BENIGN DISEASES OF

CERVIX

SUJATHA MENON
 ACUTE CERVICITIS

 In septic abortion,puerperal sepsis & gonorrhoea

 Examination through a vaginal speculum-cervix

reddened & swollen with edema,mucopurulent
discharge

 Sometimes tenderness can be elicited by

palpation of the cervix
 Gonococcal cervicitis – backache & a feeling of
fullness in the lower abdomen

 Symptoms & clinical course are often

overshadowed by those of the associated lesions
of the disease
 CHRONIC CERVICITIS
 Very common-seen in 80% of women with any
gynaecological complaint

 Causes
 Infections during abortion or childbirth
 Lacerations of cervix during childbirth
 Instrumentation
 Gonococcal infection
 a/c infection tend to persist as c/c infection
 If the organism penetrates into the depth of the
gland,it is difficult to eradicate by local treatment

 Mucous membrane of cervix is not exfoliated

during menstruation- no natural method of
overcoming infection
 ECTROPION

 Seen in a cervix which has been badly lacerated

by childbirth

 Tends to evert the endocervical canal,the lining

mucosa gets exposed

 Detected by digital examination

 As the ext os is patulous,so that the lower part of
the cervical canal can be felt

 Usually accompanied by chronic cervicitis

 Treatment- excision of scar tissue &suturing the

edges of torn cervix(trachelorrhaphy)
 CERVICAL POLYP

 Endocervical & ectocervical polyps are the most

common benign lesions of the cervix

 Causes
 c/c inflammation
 Abnormal response to increase in estrogen levels
 Congestion of blood vessels in the cervical canal
 Many types –
adenomatous,cystic,fibrous,fibromyomatous &
inflammatory

 Mucous polyps-from mucous membrane of

cervical canal

 Size ranges from the size of a pea to rare cases as

big as 2cm in diameter

 Red vascular swelling,bleeds easily on

touch,covered by smooth glistening epithelium
 Pedunculated; pedicle attached t mucous
membrane of cervical canal

 Detected by palpation,but small sessile polyps

can be detected only by speculum examination

 Usually in women of childbearing age

 Symptoms-increase in vaginal discharge,irregular

& post coital bleed
 HISTOLOGY
 Surface epithelium-columnar

 Glands in the stroma are racemose type& lined

by tall columnar epithelium

 stroma-highly vascular;round cell infiltration at

the lower pole

 Surface epithelium at the lower pole-well marked

squqmous metaplasia
 TREATMENT
 Polypectomy-outpatient procedure

 Microscopic examination of polyp

 Myomatous polyp may be mistaen for a mucous

polyp

 Fibroadenomatous polyp-removal by torsion of

pedicle

 Recurrent polyp removed under GA

 Hysteroscopic avulsion – if polyps are multiple

 Endocervical polyps must be differentiated from

endometrial polyps-endometrial polyps have a
long pedicle & the base is not accessible
 CERVICAL STENOSIS

aetiology
 Congenital
 Traumatic- cauterisation & conization
 Infection-chronic cervicitis
 Cervical cancer
 Menopausal atrophy
 Congenital stenosis

 Rare; causes primary amenorrhoea &

hematometra

 Surgery – to drain hematometra,establish

menstruation & restore reproductive function

 But restenosis is very common

 Traumatic stenosis

 Dilatation of cervix prior to cauterisation &

conization avoids stenosis

 Causes secondary amenorrhoea or

dysmenorrhoea, infertility & sometimes
hematometra
 Infection and chronic cervicitis require cervical
dilatation under anaesthesia

 Stenosis due to CA cervix – require treatment of

cancer
 MICROGLANDULAR
HYPERPLASIA
 Usually seen in women using OCPs or depot
preparations of medroxyprogesterone acetate

 Exaggerated epithelial response to

hormones;clinically 1-2cm polyps

 On cytology & histology,it is mistaken for

malignancy
 NABOTHIAN CYSTS

 During reproductive years,columnar epithelium

of cervix is replaced by squamous epithelium

 Metaplastic squamous epithelium occludes the

mouth of some of the glands & retention cysts
are formed

 Seen in the adult cervix

 MYOMAS

 Similar to those seen in the uterus,but arising

from the smooth muscle of the wall of the cervix

 Usually small & can be left alone

THANK YOU