Cervical stenosis
From Wikipedia, the free encyclopedia
The word stenosis refers to any passage in the body that is more narrow than it should typically be, for example a narrowed blood vessel (aortic stenosis for instance) or a narrowed spinal canal (spinal stenosis). Cervical stenosis means that the opening in the cervix (the endocervical canal) is more narrow than is typical. In some cases, the endocervical canal may be completely closed.
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[edit] Symptoms
According to the Nezhat Medical Center, "symptoms depend on whether the cervical canal is partially or completely obstructed and on the patient's menopausal status. Premenopausal patients will have a build up of blood inside the uterus which causes sporadic bleeding and pelvic pain. Patients also have an increased risk of infertility and endometriosis."
[edit] Impact
Cervical stenosis may impact natural fertility by impeding the passage of semen into the uterus. In the context infertility treatments, cervical stenosis may complicate or prevent the use of Intrauterine insemination (IUI) or In vitro fertilization (IVF) procedures [1].
[edit] Causes of Cervical Stenosis
Cervical stenosis may be present from birth or may be caused by other factors:
- Surgical procedures performed on the cervix such as colposcopy, cone biopsy, or a cryosurgery procedure. [2]
- Trauma to the cervix. [3]
- Repeated vaginal infections. [4]
- Atrophy of the cervix after menopause. [5]
- Cervical cancer. [6]
- Radiation. [7]
[edit] Treatment
Treatment of cervical stenosis involves opening or widening the cervical canal. The condition may improve on its own following the vaginal delivery of a baby [8]. Cervical canal widening can be termporarily achieved by the insertion of dilators into the cervix. If the stenosis is caused by scar tissue, a laser treatment can be used to vaporize the scarring [9]. Finally, the surgical enlargement of the cervical canal can be performed by hysteroscopic shaving of the cervical tissue [10].
[edit] References
"Successful treatment of cervical stenosis with hysteroscopic canalization before embryo transfer in patients undergoing IVF: a case series." by Pabuccu R, Ceyhan ST, Onalan G, Goktolga U, Ercan CM, Selam B. J Minim Invasive Gynecol. 2005 Sep-Oct;12(5):436-8.
"Carbon dioxide laser treatment of cervical stenosis" by MS Baggish and P. Baltoyannis. 1987. Fertil Steril. July, 48(1):24-8.
"Hysteroscopic cervical canal shaving: a new therapy for cervical stenosis before embryo transfer in patients undergoing in vitro fertilization." by N. Noyes. Fertil Steril. 1999 May, 71(5):965-6.