Cervical ectropion

Not to be confused with Ectropion.

Medical condition

Cervical Ectropion

Other names| Cervical eversion
Cervical ectropion
Specialty| Gynecology

Cervical ectropion is a condition in which the cells from the 'inside' of the cervical canal, known as glandular cells (or columnar epithelium), are present on the 'outside' of the vaginal portion of the cervix. The cells on the 'outside' of the cervix are typically squamous epithelial cells. Where the two cells meet is called the transformation zone, also known as the stratified squamous epithelium. Cervical ectropion can be grossly indistinguishable from early cervical cancer and must be evaluated by a physician to determine risks and prognosis. It may be found incidentally when a vaginal examination (or pap smear test) is done. The area may look red because the glandular cells are red. While many women are born with cervical ectropion, it can be caused by a number of reasons, such as:

* Hormonal changes, meaning it can be common in young women
* Using oral contraceptives
* Pregnancy.

## Signs and symptoms[edit]

Cervical ectropion can be associated with excessive, non-purulent vaginal discharge due to the increased surface area of columnar epithelium containing mucus-secreting glands as well as intermenstrual bleeding (bleeding outside of regular menses).[1] It may also give rise to post-coital bleeding, as fine blood vessels present within the columnar epithelium are easily traumatized.

## Causes[edit]

Cervical ectropion is a normal phenomenon, especially in the ovulatory phase in younger women, during pregnancy, and in women taking oral contraceptive, which increases the total estrogen level in the body.[2] It also may be a congenital problem by the persistence of the squamocolumnar junction which is normally present prior to birth.

Mucopurulent cervicitis may increase the size of the cervical ectropion.[3]

## Mechanism[edit]

The squamocolumnar junction, where the columnar secretory epithelium of the endocervical canal meets the stratified squamous covering of the ectocervix, is located at the external os before puberty. As estrogen levels rise during puberty, the cervical os opens, exposing the endocervical columnar epithelium onto the ectocervix. This area of columnar cells on the ectocervix forms an area that is red and raw in appearance called an ectropion (cervical erosion). It is then exposed to the acidic environment of the vagina and, through a process of squamous metaplasia, transforms into stratified squamous epithelium.[4]

## Treatment[edit]

Usually no treatment is indicated for clinically asymptomatic cervical ectropions. Hormonal therapy may be indicated for symptomatic erosion. If it becomes troublesome to the patient, it can be treated by discontinuing oral contraceptives, cryotherapy treatment, or by using ablation treatment under local anesthetic. Ablation involves using a preheated probe (100 °C) to destroy 3-4 mm of the epithelium. In post-partum erosion, observation and re-examination are necessary for 3 months after labour.

## References[edit]

1. ^ "UpToDate".
2. ^ Standring: Gray's Anatomy, 40th ed.
3. ^ Bope: Conn's Current Therapy 2011, 1st Edition.
4. ^ Standring: Gray's Anatomy, 40th ed.

## External links[edit]

Classification|

* ICD-10: N86
* MeSH: D002579
* DiseasesDB: 2288

|

* v
* t
* e

Female reproductive system

Internal|

| Adnexa|

| Ovaries|

| Follicles|

* corpus
* hemorrhagicum
* luteum
* albicans
* Theca of follicle
* externa
* interna
* Follicular antrum
* Follicular fluid
* Corona radiata
* Zona pellucida
* Membrana granulosa
* Perivitelline space

|

Other|

* Germinal epithelium
* Tunica albuginea
* cortex
* Cumulus oophorus
* Stroma
* Medulla

Fallopian tubes|

* Isthmus
* Ampulla
* Infundibulum
* Fimbria
* Ostium

Ligaments|

* Ovarian ligament
* Suspensory ligament

Wolffian vestiges|

* Gartner's duct
* Epoophoron
* Vesicular appendages of epoophoron
* Paroophoron

Uterus|

| Regions|

* Body
* Uterine cavity
* Fundus
* Cervix
* External orifice
* Cervical canal
* Internal orifice
* Supravaginal portion
* Vaginal portion
* Uterine horns

|

Layers|

* Endometrium
* epithelium
* Myometrium
* Perimetrium
* Parametrium

Ligaments|

* Round ligament
* Broad ligament
* Cardinal ligament
* Uterosacral ligament
* Pubocervical ligament

General|

* Uterine glands
* Urogenital diaphragm

Vagina|

* Fossa of vestibule of vagina
* Vaginal fornix
* Hymen
* Vaginal rugae
* Support structures
* Vaginal epithelium

External|

| Vulva|

| Labia|

* Mons pubis
* Labia majora
* Anterior commissure
* Posterior commissure
* Pudendal cleft
* Labia minora
* Frenulum of labia minora
* Frenulum of clitoris
* Vulval vestibule
* Interlabial sulci
* Bulb of vestibule
* Vaginal orifice
* vestibular glands/ducts
* Bartholin's glands/Bartholin's ducts
* Skene's glands/Skene's ducts

|

Clitoris|

* Crus of clitoris
* Body of clitoris (Corpus cavernosum)
* Clitoral glans
* Hood

Urethra|

* Urethral crest

Blood supply|

* Arteries
* Ovarian artery
* Uterine artery
* Arcuate artery
* Vaginal artery
* Spiral artery
* Superior vaginal artery
* Veins
* Ovarian vein
* Uterine vein
* Uterine venous plexus
* Vaginal venous plexus

Other|

* G-spot
* Urethral sponge
* Perineal sponge

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