Wounds in the womb are not always treated with cauterization
The cervix is the part of the uterus that we see in the vagina when we perform the Papanicola. The outer part of the neck, which is what we see when we introduce the speculum apparatus (duck's beak) is coated by a more resistant type of fabric. The inner part, which lines the endocervical canal, goes from the vagina to the cavity of the uterus (it is through this channel that sperm transit) and is covered by a more delicate tissue.
When a part of the skin that lines the endocervical canal is exposed to the vaginal environment - as if this skin were reversed - occurs what we doctors call ectopia or ectrópio and some still insist on calling "wounded", which ends up confusing women. The ectropion is healthy but has a reddish appearance. This can happen for a number of reasons, such as exposure to the female hormones themselves, or the canal tissue may move forward and overlap part of the outer portion of the cervix.
Ectopia is more susceptible to disease if the woman because it is a more delicate fabric. Therefore, we should reinforce guidelines such as condom use for these women and vaccination for HPV.
Ectropion is common in adolescents. After adolescence, they may be seen in women who take the pill, pregnant women or those who have had a laceration of the cervix during labor.
Cauterization is not always necessary
Ectropion should not be routinely treated , except in the occurrence of excessive secretion or lesions caused by infections such as HPV. In such cases, the malignancy should be excluded before starting any treatment through colposcopy and biopsy. If the woman experiences symptoms such as bleeding during or after intercourse, abnormal bleeding outside the menstrual period and recurrent discharge the risk is greater. In addition to changes in routine exams such as the Pap smear and colposcopy, cauterization may be indicated.
Ectopia is a healthy but more delicate tissue and therefore more likely to become ill. An accurate indication of cauterization of the cervix according to the American Society of Colposcopy and Cervical Pathology are the cases in which there is the so-called low-grade lesion caused by HPV or CIN 1, which persists after two years of follow-up. techniques of cauterization of the cervix. Cauterization is a burn of this tissue with the purpose of stimulating its regeneration to improve symptoms. There are several techniques that can be used. A procedure using electrocautery or cryocauterization is effective but nonetheless invasive and can result in abundant vaginal discharge until healing is complete, which can take weeks. It can also result in closure of the cervical canal, which can negatively affect future fertility and, if pregnancy is achieved, the work is more likely to be difficult, since the cervix may not dilate properly due to healing.
Laser cauterization seems less aggressive, since it has a better control of the amount of attacked tissue. It is also possible to use chemical cauterization or even attempt treatment with medications through the vagina. But the choice of technique will depend on several factors and should be individualized according to the medical evaluation. Most of the time it can be done without outpatient anesthesia.
In general, the above mentioned complication rates are low, about 1 to 2% after cauterization.
While the woman is of childbearing age, risk of the problem coming back and there is a need for new cauterization. Women with extensive ectopia should be advised about options for non-hormonal contraceptive methods, as the pill worsens the condition.Recovery after cauterization occurs within a few weeks, there may be bleeding, discharge, colic. The woman should remain without sexual relations until medical release.
The most important is to keep regular visits to the gynecologist and clarify doubts.
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