妇科生殖系统炎症.ppt

Cervical Erosion Etiology When the stratified epithelium (复层上皮) which normally covers the vaginal portion of the cervix is replaced by columnar epithelium which is continuous with that of the cervical canal. 2. Most erosion are not infected, nor they are the result of inflammation. 3. Occurs in the newborns, pregnancy, oral contracepives Clinical Features Symptoms The only symptom is a mucoid discharge. A slight postcoital bleeding (but malignancy should be excluded) Signs A red area is seen around the external os. Classification Depends on the depth and area of the lesion Types: simple, granular, papillary Grades: I (＜1/3), II (1/3-2/3), III (＞2/3) Treatment Erosion found on routine examination should not be treated unless it is causing troublesome discharge. A cervical smear is needed before the treatment, and if necessary, colposcopy (阴道镜) and biopsy. Cervical ectropion (宫颈外翻) Physical therapy Thermal cauterization, Cryotherapy, Laser therapy Cervical Polyps Small pedunculated neoplasms of the cervix Endocervical polyp: Originating from the endocervix Ectocervical polyp: Originating from the vaginal portion Pathology Gross appearance: Endocervical polyp: Red or pink, rounded or tongue-like Ectoervical polyp: Pale, flesh-colored, smooth, rounded with a broad pedicle Microscopic: Vascular connective tissue stroma covered with columnar or squamous epithelium or both. Congestion, edema or leukocytein filtration may be present. Clinical Features Some are asymptomatic. Slight postcoital bleeding Treatment Cervical polyp should be treated. Malignant change (1%) Polypoid cervical cancer Twisting off a polyp without an anesthetic and cauterizing the base. Recurrent cases are treated with canal dilation and cauterization of t