Cervical stenosis or blockage of the cervix

Cervical stenosis refers to a narrowing or blockage of the cervix. It can be caused by inherited malformations or damage to the cervix. As a result, the cervix is unable to produce high-quality cervical mucus for sperm motility and fertilization. Additionally, the opening of the cervix may be closed, preventing sperm from reaching the egg.
Cervical stenosis is an abnormal narrowing of the cervical canal, which can be congenital or caused by various factors such as infections, cancer, radiation, atrophy (thinning of the cervical lining due to lack of estrogen), or surgical procedures. Surgical interventions such as cone biopsy, LEEP method, and cryotherapy are performed to treat abnormal Pap smear results.

Symptoms

The symptoms depend on whether the cervical canal is partially or completely obstructed and the menopausal status of the patient. Pre-menopausal patients may experience blood accumulation in the uterus, leading to sporadic bleeding and pelvic pain. These patients also often have an increased risk of infertility and endometriosis.

Treatment

Treatment typically involves the insertion of small dilators into the cervix. This can be done during an office visit or as a non-hospitalized surgical procedure, depending on the patient and the extent of the problem. Micro-hysteroscopy may be necessary to locate the cervical canal, which involves inserting a 2-3 millimeter telescope into the cervix.

Cervical Infections

Cervical infections, although controlled and treated simultaneously with vaginal infections, differ in terms of the clinical presentation and the pathogenic microorganisms involved. Infections in the cervical canal can be caused by gonococcus, chlamydia, trichomonas, fungi, ureaplasma, mycoplasma, and bacteria. Mycobacterium tuberculosis rarely affects the cervix.

Diagnosis is made by taking cultures from the inside of the cervix to isolate the pathogens present, including anaerobic microorganisms that are often found. Specific tests performed in addition to culture from the cervical region to identify various microorganisms include:

  • Direct microscopy (for fungi, bacteria, and trichomonas)
  • Immunofluorescence (for herpes)
  • Enzyme-linked immunosorbent assay (ELISA) method (for chlamydia)
  • Polymerase chain reaction (PCR) (for DNA analysis)

Cervical Polyps

Cervical polyps are benign growths that occur in the cervix. Their frequency increases with age, and their length rarely exceeds 1-1.5 cm. They are usually discovered incidentally during gynecological examinations or during Pap smear tests.
These polyps often cause bleeding, particularly after sexual intercourse. Since the presence of polyps in the cervix coexists in a small percentage with malignancies of the uterine body, today the prevailing opinion is to remove them and perform a cleansing of the uterine cavity (curettage). The material obtained during the procedure is examined histologically.
The same applies to polyps found within the uterine cavity. In 8-10% of cases, they coexist with endometrial adenocarcinoma in elderly women. They can cause menstrual disturbances and may even induce uterine contractions and dilation of the cervical opening. If they become infected, they can cause foul-smelling discharge. Women may experience pain during sexual intercourse and bleeding between periods. Treatment involves removal of the polyps through surgical procedures.