In my medical career, I have met countless women who have come to consult about cervical health issues. Among them, cervical erosion is a common diagnosis, but many patients are confused by it, and many even question whether it really counts as a "disease". Today, I want to explain the truth about cervical erosion and why doctors sometimes recommend surgery through a real case. Last summer, Ms. Li came to my office with a worried face. She was diagnosed with cervical erosion during a routine gynecological examination. She panicked and asked me, "Doctor, I'm really scared, cervical erosion sounds so bad, is this considered a disease?, why does my doctor insist that I have surgery?" I asked her to sit down, explained in detail the medical details of cervical erosion, and discussed why surgery is a necessary option in some cases. This meeting not only eased her panic, but also made her understand why we, as doctors, recommend the most appropriate treatment for the patient's condition.
Definition and classification of cervical erosions
Cervical erosion, although the name may conjure up images of severe pathological changes, is actually a common cervical condition. In medicine, cervical erosion does not always refer to a true tissue erosion, but more often refers to an atypical proliferation of cervical epithelial cells, a condition known as cervical columnar ectopia. This phenomenon occurs at the external opening of the cervix, where columnar epithelial cells are supposed to be present inside the cervical canal, but for some reason they extend to the outside, forming the so-called "erosion" phenomenon. Cervical erosions can be classified according to their etiology and manifestations as follows: True cervical erosion: This is a less common type that involves actual damage and inflammation of the epithelial surface of the cervix. It is usually caused by infection, mechanical injury, or some chemical irritation. Pseudocervical erosion (columnar ectopia): a more common type characterized by the spread of columnar epithelial cells at the external cervical orifice without substantial tissue damage. This condition is often mistaken for cervical erosion, although it does not involve true erosion. Inflammatory cervical erosion: often associated with an infection, such as human papillomavirus (HPV) infection or other sexually transmitted diseases, the resulting inflammatory response may be described as erosion.
Why doctors recommend surgery
When dealing with cervical erosion, doctors often recommend surgery based on several key factors that are directly related to the patient's specific condition and the need to prevent more serious health problems. Here are a few main reasons why surgery is necessary in some cases: Persistent or severe erosion: When cervical erosion is persistent or severe and does not respond to conventional medical treatment, surgical treatment can effectively remove the affected tissue, reduce the extent of the erosion, and prevent the condition from worsening. High-grade intraepithelial lesions (HSIL): With a Pap smear or HPV test, if a high-grade intraepithelial lesion is found, this indicates that changes in the cells of the cervix may be indicative of a precancerous state. In such cases, surgery to remove the abnormal cells is an effective means of preventing cervical cancer.
Recurrent infections: If cervical erosions recur, with ongoing inflammation or infection, surgery may be recommended to address the problem once and for all, especially if the erosion is causing recurrent cervical inflammation or discomfort. Severe symptoms: such as persistent bleeding, dyspareunia, and other symptoms, which seriously affect the patient's quality of life, surgical treatment can effectively alleviate these symptoms and return to normal life. Ensure a thorough diagnosis: In some cases, there is uncertainty even after a thorough diagnostic evaluation. Surgery not only treats cervical erosions, but also allows for more in-depth pathological analysis of tissue samples obtained through surgery to ensure that no other underlying lesions are missed.
Precautions and care before and after surgery
Surgery is often recommended as an effective intervention in the treatment of cervical erosion, especially if non-surgical treatment is ineffective or the condition is more severe. The main goal of surgery is to remove abnormal columnar epithelial cells and reduce the risk of more serious lesions in the future. Types of surgery often include electroresection (LEEP) or cryotherapy, which can precisely remove the affected area while sparing normal tissue. Precautions before surgery: Detailed consultation: Communicate with the doctor in detail to understand the necessity, process, expected results and possible risks of surgery. Pre-procedural examination: Complete all necessary preliminary tests, such as Pap smears, HPV tests, and possibly cervical biopsy, to determine the specific plan for surgery. Physical preparation: Depending on your doctor's recommendations, you may need to suspend certain medications, such as anticoagulant medications, to reduce the risk of bleeding during surgery. Schedule rest: Make sure you have enough rest before surgery and arrange for someone to accompany you home after surgery.
Post-operative care and precautions:
Rest and recovery: Avoid strenuous exercise and heavy physical work for a few days after the operation, and ensure adequate rest. Watch for symptoms: Watch for any unusual symptoms, such as unusual vaginal bleeding or abnormal discharge, severe abdominal pain or fever, and report it to your doctor promptly. Follow your doctor's instructions: Follow your doctor's instructions for post-operative care, including the use of any prescribed medications, such as antibiotics, in case of infection. Follow-up examination: Follow-up examination will be carried out according to the doctor's arrangement to ensure the normal healing of the surgical area and evaluate the treatment effect in time.