cervicitis(chronic)
Last reviewed 01/2018
This may follow bacterial infection at delivery or abortion, or may be due to Chlamydia trachomatis. Rarely, it is due to tuberculosis.
Presentation is typically with:
- pelvic pain
- discharge
- superficial dyspareunia
On examination, the cervix is enlarged by multiple Nabothian follicles - retention cysts of the cervical glands - which may become secondarily infected.
Management:
- cervical smear for cytology
- cervical and vaginal swabs for bacteriological culture
- antibiotics if a specific organism is identifiable
- superficial lesions - cervical cautery as an outpatient procedure without anaesthesia, either electocautery or cryosurgery
- deep lesions - deeper cauterisation or conisation under general anaesthesia
The patient must be informed that cautery causes a marked discharge for 2-3 weeks and may be associated with secondary haemorrhage around the 10th day as the necrotic slough is shed.
Cervical stenosis rarely complicates cautery.