Cervical Stenosis
The cervix is a small organ located at the lower end of the uterus, serving as the passageway between the uterus and the vagina. Cervical stenosis is a medical condition characterized by the narrowing or complete closure of the cervix, which obstructs the pathway between the uterus and the vagina. Notably, cervical stenosis can lead to the accumulation of blood in the uterus, a condition referred to as hematometra. Additionally, for women still experiencing menstrual cycles, menstrual blood may combine with uterine cells and accumulate in the pelvic cavity, potentially resulting in a condition known as endometriosis. Furthermore, cervical stenosis caused by uterine or cervical cancer can lead to a severe condition called pyometra, where pus accumulates in the uterus.
Causes of Cervical Stenosis
Women may experience cervical stenosis from birth due to genetic factors. Additionally, this issue can develop as a result of various medical conditions or surgical procedures. Below are some of the primary health issues and surgical interventions that can lead to cervical stenosis:
- Cervical cancer.
- Asherman’s syndrome.
- Uterine cancer.
- Radiation therapy for cervical or uterine cancer.
- Surgical procedures on the cervix, such as those performed to treat dysplasia.
- Surgeries that affect the lining of the cervix, including endometrial ablation.
- Previous procedures such as loop electrosurgical excision (LEEP) or cone biopsy of the cervix.
- Infections.
- Aging of the cervix or vagina due to menopause.
- Vaginal dryness following menopause.
Treatment for Cervical Stenosis
It’s important to note that cervical stenosis may occur during pregnancy, but it can also manifest outside of pregnancy due to various reasons. Seeking medical evaluation is crucial for proper diagnosis and monitoring. The treatment for cervical stenosis generally depends on several factors, including:
- Age.
- Desire for pregnancy.
- The presence of symptoms experienced by the woman.
If a woman does not wish to conceive and does not experience symptoms, treatment may not be necessary. However, if a woman desires to become pregnant or experiences painful symptoms, the physician may recommend the use of cervical dilators. These are small devices placed in the cervix that gradually expand over time to help stretch and widen the cervical canal.
Symptoms of Cervical Stenosis
Some women with cervical stenosis may exhibit few or no symptoms, particularly during menopause, while others may experience specific signs. Here are the most common symptoms associated with cervical stenosis:
- Irregular menstrual cycles and abnormal bleeding.
- Amenorrhea, characterized by the absence of menstrual periods.
- Dysmenorrhea, which involves painful menstruation.
- Infertility, as severe cervical narrowing can block sperm passage to the uterus.
- Chronic pelvic pain and swelling, often linked to conditions such as pyometra and hematometra.
Diagnosing Cervical Stenosis
A gynecologist typically diagnoses cervical stenosis by conducting a pelvic examination using a device known as a speculum. The doctor inserts the speculum into the vagina to inspect the cervix’s size, color, and texture, as well as to check for any abnormal growths or cysts. If the cervix appears narrow or harbors any masses, a probe may be inserted through the cervix. A failure to insert the probe would confirm the diagnosis of cervical stenosis.
Cervical Stenosis and Pregnancy
Cervical stenosis can have direct and indirect adverse effects on pregnancy. Below are key negative implications and challenges related to pregnancy in women with cervical stenosis:
- Impeded sperm passage: Narrowing or closure of the cervix restricts sperm movement into the uterus.
- Increased risk of uterine infections and endometriosis: Stenosis can obstruct menstrual flow, causing blood to pool in the uterus, leading to pain and infections, which may result in pyometra and subsequent endometrial lesions.
- Insufficient cervical mucus: Cervical stenosis is often caused by scar tissue, which affects the production of fertile cervical mucus, thereby hindering sperm mobility.
- Obstacles in infertility treatments: Many assisted reproductive techniques require catheterization to transfer embryos to the uterus; however, stenosis presents significant challenges for this procedure.
- Heightened risk of miscarriage and preterm birth: Treatments for cervical stenosis may weaken the cervix, leading to cervical incompetence, which could result in miscarriage during the second trimester or early delivery. It is essential to consult a healthcare provider for strategies to mitigate these risks.
References
- ^ “GYNECOLOGICAL CONDITIONS AND TREATMENTS CERVICAL STENOSIS”, www.draliabadi.com, Retrieved 15-2-2019.
- ↑ “Cervical Stenosis”, www.msdmanuals.com, Retrieved 15-2-2019.
- ↑ “Picture of the Cervix”, www.webmd.com, Retrieved 15-2-2019.
- ↑ “What Is Cervical Stenosis?”, www.thebump.com, Retrieved 15-2-2019.
- ^ “Why Is My Cervix Closed If I’m Not Pregnant?”, www.healthline.com, 28-9-2018, Retrieved 1-2-2019.
- ↑ “Stenosis of the uterine cervix”, radiopaedia.org, Retrieved 15-2-2019.
- ↑ “Can Cervical Stenosis Cause Infertility”, www.verywellfamily.com, Retrieved 15-2-2019.