Atresia (fusion) of the cervical canal can lead to its complete or partial obstruction, which becomes an obstacle to the exit of menstrual flow. There is atresia of the cervical passage, and there is atresia of the uterine body. By its origin, narrowing of the passage of the cervix can be congenital and acquired. Unsuccessful moxibustion and curettage can lead to narrowing and even narrowing of the neck passage. To restore its patency, they resort to an operation called cervical canal surgery.
Causes of infection
Factors affecting the occurrence of atresia:
- Inflammatory processes of the cervical canal.
- Scarring caused by pathological processes.
- Infectious diseases for children (mumps, diphtheria).
- Sloppy scraping.
- Lesions of malignant neoplasms, endometritis, endocervicitis.
- Trauma resulting from childbirth or abortion.
- Burns to the mucous canal caused by chemicals.
- Electrocoagulation of the channel.
- Spontaneous age-related atresia.
After bougienage of the cervical canal, all functions are usually restored.
The structure of the cervix
A small segment between the cervical canal and the uterus, approximately 1 cm, is called the isthmus. Here, in the area of the isthmus, there is an internal pharynx. The lower part of the uterine cavity and the isthmus form the so-called lower segment, which plays an important role in the process of gestation and childbirth.
The lower part of the cervix descends into the vagina, and the upper rises above it. In nulliparous girls, as a rule, it has a conical shape. After childbirth, the neck becomes wider, takes the form of a cylinder, the channel also has a cylindrical shape. The external pharynx is the opening of the cervical canal, visible during vaginal examination. In giving birth to patients, the external pharynx takes the form of a gap, the reason for this is neck ruptures during childbirth. Nulliparous girls have a pointed pharynx.
Cervical canal surgery is used quite often. We will describe the method in more detail below.
Diagnostics
Various procedures are performed to examine the uterine cavity, for example, probing the uterine cavity, its curettage, administering drugs, diagnostic fluids, endoscopy of the uterine cavity, various operations - all these manipulations are performed with the expansion of the cervical canal. Carried out without proper preparation, professionalism and competence, such manipulations can lead to an injured mucous membrane of the canal and, as a result, to narrowing and fouling of the canal.
As mentioned above, one of the causes of atresia of the cervical canal may be inflammation of the mucous channel - endocervicitis. This disease is most often caused by pathogenic cocci, rods, and sometimes viruses. Endocervicitis is often combined with other inflammatory diseases (for example, colpitis, salpingoophoritis, endometritis).
Patients receive complaints of mucopurulent discharge that are not accompanied by pain. On examination, swelling and hyperemia of the mucous membrane and abundant secretion are noticeable. The prolonged course of the disease can lead to the spread of the process to the muscle walls, glands. In this case, cervical canal bougienage is indicated.
Endocervicitis is diagnosed on the basis of a clinical examination, a study of a smear from the vagina and cervical canal. In the acute period, antibiotics and local procedures are prescribed for treatment. Treatment of a chronic form requires injections of antibacterial drugs into the neck, physiotherapeutic treatment, local irrigation with protargol solution, and treatment of the neck passage with silver solution.
Primary arthresia
Diagnosis of primary atresia occurs during the first menstruation. Menstrual blood, not finding a way out, accumulates in the uterine cavity, overflowing and stretching it. At the same time, overall well-being suffers significantly. With the spread of blood through the pipes, purulent inflammation of the pipes may begin.
If the cervical canal is not poured at this time, the consequences can be disastrous.
Secondary arthresia
Secondary atresia for a long time may not appear. And the diagnosis is made when the patient begins to be examined for infertility. Blood entering the tubes creates obstruction, making it impossible for the egg to enter the uterus.
Ultrasound examination, sounding, MRI, histrosalpingoscopy and urethroscopy allows clarifying the diagnosis of atresia.
The narrowing of the cervical canal - stenosis - is a serious obstacle to the penetration of sperm into the uterus, which leads to infertility. And because of the obstruction of the tubes, the egg cannot get into the uterine cavity, which also makes fertilization impossible. Stenosis is eliminated with the help of a manipulation called "cervical canal bougienage."
Another cause of atresia is neoplasm. The most famous malignant tumor is adenocarcinoma. Symptoms of the disease: weight loss, anemia as a result of prolonged hemorrhage, pain in the lower abdomen.
Benign tumors that affect the occurrence of atresia: myoma, fibroma, polyps, cysts, fibromyoma, leiomyoma, as well as endometriosis. Symptoms of these diseases are quite diverse: these are pains during menstruation and sexual intercourse, hemorrhage, impaired bowel movements and urination.
Determination of benign tumor is performed by histological examination of the contents of the scraping channel. Examination and treatment take place under visual control.
During childbirth, during diagnostic curettage, during abortion and other medical procedures, as well as improper contraception, cervical canal injuries can occur, which can also lead to atresia.
Preparation for surgery
You can eliminate this pathology using the procedure for cervical bougienage or laser recanalization.
The operation of bougieurage is performed under general anesthesia, the following studies are necessary for its conduct:
- general blood analysis;
- infection analysis;
- blood for syphilis and HIV;
- colposcopy;
- hepatitis B and C antigens;
- coagulogram;
- swab from the vagina and cervical canal;
- ECG;
- fluorography;
- bacteriological from the vagina and CC;
- blood for biochemistry;
- Ultrasound
- specialist consultation.
But in some cases, it is possible to bougie the cervical canal without anesthesia. About it further.
How does the operation proceed?
For the operation of bougieurage, the patient is hospitalized in a hospital. The procedure lasts approximately 30 mi and is performed under local or general anesthesia. When the canal is completely closed, the operation is performed under general anesthesia, with a slight narrowing, local anesthesia is sufficient. The patient is located on a gynecological chair, the surgical field, genital fissure, treated with an antiseptic, then lidocaine is sprayed. A painkiller is introduced and the expansion procedure itself begins with the introduction of the narrowest nozzle for bougienage first, gradually increasing the diameter of the nozzles (medium, wide). Gradual widening of the passage contributes to gentle treatment.
After applying general anesthesia, the patient is prescribed in a day, and after local anesthesia, immediately. Therefore, it is preferable to cervical canalization without anesthesia. Reviews confirm that staying on outpatient treatment is 7-10 days. Locally, to accelerate epithelization, anti-inflammatory and wound healing suppositories are prescribed until complete healing of the cervical passage occurs. In case of recurrence of atresia, implantation of an artificial alloplastic channel is performed.
Measures to prevent overgrowth and narrowing of the passage
- Treatment of acute and chronic inflammatory processes of the uterus and cervical passage.
- Conducting professional examinations for the timely detection and treatment of gynecological diseases and tumors.
- Competent and qualified curettage, abortion to prevent injury. Careful obstetrics with the gradual opening of the cervix.
- Explanatory talks to exclude the uncontrolled use of douching with aggressive solutions that are not intended for this, and chemical contraceptives.
To prevent primary infection from childhood, one should adhere to a healthy lifestyle, play sports, and avoid the possibility of infection with infectious diseases. During pregnancy, try not to be exposed to teratogenic factors affecting the unborn baby.
Cervical canal surgery: price
The cost depends on the clinic and the region. The minimum price is 600 rubles, the maximum is 2000 rubles.
Cervical canal surgery: reviews
This technique of cervical canal expansion has been used for a long time. Reviews are mostly positive. Women can easily tolerate it, it rarely gives complications. Especially if the narrowing is not too pronounced and local anesthesia is used.