What are the common symptoms of chocolate cysts. How do chocolate cysts affect fertility. What causes chocolate cysts to form. When should you seek medical attention for chocolate cysts. How are chocolate cysts diagnosed and treated.

Understanding Chocolate Cysts: A Comprehensive Overview

Chocolate cysts, also known as endometriomas, are a type of ovarian cyst that can affect women of reproductive age. These cysts get their name from the dark, brown-colored, tar-like substance found inside them, which resembles melted chocolate. Typically ranging from 2 to 20 centimeters in size, chocolate cysts can form within or around the ovary.

The substance inside these cysts is composed of old, thickened menstrual blood, endometrial tissue fragments, and inflammatory enzymes. Women with endometriosis are at a higher risk of developing chocolate cysts, as they are closely related to this condition.

What causes chocolate cysts to form?

Chocolate cysts form when endometrial tissue, which normally lines the uterus, grows outside the uterus and attaches to the ovaries. During menstruation, this misplaced tissue bleeds and forms cysts filled with old blood, giving them their characteristic chocolate-like appearance.

Recognizing the Symptoms of Chocolate Cysts

The symptoms of chocolate cysts can vary significantly from woman to woman. Some may experience severe symptoms, while others may have no noticeable signs at all. It’s important to note that the severity of symptoms is not necessarily related to the size of the cyst or how long it has been present.

What are the most common symptoms of chocolate cysts?

• Painful menstrual periods (dysmenorrhea)
• Abnormal vaginal bleeding or spotting
• Severe pain or swelling in the abdominopelvic area
• Dark-colored vaginal discharge
• Pain during sexual intercourse (dyspareunia)
• Discomfort during strenuous activities, bending, or stretching
• Pain while urinating or passing stool
• Infertility

It’s worth noting that these symptoms closely resemble those of endometriosis, which is not surprising given the relationship between the two conditions.

Complications and Emergency Situations

While many chocolate cysts remain stable, there are instances where they can rupture, leading to potentially serious complications. A ruptured chocolate cyst requires immediate medical attention due to the risk of infection and internal bleeding.

When should you seek emergency medical care for a chocolate cyst?

If you experience any of the following symptoms, it may indicate a ruptured cyst:

• Sudden, severe pain on the side where the cyst is located
• Fever
• Vomiting
• Unexplained vaginal bleeding

The contents of a ruptured cyst can spill onto the ovaries and other reproductive organs, potentially causing scarring and inflammation. This can lead to additional complications and more severe symptoms.

The Impact of Chocolate Cysts on Fertility

Chocolate cysts can significantly impact a woman’s fertility in various ways. Understanding these effects is crucial for women who are trying to conceive or planning to have children in the future.

How do chocolate cysts affect fertility?

1. Hormonal imbalance: Chocolate cysts can disrupt the normal balance of reproductive hormones, potentially interfering with ovulation and implantation.
2. Physical barriers: The cysts may form a barrier on the ovary, preventing the release of eggs or making it difficult for sperm to reach the egg.
3. Ovarian function: In some cases, chocolate cysts can damage ovarian tissue, reducing the ovary’s ability to produce and release eggs.
4. Fallopian tube scarring: The inflammatory nature of chocolate cysts can lead to scarring in the fallopian tubes, making it harder for eggs to travel and be fertilized.
5. Reduced ovarian reserve: Large or multiple cysts may decrease the overall number of healthy eggs available for fertilization.

It’s important to note that while chocolate cysts can impact fertility, many women with this condition can still conceive naturally or with the help of fertility treatments. Early diagnosis and appropriate management are key to preserving fertility.

Diagnosis and Medical Evaluation

Accurately diagnosing chocolate cysts is essential for proper treatment and management. Healthcare providers use a combination of methods to confirm the presence of these cysts and assess their impact on a woman’s reproductive health.

How are chocolate cysts diagnosed?

• Physical examination: A pelvic exam may reveal tenderness or a mass in the ovarian area.
• Ultrasound: Transvaginal or abdominal ultrasounds can provide detailed images of the ovaries and any cysts present.
• MRI: In some cases, magnetic resonance imaging may be used to get a more detailed view of the cysts and surrounding structures.
• Blood tests: Hormone levels and markers for certain types of ovarian cysts may be checked.
• Laparoscopy: This minimally invasive surgical procedure allows direct visualization of the cysts and can be used for both diagnosis and treatment.

Your healthcare provider may also ask about your medical history, including any symptoms you’ve experienced and your family history of reproductive health issues.

Treatment Options for Chocolate Cysts

The treatment approach for chocolate cysts depends on various factors, including the size of the cysts, severity of symptoms, and the patient’s fertility goals. Management strategies range from watchful waiting to surgical intervention.

What are the main treatment options for chocolate cysts?

1. Watchful waiting: For small, asymptomatic cysts, your doctor may recommend monitoring the cyst with regular ultrasounds to check for changes in size or appearance.
2. Hormonal therapy: Birth control pills or other hormonal medications may be prescribed to regulate menstrual cycles and potentially shrink the cysts.
3. Pain management: Over-the-counter or prescription pain relievers can help manage discomfort associated with chocolate cysts.
4. Surgical removal: For larger cysts or those causing significant symptoms, laparoscopic surgery may be recommended to remove the cysts while preserving healthy ovarian tissue.
5. IVF and fertility treatments: If infertility is a concern, assisted reproductive technologies like in vitro fertilization (IVF) may be considered.

The choice of treatment will be tailored to each individual’s specific situation and goals. It’s important to discuss all options with your healthcare provider to determine the best course of action.

Living with Chocolate Cysts: Lifestyle and Management Strategies

While medical treatments play a crucial role in managing chocolate cysts, certain lifestyle changes and self-care strategies can help alleviate symptoms and improve overall quality of life for women living with this condition.

What lifestyle changes can help manage chocolate cysts?

• Diet modifications: Some women find relief by adopting an anti-inflammatory diet rich in fruits, vegetables, and omega-3 fatty acids.
• Regular exercise: Moderate physical activity can help reduce pain and improve overall well-being.
• Stress management: Techniques such as yoga, meditation, or counseling may help manage stress, which can exacerbate symptoms.
• Heat therapy: Applying a heating pad to the lower abdomen can help alleviate pain and discomfort.
• Complementary therapies: Some women find relief through acupuncture or massage therapy, though more research is needed to confirm their effectiveness.

It’s important to work closely with your healthcare provider to develop a comprehensive management plan that addresses both the medical and lifestyle aspects of living with chocolate cysts.

Prevention and Long-term Outlook

While it may not be possible to prevent chocolate cysts entirely, especially for women with endometriosis, there are steps that can be taken to reduce the risk of complications and manage the condition effectively over time.

Can chocolate cysts be prevented?

While complete prevention may not be possible, the following strategies may help reduce the risk or severity of chocolate cysts:

• Regular gynecological check-ups to detect and address any issues early
• Maintaining a healthy weight and lifestyle
• Managing stress levels
• Considering hormonal birth control methods, which may help regulate menstrual cycles and reduce the risk of cyst formation

What is the long-term outlook for women with chocolate cysts?

The prognosis for women with chocolate cysts varies depending on several factors, including the severity of the condition, response to treatment, and individual health circumstances. With proper management and regular medical follow-up, many women can effectively control their symptoms and maintain good reproductive health.

However, it’s important to be aware that chocolate cysts can recur, even after successful treatment. Ongoing monitoring and a proactive approach to management are essential for long-term health and well-being.

For women concerned about fertility, early intervention and working closely with a reproductive specialist can help optimize chances of conception and successful pregnancy.

By staying informed, maintaining open communication with healthcare providers, and actively participating in their care, women with chocolate cysts can navigate this condition successfully and maintain a good quality of life.

Chocolate Cysts Symptoms: What Every Woman Should Know

A chocolate cyst is a benign and blood-filled cyst found in women of reproductive age. This cyst can be formed in the ovary or encapsulating the ovary. The size of the cyst ranges from 2 to 20 centimeters. The chocolate cyst got its name due to the dark, brown colored, tar-like substance present inside it. These substances include old and thickened menstrual blood, bits of endometrial tissues and inflammatory enzymes. The chances of chocolate cysts are higher in women with endometriosis.

Symptoms of Chocolate Cysts

The signs and symptoms of this condition, vary from women to women. Some women may experience severe symptoms, whereas for others this condition may cause no symptoms at all. Also, the severity of the chocolate cyst symptoms depends neither on the size of the cyst nor on the duration of this condition. The symptoms of chocolate cyst are almost similar to those of endometriosis.

Let’s discuss the most common chocolate cyst symptoms below:

• Painful menstrual periods
• Abnormal vaginal bleeding or spotting
• Extreme pain or swelling in the abdominopelvic area
• Dark-colored vaginal discharge
• Pain during sex
• Pain during strenuous activities or even bending and stretching
• Pain while urinating
• Pain while passing stool
• Infertility

A ruptured chocolate cyst needs immediate medical attention. The content inside the ruptured cyst spills on the ovaries and other reproductive organs which then leads to scarring and inflammation causing the following symptoms such as:

• Severe or sharp pain on the side where the cyst is present
• Fever
• Vomiting
• Bleeding

Effect of Chocolate Cysts on Fertility

The chocolate cyst can interfere with a woman’s fertility in many ways. In some cases, these cyst imbalances the reproductive hormones leading to infertility. Also, sometimes, the sperm may not be able to penetrate the barrier formed by the cyst on the ovary that released the egg or the cyst is preventing the ovary from forming eggs. Fallopian tube scarring is also one of the reasons that can cause fertility issues in women due to a chocolate cyst.

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Ovarian cysts | healthdirect

Key facts

• An ovarian cyst is a fluid-filled sac in your ovary.
• Most are not cancerous and many go away without treatment.
• Many cysts don’t cause symptoms.
• If they need to be removed, it’s usually possible with keyhole surgery.
• Sometimes a cyst can rupture or make your ovary twist. This may need emergency treatment.

What is an ovarian cyst?

An ovarian cyst is a fluid-filled sac that forms in your ovary. They are common, and almost every female will have one at some stage. Most are not cancerous.

What types of ovarian cysts are there?

Functional cysts

During a normal menstrual cycle your ovaries release an egg, which has grown inside a tiny follicle (sac). After releasing the egg, the follicle eventually gets smaller and disappears.

Sometimes, the follicle doesn’t open and release the egg. Instead, it continues growing and fills with fluid. This forms a follicular cyst.

Sometimes, the follicle doesn’t shrink after it releases the egg. Instead, it keeps growing and fills with fluid and sometimes blood. This forms a corpus luteum cyst.

These cysts are common and usually disappear within 2 to 3 months. While the cyst is there, your period might not come on time. Once the cyst has gone, your period usually goes back to normal.

Endometrioma

Also known as ‘chocolate cysts’, these are caused by endometriosis and can develop if cells from the lining of your uterus (womb) attach to your ovaries. When you get your period, these spots bleed and can form cysts filled with blood.

These cysts grow, but are not cancerous. Some endometriomas cause pain or pressure. They may also make it more difficult for you to become pregnant.

Dermoid cyst

These contain different types of body tissue, such as hair, fat, skin, teeth and bone. They grow very slowly and are not cancerous.

Cystadenoma

These are filled with watery fluid or mucus. They keep growing and are not cancerous.

Hydrosalpinx

This occurs when a fallopian tube becomes blocked and fills with fluid. It is usually caused by a sexually transmitted infection. It can lower your fertility.

Ovarian cancers

Cancerous cysts are rare, especially before menopause. There are several types of ovarian cancer.

What are the symptoms of ovarian cysts?

Many cysts don’t cause symptoms. You might discover you have one if you have an ultrasound for another reason.

Symptoms are more likely if a cyst is large, growing quickly or pressing on other organs.

Symptoms may include:

• lower abdominal fullness (feeling bloated)
• needing to urinate more often
• discomfort with bowel motions
• pelvic pain, usually mild
• irregular periods
• pain during sexual intercourse

Haemorrhage or rupture

Sometimes there is bleeding inside a cyst, or a cyst can break open and cause heavy bleeding. This causes sudden severe pelvic pain and sometimes light-headedness and nausea.

Ovarian torsion

If a cyst grows bigger than 5 cm, it can make the ovary twist. This cuts off the ovary’s blood supply. It causes sudden severe pelvic pain, nausea and vomiting. It is an emergency.

If you have sudden pelvic pain and vomiting or light-headedness, go to your nearest hospital emergency department.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

How will I be diagnosed with an ovarian cyst?

Your doctor may examine you and suggest tests, including:

• an ultrasound (usually done through the vagina)
• a pregnancy test
• blood tests

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

What treatment will I need for an ovarian cyst?

Many ovarian cysts go away without treatment.

If tests indicate your cyst is non-cancerous, your doctor may advise that no treatment is necessary but that you have regular check-ups to monitor the cyst’s size.

Your doctor may suggest removing the cyst if it:

• doesn’t go away after 3 months
• grows, especially if it’s bigger than 6cm
• causes symptoms
• may be cancerous

Non-cancerous cysts are usually removed by laparoscopy (keyhole surgery). Before menopause, your surgeon will usually try to remove just the cyst and not your whole ovary. Even if your ovary needs to be removed, your fertility and hormones are usually not affected, as you still have a second ovary.

If a cyst bleeds or ruptures, it usually gets better by itself within 1 to 3 days. Pain relieving medicines may help. If there is heavy bleeding, you may need emergency treatment in hospital and sometimes surgery.

Ovarian torsion requires emergency surgery.

Are ovarian cysts related to polycystic ovary syndrome?

No. Polycystic ovary syndrome (PCOS) is a hormonal condition. If you have PCOS, your ovaries will contain many small cysts. These are not true ovarian cysts. They are follicles containing eggs that haven’t fully developed.

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Surgery: Liver cysts – diagnosis and treatment in St. Petersburg, price

Cysts are liquid formations that have their own capsule. You can find a cyst in any organ. Liver cysts are found in 1-5% of the population.

In recent decades, the number of people seeking medical help in connection with discovered cysts in the liver has been increasing. These are often accidental findings during ultrasound examination or computed tomography of the abdominal organs.

Etiology, pathogenesis, classification

The disease usually manifests clinically between the ages of 30 and 50 and occurs 35 times more often in women than in men. There are true and false liver cysts. The former have a cover on the inner surface of the cavity, consisting of the epithelium of the bile ducts. It is believed that they are formed due to changes in the ducts in embryogenesis, followed by their disconnection from the common biliary tree. False cysts are more often the result of trauma. The basis of the wall of the false cyst is the fibrous-altered liver tissue at the site of damage or inflammation.

The fluid contained in the liver cysts is most often clear, light or slightly yellowish, in rare cases it has an admixture of blood or bile.

What are the symptoms of the disease?

Symptoms are associated with the growth of formations, their number, the location of the cyst (cysts) in the organ, as well as compression of adjacent organs. An increase in the size of the formation leads to pressure on the tissues and vessels of the liver, impaired blood circulation and atrophy of the compressed areas. In addition, there is pressure on the stomach, duodenum and diaphragm. This causes pain in the stomach area, there is a constant heaviness in the right hypochondrium, eating is accompanied by discomfort, a person is quickly satiated. Then nausea joins, appetite is lost, weakness increases, jaundice is possible due to compression of the bile ducts. Some patients develop liver fibrosis and liver dysfunction. On examination and palpation of the liver, it is possible to detect a smooth, dense, tense mass associated with the liver. Often there is pain when feeling the cyst. An experienced doctor will describe the cyst as “an elastic, fluctuating (oscillating, iridescent) formation.” Rarely, single large cysts appear in the left lobe, protruding beyond the borders of the liver, which can be mobile. But still, it is not always possible to probe even large formations because of their location.

When a liver cyst is detected, it is required to clarify its nature and find out if it is parasitic. For this purpose, laboratory blood tests (serological reactions) are performed for the presence of echinococcus in the body. It is also necessary to carry out differential diagnostics with various tumors of both the liver itself and the intestines, retroperitoneal space, pancreas, formations or dropsy of the gallbladder.

Despite the fact that the cyst grows very slowly and may not cause any complaints, this problem should be taken seriously. The development and progression of the cyst often leads to formidable complications. Violation of the movement of food through the stomach and small intestine due to compression of these organs by a large cyst can cause not only food absorption disorders, but also hepatic or renal colic. The cyst, squeezing the bile ducts, can contribute to their inflammation, lead to obstructive jaundice. In addition, suppuration of the cyst, hemorrhages in it, ruptures into the abdominal cavity with subsequent bleeding are possible. If the cyst is on a leg, then its torsion occurs, which causes symptoms of an acute abdomen. Cases of transformation of cysts into malignant neoplasms are described.

It is necessary to distinguish the formation of single liver cysts from polycystic. Polycystic is a hereditary disease that is characterized by the development of multiple cysts in the liver and other parenchymal organs – the kidneys, pancreas, ovaries. Such a disease has a favorable course for a long time. Only when the organ is damaged is more than 50%, symptoms associated with an enlarged liver appear: dyspeptic disorders, a feeling of heaviness, dense tuberous liver tissue is detected on palpation. Violations of the liver function appear only with a far advanced process – the synthesis of albumin, prothrombin, etc. decreases. Later, when there are few working liver cells, liver failure increases, which can lead to death.

Algorithm for examination of patients with liver cysts

Examination of patients with idiopathic liver cysts, in addition to general issues, should solve the following specific tasks:

• Detection of the exact location of the cyst in the organ, determination of its size.
• Differential diagnosis with other focal liver diseases (parasitic cysts, abscesses, hemangiomas, etc.) or cysts of perihepatic localization.
• Assessment of the functional state of the liver.

The diagnosis of a non-parasitic liver cyst is based on the results of a comprehensive study, including the clinical picture, data from laboratory and serological studies, various methods of radiation diagnostics (X-ray, ultrasound, CT, MRI, SCG), and, if necessary, supplemented by immunological tests and angiographic studies.

X-ray examinations reveal only some indirect signs of the disease in the form of changes in the contours of the liver, displacement of the diaphragm, displacement of hollow organs, in rare cases, the cyst becomes visible due to the deposition of salts in its wall.

Ultrasound examination is a very valuable method in the diagnosis of focal liver diseases.

Liver cysts are fluid-filled cavities delimited by a thin wall (1-2 mm); their shape can be round or oval. If there is an internal septum, liver cysts may have a spotty pattern. Sometimes, for differential diagnosis, it is necessary to perform a percutaneous puncture of the cyst to obtain its contents in order to conduct a cytological and bacteriological examination of the material. This procedure is performed under ultrasound guidance.

Computed tomography

This type of study allows you to detect any asymptomatic non-parasitic liver cysts. They look like homogeneous foci of a rounded shape, with clear and even contours. The wall of the “true” cyst, as a rule, is not visible. In order to distinguish a cyst from another mass of the liver, computed tomography is used with the “amplification” technique, i.e. intravenous administration of a radiopaque preparation. This technique also makes it possible to distinguish between complicated and uncomplicated, parasitic (Echinococcus) and non-parasitic liver cysts.

Based on the results of the examination, the following issues of medical tactics are decided:

• Indications for surgical treatment.
• Method and extent of surgical intervention.
• Access and operation type.

Traditional treatments for non-parasitic liver cysts

The size and localization of liver cysts are the determining parameters for choosing a method of surgical treatment. Identified asymptomatic small liver cysts of stable size are subject to observation in dynamics, except when they are localized in the area of ​​the liver gate and create biliary stasis.

The most radical method of surgical treatment is liver resection. However, the risk of organ resection is quite high and, in comparison with the medical need, is justified only in the presence of multi-chamber cystadenoma or huge cysts with a potentially high degree of malignancy.

The leading role in liver cyst surgery belongs to organ-preserving operations. These include partial resection of the cyst wall or opening of the cyst with drainage of the remaining cavity.

Fenestration of cysts is technically simple, gives significantly fewer complications, allows you to save liver tissue, creates effective decompression and drainage of cysts that lie deep in the parenchyma of the organ. The essence of the method is to open the formation cavity, evacuate the contents, remove part of the wall and coagulate the remaining part. As a rule, they are performed with total polycystosis. Also, with polycystic, you can use percutaneous puncture and sclerosis of rapidly growing cysts.

Endovideo surgery

Modern video-laparoscopic technique allows obtaining a high-quality image of the liver, identifying pathological changes in it, performing targeted biopsy and surgical treatment. The approach of the laparoscope to the object creates the effect of its multiple increase, which opens up the possibility of a detailed, more complete study of pathological foci. Laparoscopic interventions are performed after the imposition of pneumoperitoneum, which moves the anterior abdominal wall away from the abdominal organs and creates sufficient conditions for performing various surgical procedures. Non-parasitic cysts of the liver, located on its anterior-upper, lateral and lower surfaces, are well visualized and quite accessible for performing such laparoscopic operations as external drainage, fenestration, resection-exfoliation and enucleation of cysts.

Liver cyst punctures

The experience of performing percutaneous targeted aspiration biopsy of the liver under ultrasound control allows not only to determine the presence of a cyst and the nature of its contents, but also to perform a therapeutic intervention: decompression, sclerosing and antibiotic therapy.

Undoubtedly, the puncture method of treatment is the most gentle. However, often 1 to 3 punctures are required to achieve a therapeutic effect, and large cysts require drainage due to the high recurrence rate.

Our clinic has extensive experience in the treatment of focal liver diseases and all the possibilities to perform a full examination and choose the optimal method of treatment for each patient.

Cervicitis (endocervicitis): features of diagnosis and treatment

Currently, in the structure of gynecological morbidity, there is a clear tendency towards an increase in the frequency of inflammatory diseases, especially infectious processes of the vulva, vagina and cervix. Let us dwell in detail on inflammatory diseases of the cervix.

The cervix is ​​one of the protective biological barriers that prevent the introduction of pathogens into the uterine cavity. This is due to a combination of anatomical and physiological features of the cervix: the narrowness of the cervical canal, the presence of a “mucus plug”, which contains secretory immunoglobulin A, lysozyme and other substances of the local immunity system.

Factors such as trauma to the cervix during childbirth, abortion, diagnostic curettage causing scarring, and the use of contraceptives such as the IUD lead to a violation of the integrity of the cervix and its protective mechanisms, which contributes to the penetration of infection into the genital tract and the development of the inflammatory process, in particular, exo- and endocervicitis. In addition, benign cervical formations, as well as a decrease in immunity, can be provoking factors.

The vaginal part of the cervix (exocervix) is normally covered with stratified squamous epithelium 150-200 microns thick, which undergoes cyclic changes during the menstrual cycle under the influence of sex hormones. Under the influence of estrogen, proliferation processes occur (this is an increase in the number of cells due to their reproduction), the accumulation of glycogen and keratin in the layers of the epithelium. The main function of the stratified squamous epithelium of the cervix is ​​protective. At the same time, mechanical strength is provided by the presence of keratin lumps, and glycogen granules provide local immunity of the vaginal biotope.

The mucous membrane of the cervical canal (endocervix) is lined with a single-row cylindrical epithelium, in which there are many cracks and depressions called cervical glands. The main function of this epithelium is secretory. The quantitative and qualitative characteristics of the secret depend again on the phase of the menstrual cycle.

Currently, the term exocervicitis is understood as inflammation of the vaginal part of the cervix, and endocervicitis is an inflammation of the mucous membrane of the cervical canal. It should be noted that inflammatory processes of the cervix are rarely isolated. Usually it is accompanied by other diseases of the genital area: vulvovaginitis, bartholinitis, pseudo-erosion of the cervix.

Cervicitis can be caused by both non-specific and specific pathogens. Nonspecific cervicitis is an infectious and inflammatory disease caused by the action of opportunistic microorganisms (E. coli, streptococci, staphylococci, etc.). I would like to note that in the microbiocenosis of the vagina in a healthy woman, along with lactobacilli, epidermal staphylococcus aureus is most common, less often bacteroids and anaerobic cocci, corynebacteria, etc. In healthy women, anaerobic flora prevails (microorganisms that reproduce without access to oxygen) in a ratio of 10:1 to aerobic . The normal bacterial flora prevents the invasion of pathogenic microorganisms that cause changes in the microflora of the vagina, which in turn can lead to the development of inflammation of the cervix and vagina.

Specific cervicitis may be caused by sexually transmitted infections (chlamydia, trichomoniasis, viral diseases, etc. )

The most common disease occurs in women of reproductive age (up to 70%). However, often as a result of age-related changes associated with estrogen deficiency, changes occur that contribute to the occurrence of atrophic colpitis (vaginitis) and nonspecific cervicitis, and in women during the perimenopause.

Cervicitis is a common cause of miscarriage and premature birth. The consequence of cervicitis can be polyps and erosion of the cervix, precancerous conditions (cervical dysplasia), ascending inflammation of the pelvic organs (endomyometritis, salpingoophoritis, pelvioperitonitis, etc.).

According to the course, acute and chronic cervicitis are distinguished, according to the degree of damage – diffuse and focal. Sometimes it can initially proceed in an erased form against the background of a decrease in immunity.

Clinical symptoms of acute nonspecific cervicitis and vaginitis are profuse mucous or purulent discharge, itching, less often dull pain in the lower abdomen. During the study, hyperemia (redness), edema, and sometimes small hemorrhages in the mucous membrane of the cervix are observed. In severe cases, ulceration may appear, and the neck acquires a spotty, bright red color.

In the chronic stage, as a rule, the discharge is moderate or insignificant. The cervix looks edematous, with focal hyperemia around the external opening of the cervical canal, protrusion of hyperemic edematous mucosa. With a prolonged course, the cervix becomes compacted and thickened, infiltrates are formed in the underlying tissues and cysts.

Cervicitis has various manifestations depending on the pathogen and the state of immunity. With gonorrhea, cervicitis is usually acute, with a vivid clinical picture. With chlamydial infection – the picture is erased. With a herpes infection, the cervix is ​​bright red, loose, with areas of ulceration. Atypical cells may appear in the smear. With papillomavirus infection, warts can appear – flat and pointed.

Diagnosis of cervicitis

Cervicitis is often asymptomatic and discovered incidentally during routine check-ups or when a woman visits a doctor for other problems. Diagnosis is aimed primarily at identifying the cause of cervicitis. Along with clinical signs, laboratory research methods play an important role:

• Smear microscopy is the most accessible method. Allows you to set the total number of associated microbes, determine their belonging to obligate anaerobes or lactobacilli.
• Sowing on microflora and sensitivity to antibiotics (bacteriological examination) Allows you to identify the genus and type of the pathogen and select the appropriate antibiotic for it.
• Smear cytomorphology allows assessing the structure and cellular level of tissue damage, as well as tracking the effectiveness of the treatment over time. The results of a cytological study in cervicitis depend on the intensity of the inflammatory process. In an acute process, smears contain a large number of leukocytes (> 30), lymphocytes, histiocytes. Pronounced phagocytosis. In the squamous epithelium, dystrophic changes in the nuclei and cytoplasm can be expressed, in the cylindrical epithelium – hypertrophy of the nuclei and vacuoles. In chronic cervicitis, cells of cylindrical epithelium of various sizes with slightly enlarged nuclei are found, there may be phenomena of cytolysis, i.e. cell destruction. It should be noted that the inflammatory process can simulate the process of cellular atypia. After anti-inflammatory treatment, the signs of atypia disappear.
• PCR diagnostics allows to detect cell DNA of various types of microorganisms, incl. latent infections (chlamydia, mycoplasmas, ureaplasmas, etc.) and viruses (herpes, cytomegalovirus, papillomaviruses).
• ELISA. Allows you to detect the presence of antibodies in the blood to various pathogens.
• Colposcopy. Allows you to detail the pathological changes in the cervix in cervicitis: hyperemia and swelling of the mucous membrane, the presence of vascular loops, the presence of ectopia or pseudo-erosion, to identify the diffuse or focal nature of inflammation.

Our doctors

Sultanova Marina Anatolievna

Gynecologist, doctor of the highest category (children, adults)

Adamaitis Anna Alexandrovna

Gynecologist, doctor of the first category

Treatment of the cervix citation

• Involves the use of antibacterial, antiviral and other agents depending on the identified pathogen and the stage of inflammation (acute or chronic).