Chronic cervicitis

　　Chronic cervicitis is often transformed from acute cervicitis, mostly due to infection caused by pathogens (mainly Staphylococcus, Streptococcus, Escherichia coli, and anaerobic bacteria) after injury to the cervix during childbirth, abortion, or surgery. Clinically, there are often no manifestations of an acute process, and the endocervical folds are abundant, where pathogens may hide, making it difficult to completely clear the infection, thus often leading to chronic cervicitis.

　　Leukorrhea, cervical stenosis, and infertility are sequelae of chronic cervicitis -- complications of chronic cervicitis.

　　Leukorrhea:The secretion is usually caused by persistent cervicitis caused by purulent pathogenic bacteria, for acute cases, cervical endometrial culture should be performed, and appropriate antibiotic treatment should be given. For chronic cases, continue to treat cervicitis.

　　Cervical stenosis: Gently insert a graduated probe into the cervical canal during menstruation, once a week, for 2-3 months, to prevent or correct cervical stenosis.

　　Infertility:Due to the lack of cervical mucus necessary for sperm motility, infertility often occurs. The cause may be due to widespread destruction of endocervical glandular cells (ablation, cryosurgery, or vaporization) or resection (cone biopsy, cervical suture, cervical amputation). Oral combined estrogenic substances or their equivalents 3-4 days before ovulation and on the day of ovulation, 0.3mg per day can stimulate the residual endocervical cells to produce more mucus. Assisted reproductive technology may be needed sometimes.

　　1.Increased vaginal discharge, usually thick mucus or purulent mucus.

　　2.A small number of secretions may contain blood streaks or slight vaginal bleeding, or there may be contact bleeding.

　　3.There may be lower abdominal distension and back pain, which may worsen during menstruation, defecation, or sexual life.

　　4.There may be secondary urinary tract infections, which may lead to irregular menstruation or infertility in severe cases.

　　During the acute stage of cervicitis, it is necessary to choose the best treatment plan to completely kill the pathogenic bacteria. Common preventive measures include:

　　1.Pay attention to the hygiene of sexual life, appropriately control sexual life, resolutely prohibit extramarital sex, and avoid sexual intercourse during menstruation.

　　2.Take timely and effective birth control measures to reduce the incidence of induced abortion and elective termination of pregnancy, thereby reducing the opportunities for artificial trauma and bacterial infection.

　　3.For those with abnormally short menstrual cycles and prolonged menstrual periods, active treatment should be given.

　　4.Prevent instrumental injury to the cervix during childbirth.

　　5.Cervical lacerations found postpartum should be sutured promptly.

　　6.Regular gynecological examinations should be conducted to detect cervical inflammation in a timely manner and receive timely treatment.

　　Gynecological examination:

      1. Increased leukorrhea, sticky or purulent, sometimes with blood.

　　2. Cervical erosion: There is a clear boundary between the red area around the external os of the cervix and the normal mucosa, the surface is smooth or granular and papillary. The iodine solution does not stain, and it is divided according to the size of erosion: mild erosion (Ⅰ degree): the erosion area is less than 1/3 of the entire cervical area. Moderate erosion (Ⅱ degree): the erosion area accounts for 1/3-2/3 of the cervix. Severe erosion (Ⅲ degree): the erosion area is greater than 2/3 of the cervix.

　　3. Cervical polyps: There are single or multiple pedunculated bright red polyps at the external os of the cervix, the pedicles are often connected to the cervical canal, the surface is smooth, and it is easy to bleed.

　　4. Cervical Nabothian cysts: There are scattered small cysts on the surface of the cervix, which are often white and often accompanied by cervical erosion.

　　5. Exclude malignancy in smears or biopsies

　   Dietary considerations for chronic cervicitis:

　　1.Avoid sweet and greasy foodsSweet and greasy foods such as candy, cream cakes, eight-treasure rice, glutinous rice dumplings, lard, and fatty pork, sheep fat, and egg yolks have the effect of aiding dampness, which can reduce the therapeutic effect and make the condition difficult to treat.

　　2.Avoid drinking alcoholAlcohol is a warm and stimulating food that can worsen damp-heat after drinking, thereby aggravating the condition.

　　3.Dietary taboos for chronic cervicitis include avoiding spicy, fried, and warm foodsSpicy, fried foods such as chili, fennel, Sichuan pepper, onions, mustard, roasted chicken, fried pork chops, etc.; warm foods such as beef, mutton, and dog meat can all cause heat and exacerbate the condition.

　　4. Avoid seafood and river fish irritantsSea fish, crabs, shrimps, clams, univalve, oysters, abalones, etc., are all irritants that are not conducive to the regression of inflammation.

　　Principles of Treatment

　　1. Before treatment, a cervical smear test should be performed to rule out early cervical cancer to avoid mistaking early cancer for inflammation and delaying treatment.

　　2. Local physical therapy is the main method, causing the columnar epithelium on the erosion surface to necrose, shed, and then be covered by new squamous epithelium. The following methods can be used: electric ironing, cryotherapy, laser, phototherapy, etc.

　　Surgical treatment: For patients with chronic cervical erosion or those suspected of having cancer based on cervical smear tests, cervical cone resection can be performed.

　　Treatment of cervical polyps: remove the polyps and send them for pathological examination, and apply 10% silver nitrate solution to the wound. Electrotomy or cryotherapy can be used for hemostasis.

　　Cervical Nabothian cysts: After local disinfection, puncture the cysts with a needle to expel the contents, and then treat the wound with electric ironing, cryotherapy, laser, or photothermal therapy.

　　Principles of Medication

　　For cases with small erosion surfaces and shallow inflammation infiltration, silver nitrate corrosion was used in the past, but it is now rarely used.

　　Physical therapy is currently the most effective method for treating cervical erosion with the shortest course of treatment, generally requiring only one treatment session to cure, hence it is most commonly used in clinical practice.

　　For patients with chronic cervical erosion or those suspected of having cancer based on cervical smear tests, cervical cone resection can be performed.