Atresia (fusion) of the cervical canal can lead to its complete or partial obstruction, which becomes an obstacle to the release of menstrual flow. There is atresia of the cervical canal, and there is atresia of the body of the uterus. By its origin, the narrowing of the passage of the cervix can be congenital and acquired. Unsuccessful cauterization and curettage can lead to narrowing and even infection of the cervical passage. To restore its patency, they resort to an operation called bougienage of the cervical canal.
Reasons for infection
Factors affecting the occurrence of atresia:
- Inflammatory processes of the cervical canal.
- Scarring caused by pathological processes.
- Children's infectious diseases (mumps, diphtheria).
- Sloppy scraping.
- Malignant neoplasms, endometritis, endocervicitis.
- Arisingduring childbirth or abortion injury.
- Burns of the canal mucosa caused by chemicals.
- Electrocoagulation of the channel.
- Spontaneous age-related atresia.
After bougienage of the cervical canal, all functions are usually restored.
Structure of the cervix
A small section between the cervical canal and the uterus, approximately 1 cm, is called the isthmus. Here, in the region of the isthmus, the internal pharynx is located. The lower part of the uterine cavity and the isthmus form the so-called lower segment, which plays an important role in the process of gestation and childbirth.
The lower part of the cervix descends into the vagina, while the upper one rises above it. In nulliparous girls, as a rule, it has a conical shape. After childbirth, the cervix becomes wider, takes the form of a cylinder, the canal also has a cylindrical shape. External pharynx is the opening of the cervical canal, visible during vaginal examination. In patients who have given birth, the external os takes the form of a gap, the reason for this is the rupture of the cervix during childbirth. Nulliparous girls have pinpoint pharynx.
Bougienage of the cervical canal is used quite often. We will describe the method in more detail below.
Diagnosis
To examine the uterine cavity, various manipulations are performed, such as probing the uterine cavity, its curettage, the introduction of drugs, fluids for diagnostics, endoscopy of the uterine cavity, various operations - all these manipulations are performed with the expansion of the cervical canal. Carried out withoutproper training, professionalism and competence, such manipulations can lead to traumatized canal mucosa and, as a result, to narrowing and fusion of the canal.
As mentioned above, one of the causes of atresia of the cervical canal may be inflammation of the canal mucosa - endocervicitis. This disease is most often caused by pathogenic cocci, rods, sometimes viruses. Often, endocervicitis is combined with other inflammatory diseases (for example, colpitis, salpingoophoritis, endometritis).
Patients complain of mucopurulent discharge, not accompanied by pain. On examination, swelling and hyperemia of the mucous membrane and abundant secretion are noticeable. A protracted course of the disease can lead to the spread of the process to the muscle walls, glands. In this case, bougienage of the cervical canal is indicated.
Endocervicitis is diagnosed on the basis of a clinical examination, examination of a smear from the vagina and cervical canal. In the acute period, antibiotics and local procedures are prescribed for treatment. Treatment of the chronic form requires injections of antibacterial drugs into the cervix, physiotherapy, local irrigation with a solution of protargol, treatment of the cervical passage with a solution of silver.
Primary artresia
Diagnosis of primary atresia occurs during the first menstruation. Menstrual blood, not finding a way out, accumulates in the uterine cavity, overflowing it and stretching it. In this case, the general well-being suffers significantly. Atthe spread of blood through the tubes may begin purulent inflammation of the tubes.
If the bougienage of the cervical canal is not carried out at this time, the consequences can be disastrous.
Secondary artresia
Secondary atresia may not appear for a long time. And the diagnosis is made when the patient begins to be examined for infertility. Blood trapped in the tubes creates an obstruction, making it impossible for an egg to enter the uterus.
Ultrasound, probing, MRI, hystrosalpingoscopy and ureteroscopy can clarify the diagnosis of atresia.
Narrowing of the cervical canal - stenosis - is a serious obstacle to the penetration of spermatozoa into the uterus, which leads to infertility. And because of the obstruction of the tubes, the egg cannot enter the uterine cavity, which also makes fertilization impossible. Stenosis is eliminated with the help of a manipulation called "bougienage of the cervical canal".
Another cause of atresia are neoplasms. The most well-known malignant tumor is adenocarcinoma. Symptoms of the disease: weight loss, anemia as a result of prolonged bleeding, pain in the lower abdomen.
Benign tumors that affect the occurrence of atresia: myoma, fibroma, polyps, cysts, fibromyoma, leiomyoma, and endometriosis. The symptoms of these diseases are quite diverse: these are pain during menstruation and sexual intercourse, blood smearing, impaired defecation and urination. Definition of good qualitythe tumor is produced by histological examination of the contents of the canal scraping. Examination and treatment take place under visual control.
During childbirth, during diagnostic curettage, abortion and other medical procedures, as well as improper contraception, injuries of the cervical canal can occur, which can also lead to atresia.
Preparation for surgery
This pathology can be eliminated using the cervical bougienage procedure or laser recanalization.
The bougienage operation is performed under general anesthesia, the following tests are required for its implementation:
- complete blood count;
- analysis for infection;
- blood for syphilis and HIV;
- colposcopy;
- antigens of hepatitis B and C;
- coagulogram;
- vaginal and cervical swab;
- ECG;
- fluorography;
- bacteriological from the vagina and CC;
- blood for biochemistry;
- ultrasound;
- specialist consultation.
But in some cases it is possible to bougienage the cervical canal without anesthesia. More on that later.
How is the operation going?
For the operation of bougienage, the patient is hospitalized in a hospital. The procedure lasts approximately 30 minutes and is performed under local or general anesthesia. When the canal is completely closed, the operation is performed under general anesthesia, with a slight narrowing, local anesthesia is sufficient. The patient is located on the gynecological chair, the operating field, genital gap, treated with an antiseptic, then lidocaine is sprayed. An anesthetic is administered and the expansion procedure itself begins with the introduction of the narrowest bougienage nozzle first, successively increasing the diameter of the nozzles (medium, wide). The gradual expansion of the passage contributes to a gentle treatment.
After applying general anesthesia, the patient is discharged in a day, and after local anesthesia - immediately. Therefore, bougienage of the cervical canal without anesthesia is preferable. Reviews confirm that the stay on outpatient treatment is 7-10 days. Locally, to accelerate epithelialization, anti-inflammatory and wound-healing suppositories are prescribed until the complete healing of the cervical passage occurs. In case of recurrence of atresia, an artificial alloplastic canal is implanted.
Measures to prevent infection and narrowing of the passage
- Treatment of acute and chronic inflammation of the uterus and cervical passage.
- Providing medical examinations for the timely detection and treatment of gynecological diseases and tumors.
- Competent and qualified curettage, abortion in order to avoid injury. Gentle delivery with gradual opening of the cervix.
- Explanatory conversations to exclude the uncontrolled use of douching with aggressive solutions that are not intended for this, and chemical contraceptives.
Forprevention of primary infection from childhood, one should adhere to a he althy lifestyle, play sports, and avoid the possibility of contracting infectious diseases. During pregnancy, try not to be exposed to teratogenic factors that affect the unborn child.
Cervical canal bougienage: price
The cost depends on the clinic and the region. The minimum price is 600 rubles, the maximum price is 2000 rubles.
Bougienage of the cervical canal: reviews
This method of expanding the cervical canal has been used for a long time. Reviews are mostly positive. Women easily tolerate it, it rarely gives complications. Especially if the narrowing is not too pronounced and local anesthesia is used.
