TAILIEUCHUNG - Benign disease of the uterus and cervix

Benign disease o1 the cervix and body of the uterus is extremely common. Cervical ectropion and fibroids are often present without symptoms, but are also common problems encountered in almost every gynaecological outpatient clinic. Adenomyosis Endometriosis, other important benign conditions, are considered in Chapter 10. | Chapter 9 0ege of Obstetricians Bsoond procedures in Ì. 1995 Benign disease of the uterus and cervix Epithelium1 the uterine cervix Endometrium 103 Myometrium uterine fibroids 105 104 OVERVIEW Benign disease o1 the cervix and body of the uterus is extremely common. Cervical ectropion and fibroids are often present without symptoms but are also common problems encountered in almost every gynaecological outpatient clinic. Adenomyosis Endometriosis other important benign conditions are considered in Chapter 10. Benign of the uterus may conveniently be classified in terms of the tissue of origin the uterine cervix the endometrium or the myonietrium. Epithelium the uterine cervix The transformation zone it. a special feature of the ecto-iervix and corresponds to that portion of die uterine cervix visible during speculum examination. Within this aone the stratified squamous epithelium of the vagina meets the columnar epithelium of the cervical canal. The anatomical site of the squamocolumnar junction fluctuates under hormonal influence and the high cell mrnover ofthis tissue is important in the pathogenesis rf cervical carcinoma discussed in Chapter 12. The lotumnar epithelium is normally visible with the ipeculum during the ovulatory phase ofthe menstrual c de. during pregnancy and in women taking the corn-wed oral contraceptive pill in whom oestrogen levels arc elevated. In contrast only squamous epithelium is visible in a postmenopausal woman not taking hormone replacement therapy. Cervical ectropion The presence ofa large area of columnar epithelium on the ectocervix can be associated with excessive mucus secretion leading to a complaint of vaginal discharge. The appearance of the cervix is termed cervical ectropion or very inappropriately a cervical erosion . The latter term is best avoided as it conveys quite the wrong impression of what is really a normal phenomenon. Ectropion can be associated with excessive but non-purulent vaginal discharge as .

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