What are the treatments for cervical ectropion?

Cervical ectropion is a symptom that occurs relatively frequently in postpartum women. Tearing is inevitable during the delivery process. If surgery is not performed in time to repair the tear, it can easily lead to exposure of the cervical mucosa outside the body, which is cervical ectropion. There are five major treatments for cervical ectropion: traditional Chinese medicine, Western medicine, electrocoagulation, cryotherapy, and laser treatment.

1. Treatment with Chinese medicine

1. Sophora flavescens suppository: has antibacterial and anti-inflammatory functions. It is used to treat damp-heat type cervical erosion, with symptoms such as increased leucorrhea, yellow and sticky color, foul odor, less urination, and yellow tongue coating. For external use, take 1 capsule every night and insert deep into the vagina.

2. Yunnan Baiyao: It has the effects of promoting blood circulation, removing blood stasis, reducing inflammation and relieving swelling. It can be used to treat cervical eversion, mainly for local medication, adding vaseline and mixing into a paste.

2. Western medicine treatment

1. Local vaginal irrigation and local medication: the most commonly used treatment methods. Irrigation can be performed with 1:5000 potassium permanganate solution, 1:1000 chlorhexidine solution, 1% acetic acid solution or 0.5-1% lactic acid solution. For mild and superficial cases, you can use a cotton swab dipped in 5-10% iodine tincture or 5-10% silver nitrate solution to locally corrode the eroded surface once a week to promote healing of the eroded surface. However, care must be taken during application to avoid leakage of the drug solution onto normal mucosa outside the lesion area. After applying silver nitrate, gently rub it with a cotton ball dipped in saline solution. This is now rarely used. Topical application of chloramphenicol tablets (chloramphenicol 250 mg and prednisone 5 mg tablets) should be placed deep in the vagina every night or every other night. Ten consecutive uses constitute a course of treatment. Its effect is comparable to general disinfectant irrigation and can be selected according to the situation.

2. Vaginal fornix closure: See the closure therapy in the other therapies chapter for details. It can be used for patients with chronic cervicitis complicated with paracervical connective tissue inflammation, lumbosacral pain, and obvious cervical lifting pain, which seriously affects their sexual life.

3. Chinese herbal lotion Jieryin: suitable for various acute and chronic cervicitis. Its main ingredients are Cnidium monnieri, Phellodendron chinense, Sophora flavescens, and Atractylodes lancea. Generally, 10% of the medicine solution is used for vaginal washing or sitz bathing once a day, and one course of treatment is two weeks.

3. Electrocoagulation

In the past, radial fashion electrocauterization was used, which took a long time to heal (6 to 8 weeks). Currently, electrocoagulation is used to iron out the entire erosion, so it is also called electric ironing. According to the summary of 2095 cases in the Affiliated Hospital of Shandong Medical University, the effectiveness of electric ironing therapy in treating cervical erosion is 100%. For specific operations, first place the electric iron and routinely disinfect the vulva, vagina and cervix. Use a vaginal speculum to expose the cervix, bring the electric iron head into contact with the eroded surface, and iron evenly, with the range slightly exceeding the eroded surface. The depth of electric ironing is about 0.2 cm. Too deep may cause bleeding and slow healing; too shallow may affect the efficacy. After electric ironing, spray the wound with furacillin powder or apply chloramphenicol glycerin.

4. Cryotherapy

It is an ultralow temperature therapy, the cooling source is liquid nitrogen, and the temperature is -196℃. During treatment, select an appropriate probe based on the severity of the erosion. To improve the therapeutic effect, the freeze-thaw-freeze method can be used, that is, freezing for 1 minute, thawing for 3 minutes, and freezing again for 1 minute. Its advantages are simple operation, and rarely bleeding and cervical stenosis occur after surgery. The disadvantage is that there is a lot of vaginal discharge after surgery.

5. Laser treatment

It is a high temperature treatment, the temperature can reach over 700℃. The main function is to carbonize and form scabs on the eroded tissue. After the scabs fall off, the wound surface is covered with new squamous epithelium. Cervical erosion is generally treated with a carbon dioxide laser and infrared light with a wavelength of 10.6μm. Preparation before treatment is the same as that for electric ironing. In addition to thermal effects, its advantages also include pressure, photochemical and electromagnetic field effects. Therefore, it has anti-inflammatory effects (stimulating the body to produce stronger defensive immune functions), analgesic effects (reducing tissue edema and reducing chemical and mechanical stimulation to nerve endings) and promoting tissue repair (enhancing the anabolism of epithelial cells, promoting epithelial proliferation, and accelerating wound repair). Therefore, the treatment time is short and the cure rate is high.