc.

Attention! Some women have congenital erosion of the cervix. In the absence of fungal, viral, or infectious pathologies, the lesions disappear on their own up to 27 years of age.

There are contraindications to cauterization of the cervix:

• inflammatory processes occurring in the reproductive and urinary systems;
• pathologies of the heart and blood vessels;
• sexually transmitted diseases in chronic and acute form;
• CNS disorders;
• failure in the hematopoietic system;
• diabetes;
• endocrine pathologies;
• metabolic disorders;
• polyps localized in the cervical canal.

Attention! Recent birth, breastfeeding, any stage of pregnancy are relative contraindications. The advisability of performing surgical manipulation on the cervix for this category of patients is determined by gynecologists.

Causes of erosion

Cervical erosion, as well as the causes of its appearance, have been discussed by doctors for quite a long time. Currently, several theories have become widespread:

• In the first place is the theory of inflammation of the female genital organs, especially endocervicitis, which is accompanied by increased secretion of the glands of the cervical epithelium.
• Of lesser importance are pathological discharges coming from the uterus (endometritis, collapsing polyps, inflamed myomatous nodes, etc.). Such pathological discharges have a long-term effect on the epithelial lining of the vaginal part of the cervix, as a result of which it macerates and sloughs off (desquamation). As a result, true erosion occurs, the surface of which is actively populated by pathogenic microorganisms (chlamydia, ureaplasma, herpes viruses, human papillomas, Trichomonas, gonococci and others).
• Another, no less important, theory of the development of erosion is traumatic. Mechanical trauma to the cervix occurs during childbirth, cervical surgery, abortion (consequences), intrauterine procedures, and other things that lead to the formation of ectropion (cervical inversion) and its erosion.
• The theory of dishormonal origin of cervical ectopia suggests a violation of the ratio of sex hormones. Thus, hormonal changes include early and late puberty, various cycle disorders, ovarian dysfunction, chronic inflammation of the ovaries, childbirth at a young and late age.

And predispose to the occurrence of the disease:

• early sex life
• promiscuity
• rare sexual intercourse
• weakened immune system

Relationship between factors such as:

• heredity
• smoking
• The use of hormonal contraceptives and the development of ectopia is still being proven.

Main methods of treatment

When treating erosion localized on the cervix, various medical and surgical techniques can be used.

If the lesions are small in size, then it is enough to undergo a conservative course of therapy so that they disappear on their own. With progressive pathology, doctors recommend cauterization to patients, which can be performed in different ways.

Diathermocoagulation

This technique is considered outdated and many hospitals have already abandoned it. Before the manipulation, all inflammatory processes are stopped, and the vagina is sanitized.

Using an electrode that emits current discharges, the specialist carries out a targeted effect on the affected area. The manipulation is carried out until the surface of the erosive lesion is covered with a scab. The crust covering the bleeding wound on the neck will fall off on its own after two weeks.

Important! Gynecologists do not recommend diathermocoagulation for girls planning to conceive, and especially for nulliparous women. This is due to a side effect of the procedure - the formation of a scar consisting of connective tissue.

Diathermoexcision

Tissue from the affected area of ​​the cervix is ​​removed using an electric knife. The technique can be used on days 7-9 of the monthly cycle, and is accompanied by various complications, in particular the formation of scars.

Radio wave methods

Manipulations on the cervix are carried out using a special device “Surgitron”, which generates radio waves.

Thanks to the point effect, a wound surface is formed on the lesion. After the crust falls off (up to 1.5 months), there is no scar tissue at the site of erosion. This method is often used in the treatment of nulliparous patients.

Laser vaporization

This method is considered one of the most modern. The lesion is targeted with a laser beam. In its place, a wound forms, and after its healing (1-1.5 months) flat epithelium.

Cryodestruction

Pathological changes in the cervix are treated with liquid nitrogen. Under the influence of extremely low temperatures, tissues affected by erosion die. The procedure is carried out from the 7th to the 9th day of the menstrual cycle, it is considered the least traumatic, with virtually no complications.

Early consequences of cauterization, or what to expect in the first month after the procedure

The rehabilitation period after treatment of erosion is 4–8 weeks. Its duration directly depends on the chosen method of therapy. The body recovers most quickly after radio wave and laser coagulation (3-4 weeks). After DEC, rehabilitation can take up to 2-3 months.

It is also useful to read: Folk remedies for the treatment of cervical erosion: are they effective and what are the risks when using them

Discharge after cauterization

During the first two weeks after treatment of erosion, a woman may feel an increase in natural discharge. This is a completely normal process that occurs during the gradual healing of a mucosal defect. In the first days there will be moderate bloody or slightly brown discharge without an unpleasant odor. After 3–5 days, the discharge will become lighter, less abundant, and then practically disappear. After the next menstruation, the woman’s condition should completely return to normal.

Important aspects:

• After using DEC, a scab forms on the cervix, which comes off after 10–14 days. All this time, the woman may experience bleeding;
• After cryodestruction, the appearance of copious watery discharge (hydrorrhea) is noted within 4–6 weeks.

The discharge that occurs after cauterization should not be accompanied by itching, burning or other unpleasant sensations. The appearance of such symptoms indicates a possible infection and indicates the development of complications.

On a note

According to patient reviews, after radio wave and laser therapy, heavy discharge persists for no more than 14 days and does not cause significant discomfort.

After cauterization of the erosion, bloody discharge will be observed for 1-1.5 months: at first watery, then it will acquire a pinkish tint with blood clots, and after 3-4 weeks during the healing process it will turn brown.

Lower abdominal pain

Unpleasant pulling sensations over the pubis are observed in half of all women during cauterization of erosion. The pain persists for several hours or days, after which it goes away without the use of analgesics. There should not be any significant discomfort, however, women often complain of pain in the lower abdomen after the procedure. This is probably due to the low pain threshold and individual sensitivity of the patient.

Important point

If the discomfort after cauterization does not subside and even intensifies, you should immediately consult a doctor.

Bleeding

Heavy bleeding often occurs after cauterization with electric current. DEC is considered a fairly aggressive procedure, and the scab that forms after the manipulation may be torn off ahead of time. This leads to moderate or heavy bleeding from the genital tract, sometimes with an unpleasant, pungent odor. After other methods of therapy, bleeding occurs extremely rarely.

Bloody discharge may also be associated with damage to healthy tissue during cauterization. The doctor will be able to recognize the cause of the bleeding after a follow-up examination of the patient.

On a note

Scanty bleeding during the first 10–14 days after cauterization is considered normal and does not require treatment.

Inflammation

Infection of a surgical wound occurs mainly after contact methods of therapy: DEC and cryodestruction. When using non-contact techniques (laser, radio wave therapy), the likelihood of infection is almost zero. Complications can arise if intimate hygiene rules are not followed after the procedure. Against the background of untreated cervicitis (inflammation of the cervical canal) and subsequent cauterization, the spread of infection is also likely. This is why gynecologists strongly recommend removing the inflammation first and only then cauterizing the erosion.

Signs of cervicitis:

• Copious discharge from the genital tract (yellow, green, gray) with an unpleasant odor;
• Itching and burning in the vagina;
• Possible increase in body temperature.

At the slightest suspicion of infection, you should consult a doctor. Without treatment, the inflammatory process can spread to the uterine cavity, leading to the development of endometritis and, in the long term, to infertility.

When a surgical wound becomes infected, an inflammatory process of the inner lining of the uterus can develop - endometritis, which in some cases can lead to infertility.

Answers on questions

Women ask many questions about erosion localized on the cervix. They are especially interested in the consequences of cauterization and the duration of rehabilitation.

What not to do after the cervical cauterization procedure

Doctors give patients the following instructions (to follow for 1-2 months):

• lifting weights is not allowed;
• ban on physical activity, visiting swimming pools, solariums, saunas, baths, beaches;
• Hypothermia and direct exposure to sunlight should be avoided;
• you can't have sex;
• it is necessary to prevent injury to the mucous membranes of the cervix during ultrasound, the use of tampons, and douching.

Can the disease reappear?

Lesions on the cervix in new places may appear after undergoing drug or surgical therapy. External and internal factors can provoke a pathological process.

Is it possible to cauterize erosion during pregnancy?

During the period of gestation, any surgical manipulations are carried out only for serious indications, with the direction of doctors.

Is it possible to give birth after cauterization of the cervix?

If a woman has cauterized erosion using a gentle method, in which scars do not form on the mucous membranes, she can plan a pregnancy. In this case, the birth should proceed without complications.

How to treat

Treatment for cervical erosion is selected taking into account many factors. After the examination, the doctor determines the cause that caused the disease. If possible, the cause is eliminated.

• That is, if latent sexually transmitted infections have been detected, appropriate therapy is recommended, depending on the pathogen isolated (antiviral drugs or antibiotics).
• After completing the course of anti-inflammatory treatment, the gynecologist selects the optimal method for removing pseudo-erosion, taking into account the area of ​​the pathological focus, the woman’s age, her attitude towards having a child in the future and other factors.
• Almost all methods for removing cervical ectopia can now be used in women who have not gone through childbirth (this is important; not so long ago, treatment of erosion was postponed until after the birth of a child, which could take either a year or 10 years).
• Removal of pseudo-erosion of the cervix should be carried out in the first phase of the cycle, immediately after the end of menstruation, but the diathermocoagulation method is an exception.

“Cauterization of cervical erosion” is carried out pharmacologically and non-drug methods.

Chemical coagulation

This method of removing cervical ectopia involves treating the pathological area with chemical solutions, for example, the drug Solkovagin. Its constituent components are organic acids (oxalic and acetic) and zinc nitrate with nitric acid. Chemical destruction is used only when treating small areas of ectopia.

Not so long ago, Vagotil was popular, with tampons applied to the erosion for 7–10 days. Today, Vagotil treatment is not used, since the depth of its penetration into the altered tissues is small, and therefore the effectiveness of therapy is low. After cauterization of the erosion by the solkovagin, a scab forms on its surface, which is torn off after a few days. Complete regeneration occurs after 6 – 8 weeks.

The advantages include:

• almost complete painlessness;
• ease of processing (twice with an interval of several minutes);
• relatively inexpensive (the cost of Solkovagin ranges from 750 to 1200 rubles: the package contains 2 ampoules of 0.5 ml);

The disadvantages include low efficiency; treatment is carried out only for small-sized ectopia of the cervix.

Diathermocoagulation

Quite an old method with a lot of disadvantages. The essence of diathermocoagulation is to cauterize the ectopia with a high-frequency current, that is, a black scab forms at the site of erosion, like after a burn. Currently practically not used.

Disadvantages of DTK:

• soreness;
• risk of bleeding occurring during cauterization and after;
• altered by cervical scars, and this makes it impossible to use the method in nulliparous girls and in women planning a pregnancy.

Complete healing occurs by 4–6 weeks. Cauterization is carried out in the second phase of the cycle, on the eve of menstruation, so that menstruation “washes” the scab, which contributes to its more “gentle” rejection.

Positive aspects of DTK: the possibility of performing conization of the cervix if necessary, the simplicity and low cost of the method.

Laser vaporization

A widely used method that involves treating the pathological area with a laser beam (non-contact method). Before manipulation, the cervix is ​​wiped with a solution of acetic acid to spasm the blood vessels and with an iodine solution to determine the boundaries of ectopia. Under the action of laser beams, the liquid from the pathologically altered cells evaporates and they are destroyed.

Pros of the procedure:

• the method is practically painless;
• high efficiency (98% cure);
• do not form scars on the cervix.

The disadvantages include the high cost and the need for special equipment, which makes the method’s accessibility relative and a larger zone of decay of healthy tissue (1.2 mm) than with radio wave treatment of erosion.

Cryodestruction

Cryocoagulation is based on treating the pathological focus with liquid nitrogen cooled to 100 - 150 degrees (replacement is nitrous oxide), which is sprayed by the device. The treated area turns white and loses sensitivity. The fluid in the cells crystallizes, causing them to collapse. The duration of the manipulation is 15 minutes. After treatment, significant watery discharge appears, restoration of most of the ectopia begins by day 7, and complete healing occurs after 4 to 6 weeks.

Advantages of the method:

• quite effective (85 – 97%);
• simplicity;
• almost complete painlessness;
• does not disturb the structure of the cervix.

Disadvantages include the possibility of bleeding after treatment and the risk of incomplete treatment of pathological cells.

Radio wave method

This method of treating ectopia and more has become very popular lately. Gynecological oncologists consider the treatment of cervical diseases with radio waves to be the most optimal method among all those used. The method is non-contact and is based on the conversion of electric current into radio waves (Surgitron apparatus), which are directed to the affected area using an electrode.

During manipulation, the electrode does not come into contact with tissues and does not heat up, that is, the risk of burns is completely eliminated. Under the influence of radio waves, the liquid from the cells evaporates and they disintegrate. The zone of altered epithelium at the border of healthy and pathological tissue is 0.04 mm, that is, we can say that radio waves stop at the affected area without affecting healthy cells. The method is relatively painful, but requires only local anesthesia.

Advantages of the method:

• cicatricial deformation of the cervix does not occur after manipulation;
• efficiency reaches 100%;
• the risk of bleeding is almost zero.

Healing occurs in 2–3 weeks. The procedure can be performed on any day of the cycle.

The only disadvantage is that not all antenatal clinics have special equipment.

Recovery

If no complications are noted, then healing occurs in a short time. Before the scab leaves after surgery, the patient experiences mucous discharge mixed with blood.

After the scab is separated, the process of tissue regeneration begins, which finally ends after 3-4 months. Relapses are possible, but their occurrence is extremely rare.

Cauterization of cervical erosion is an effective operation that helps prevent possible adverse reactions. The recommendations of a specialist should be followed to avoid adverse reactions .

Basic recommendations

Cauterization is carried out using different methods, and wound healing also occurs in different ways. Electric shock is an inexpensive method. However, it leads to the formation of a wound and bleeding, which causes pain in the woman’s lower abdomen. Bleeding can last up to 4 weeks, and in order to prevent the formation of inflammation and pus, after the procedure you must follow the following rules:

- exclude sexual activity for 6 weeks

- do not take hot baths, you can take a warm shower

- do not expose yourself to physical stress.

Therapy after coagulation

For comparison: after using Solkovagin there are no restrictions on bathing and sexual activity. This method is not surgery or coagulation. This is a gentle therapy that does not require special preparation. In contrast, cryotherapy of complex areas with uneven edges does not provide 100% confidence in the complete treatment of the erosion boundaries.

After laser therapy or diathermocoagulation, a woman may experience pain in the lower abdomen. Any surgery requires post-intervention support of the body with an antiseptic. And after diathermocoagulation, this is especially necessary, since the effect of electric current leads to scars and the patient is in pain for a long time. In this case, anti-inflammatory suppositories must be used.

What are the risks of cervical erosion?

Many young women do not attach importance to the disease and neglect medical recommendations and prescriptions. One of the consequences of such neglect of the health of the reproductive system is the inflammatory process and infections in the uterus and appendages. A defect in the mucous membrane, in fact, an erosive surface in the cervical area is an excellent place for the proliferation of pathogenic bacteria. Increased growth and reproduction of microorganisms that make up the vaginal microflora can also trigger the disease.

When there is a long-term inflammatory process of cervical erosion, treatment for this disease is not carried out, and the death of mucosal cells occurs. Subsequently, the pathology spreads deeper into the uterus and appendages. Involvement of deep cervical structures in pathology can provoke the formation of atypical cells. Due to these features, in pathologies such as cervical erosion, dysplasia is one of the common consequences.

With this disease, atypical cells grow and multiply, which can ultimately cause cervical cancer (1.5–2% of cases). Among the common consequences of cervical erosion:

• cervicitis;
• adnexitis;
• oophoritis;
• vaginitis

Consequences of cauterization by radio waves

The peculiarity of cauterization with radio waves is the absence of human exposure to the erosive area. Using special equipment, the affected cells are crushed. The electrodes create high-frequency waves that partially melt the tissue. Subsequently, they evaporate and not a trace remains of erosion.

Advantages of the method

Cauterization of erosion with radio waves has recently become increasingly popular due to the following advantages:

• Absolute safety.
• Do not harm healthy tissues, since the effect occurs only on affected tissues.
• Minimum recovery period.
• Allows you to cure erosion in 1 procedure.
• After cauterization with radio waves, no traces of erosion remain.
• Does not cause burns.

This method is suitable for treating women of any age and even nulliparous women.

Disadvantages of the method

Despite the advantages of the method, some women may experience negative consequences:

• Discharge for 10 days. They may be white, and in some cases with blood in them.
• Pain in the lower abdomen for 3 days.

Diagnostics

Erosion of the vagina or that part of the cervix that is closest to it - diagnoses that a doctor can first make after a manual examination in the mirrors.

However, in order to make a final diagnosis, the gynecologist should not rely only on external signs of cervical erosion and complaints made by the patient.

The diagnostic algorithm for this disease consists of conducting such laboratory and instrumental research methods as:

• examination of a smear taken from the vagina to determine its qualitative and quantitative composition. Not only the type of pathogenic microflora (if present) is determined, but also the approximate quantitative value. In addition, this method allows you to count the number of leukocytes in a smear and roughly determine the degree of inflammation and neglect of the pathological process;
• cytological analysis of material taken from the vagina - analysis of cells taken by scraping from different parts of the mucous membrane. With this study, altered cells can be identified;
• full (extensive) colposcopy - used to identify cells changed by the erosive process, as well as the boundaries of the pathological focus. This method uses special dyes that change color depending on what medium they come into contact with. This is what prompts the doctor to assume a particular diagnosis. During colposcopy, iodine solution and 3% acetic acid are widely used. These solutions cause discomfort and a burning sensation only if they get into areas with a wound surface or ulcers. Colposcopy is a mandatory diagnostic test when determining tumor or inflammatory processes. Uterine erosion is determined using hysteroscopy;
• inoculation of the collected material to identify the causative agent of infection and determine its antibiotic resistance. It is carried out with the aim of prescribing the most rational therapy with a narrow-spectrum antibacterial drug;
• PCR, ELISA and RIF analysis to identify the infectious agent;
• biopsy - taking a biopsy sample (a section of affected tissue) to determine its cellular composition and identify atypical (cancerous) cells;
• histology - allows you to evaluate the structure of cells, and if it changes, determine the possible causes of their degeneration, as well as predict the further development of the pathological process.

Additional examination is mandatory, since symptoms of cervical erosion cannot be the basis for making a final diagnosis.

Treatment of cervical erosion at home

Treatment of cervical erosion involves the use of local remedies. Therapy is always carried out comprehensively and under the strict supervision of a gynecologist. Doctors determine the type of drug, its dosage, frequency of administration and duration of therapy. Among the drugs and groups of drugs used:

• anti-inflammatory drugs;
• antiviral;
• antibiotics;
• hormonal drugs.

When choosing a dosage form, preference is given to:

• ointments;
• gels;
• candles.

Treatment of cervical erosion - drugs

As mentioned above, one of the common methods of treatment is cauterization of erosion. It can be carried out with the help of medications or by exposing the lesion to laser, heat, or radio waves. Thus, with the chemical coagulation method, cervical erosion is treated with Solkovagin. This is a drug for local use used to treat benign tissue changes on the surface of the reproductive organ.

After cauterization, to prevent recurrence of cervical erosion, treatment is carried out comprehensively. The following medications are used:

• antiviral and antibacterial: Tsiprolet, Virolex, Acyclovir;
• candles: Hexicon, Suporon;
• hormonal drugs: Ovestin, Diane-35, Yarina.

Cervical erosion - treatment with folk remedies

Treatment of erosion using traditional medicine is used as an additional method of therapy. Before any use of traditional medicine, you should consult your doctor. Among the common, effective recipes it is worth noting the following.

Douching solution

Ingredients:

• calendula flowers – 2 tbsp. spoons;
• water – 1 l.

Preparation, use

1. The raw materials are poured with boiling water and left for 30 minutes.
2. Strain and douche 1-2 times a day for a course of 7-10 days.

Soda solution for douching

Ingredients:

• baking soda – 2 tbsp. spoons;
• water – 1 l.

Preparation, use

1. Add soda to warm boiled water and stir thoroughly.
2. Douching is carried out in the morning and evening for 10 days.