RESUMEN
OBJECTIVE: Cervical ectropion occurs due to the eversion of the endocervix that exposes glandular cells to the vaginal milieu. The aim of the present study was to evaluate and compare the clinical efficacy of effervescent vaginal tablets of tranexamic acid and cryotherapy in women with symptomatic cervical ectopy. METHODS: The current randomized clinical trial was conducted on 92 samples of women with cervical erosive ectropion from March 20, 2022 to August 27, 2022. Participants were divided into two groups; the intervention group (n = 46) was treated with a 400 mg effervescent vaginal tablet of tranexamic acid and the control group (n = 46) underwent cryotherapy. All the patients were requested to visit weekly in the first month and then monthly for the next 3 months, and the outcomes encompass improvement of symptoms (leukorrhea, dyspareunia, pelvic pain, post-coital bleeding, and suprapubic pain) and cervical erosive ectropion view were monitored based on repeated examinations. RESULTS: In this study, no statistically significant difference was observed in cure rate of symptoms between study groups (P value > 0.05). Women in both the tranexamic acid and cryotherapy groups reported significant improvements in dyspareunia (34 [75%] vs 31 [67%]), pelvic pain (34 [75%] vs 34 [74%]), post-coital bleeding (37 [81%] vs 31 [67%]), leukorrhea (36 [78%] vs 36 [78%]), suprapubic pain (32 [71%] vs 33 [73%]) disappearance of cervical ectropion tranexamic acid (40 [86%], vs 39 [84%]). CONCLUSION: Our findings highlighted the equal effect of tranexamic acid and cryotherapy for treating cervical ectropion. Due to the ease of use, availability, and fewer side effects of tranexamic acid, it can be a suitable alternative to cryotherapy. TRIAL REGISTRATION: IRCT20220115053719N1. The name of the registry: Iranian Registry of Clinical Trials. URL of registration: https://en.irct.ir/trial/61483.
Asunto(s)
Antifibrinolíticos , Crioterapia , Ácido Tranexámico , Humanos , Femenino , Ácido Tranexámico/administración & dosificación , Ácido Tranexámico/uso terapéutico , Crioterapia/métodos , Adulto , Antifibrinolíticos/uso terapéutico , Antifibrinolíticos/administración & dosificación , Resultado del Tratamiento , Administración Intravaginal , Cuello del Útero , Persona de Mediana Edad , Erosión del Cuello del Útero/terapiaRESUMEN
OBJECTIVE: To study a suppository for treating cervical erosion, its preparation method, and to observe its therapeutic effect on cervical erosion in animal models. METHODS: Twenty rats were divided into five groups: blank control group, model group, and three different therapeutic concentration groups. Phenol slurry was injected through the vagina to create cervical erosion animal models. After seven days of drug treatment, the difference of cervical histopathology was observed and compared between different groups. RESULTS: Compared with the control group, the model group showed obvious cervical erosion, inflammatory cell infiltration, vascular dilatation, and congestion. Among the administration group, the high administration group had the least inflammation and cell infiltration in the mucous membrane. CONCLUSIONS: There is a significant effect of therapeutic drugs in rats with cervical erosion, which is related to the concentration of drugs.
Asunto(s)
Factor 2 de Crecimiento de Fibroblastos/administración & dosificación , Erosión del Cuello del Útero/terapia , Animales , Relación Dosis-Respuesta a Droga , Femenino , Conejos , Ratas Sprague-Dawley , SupositoriosRESUMEN
BACKGROUND: Postcoital bleeding is a common gynaecological problem that impacts on a woman's quality of life and sexual function. There is little systematic research into its management. AIMS: To assess the efficacy and side-effects of cryotherapy as treatment for postcoital bleeding. METHODS: A prospective randomised controlled trial was conducted in a tertiary referral hospital in Hong Kong. A total of 85 women who presented with postcoital bleeding were recruited, and randomised to cryotherapy or no treatment. The treatment group received cryotherapy with compressed carbon dioxide through a cryoprobe placed on the cervix, and controls had cryoprobe on the cervix without compressed carbon dioxide flow. All recruited women were followed up two weeks, three months and six months to review their symptoms and response to the treatment. RESULTS: The treatment group had a significantly better long-term cure rate and improvement rate. At six months, the cryotherapy group reported a cure rate of 72.1% while that in the control group the cure rate was 50.0% (P = 0.04). The number needed to treat was 5. The mean improvement rate of the cryotherapy group was 82.88% +/- 35.87 but was only 61.62% +/- 55.30 in the control group (P = 0.04). The results were more significant in women with the defined pathological cervix. Apart from the vaginal discharge at second week follow up in the treatment group, there was no statistical significant difference in side-effects and complications among two groups. CONCLUSION: Our study demonstrated that cryotherapy is a safe and an effective treatment for postcoital bleeding.
Asunto(s)
Coito , Crioterapia , Infecciones por Papillomavirus/terapia , Erosión del Cuello del Útero/terapia , Hemorragia Uterina/terapia , Adulto , Crioterapia/efectos adversos , Femenino , Humanos , Persona de Mediana Edad , Infecciones por Papillomavirus/complicaciones , Resultado del Tratamiento , Erosión del Cuello del Útero/complicaciones , Hemorragia Uterina/etiologíaRESUMEN
OBJECTIVE: To investigate the effects of focused ultrasound (FUS) treatment on cervical microenvironment in infertility women with chronic cervicitis. METHODS: A total of 10 women treated in Infertility Clinic of Obstetrics and Gynecology Hospital of College of Medicine of Zhejiang University were assessed. The women aged from 25 to 34 with normal menstrual cycles had moderate or severe cervical erosion. Ultrasound showed they had normal ovulation. The sperms of their husbands had normal motility and number. The FUS they received had a focal depth range of 4 - 6 mm, a resonant frequency of 9 - 11 MHz, and an output power of 3.5 W. The follow-up time was three months. The changes of cervical mucus and the results of postcoital test were evaluated. The clinical effects on cervical erosion and complications were also evaluated. RESULT: In 6 cases of severe cervical erosion, 2 were cured, 2 were improved significantly (more than 50 % reduction of erosion area) and 2 were improved (less than 50 % reduction of erosion area). In 4 cases of moderate cervical erosion, 2 were cured, 2 were improved significantly. After the treatment, the median of cervical mucus score during LH peak were increased from 11 to 13 (Wilcoxon test, P=0.014). Postcoital test showed that the median of highly motile sperm (grade III and grade II) of 5 high-power field were increased from 22 to 52 (Wilcoxon test, P=0.015). Mild side effects without medical intervention included vaginal fluid in all 10 women, vaginal spotting in 2 women. No serious side effects were observed. CONCLUSION: The focused ultrasound therapy can help to improve the cervical microenvironment for infertility women with moderate or severe cervical erosion without serious side effects.
Asunto(s)
Infertilidad Femenina/terapia , Terapia por Ultrasonido/métodos , Cervicitis Uterina/terapia , Adulto , Enfermedad Crónica , Femenino , Humanos , Masculino , Resultado del Tratamiento , Erosión del Cuello del Útero/terapiaRESUMEN
OBJECTIVE: To explore the therapeutic effect of focused ultrasound (FU) on chronic cervicitis unitarily and its influential factors. METHODS: Three hundred and thirteen patients of chronic cervicitis were treated with the device of CZF model focused ultrasound. The therapeutic effects in 300 cases with complete records, as well as the relationship between the diameter of cervical erosion and the exposure time to FU were analyzed. RESULTS: The effective rates of FU in treatment of chronic cervicitis unitarily were 100.0% (53/53), 95.2% (120/126) and 91.7% (111/121), respectively, for mild, moderate and severe cases. The overall effective rate was 94.7% (284/300). With other parameters of FU unchanged, the exposure time to FU showed an exponential relationship with the diameter of erosion, and the regression equation was D = 31.71e(0.4808t) (R(2) = 0.9966). CONCLUSIONS: The controllability and achievement ratio of FU to treat cervical erosion could be enhanced when exposure time and manners were fully considered based on the diameter and type of cervical erosion. A satisfactory therapeutic efficacy could be achieved with FU to treat cervical erosion unitarily.
Asunto(s)
Terapia por Ultrasonido/métodos , Erosión del Cuello del Útero/terapia , Cervicitis Uterina/terapia , Adulto , Cuello del Útero/patología , Enfermedad Crónica , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Resultado del Tratamiento , Erosión del Cuello del Útero/patología , Cervicitis Uterina/patologíaRESUMEN
OBJECTIVE: To observe the effect of recombinant human epithelial growth factor (rhEGF) in promoting the healing of cervical erosion. METHODS: Forty-eight patients with cervical erosion were treated with rhEGF and 30 with 500 kHz high-frequency electromagnetic wave, and the effects of the therapies were compared in terms of healing of the cervical wound, healing time, volume of vaginal discharge and bleeding and the lasting time. RESULTS: In comparison with radiofrequency therapy, the healing of the lesion took significantly shorter time with rhEGF therapy, which also resulted in less vaginal discharge that lasted for shorter time without causing vaginal bleeding. CONCLUSION: rhEGF can obviously accelerate the healing of cervical erosion.
Asunto(s)
Factor de Crecimiento Epidérmico/uso terapéutico , Proteínas Recombinantes/uso terapéutico , Erosión del Cuello del Útero/tratamiento farmacológico , Cicatrización de Heridas/efectos de los fármacos , Adulto , Fenómenos Electromagnéticos , Factor de Crecimiento Epidérmico/genética , Femenino , Humanos , Persona de Mediana Edad , Resultado del Tratamiento , Erosión del Cuello del Útero/patología , Erosión del Cuello del Útero/terapiaAsunto(s)
Terapia por Ultrasonido/métodos , Erosión del Cuello del Útero/terapia , Animales , Biopsia , Cuello del Útero/metabolismo , Cuello del Útero/patología , Estudios de Evaluación como Asunto , Femenino , Histocitoquímica , Humanos , Ratas , Factores de Tiempo , Terapia por Ultrasonido/instrumentación , Erosión del Cuello del Útero/metabolismo , Erosión del Cuello del Útero/patologíaRESUMEN
Inflammation of the cervix and urethra in adolescents is primarily due to infection by sexually transmitted disease (STD) organisms. These organisms are most commonly Chlamydia trachomatis, Neisseria gonorrhoeae, Urea-plasma urealyticum, and herpes simplex virus. The frequency and seriousness of these infections is, in part, due to developmental, behavioral, and biological changes which put adolescents at special risk for acquisition of these syndromes. Medical knowledge is now sufficient to effectively recognize and treat these STD syndromes. What is further needed is the personal and institutional determination, adaptability, and resources to apply present knowledge among adolescents. It is among these teenagers that the personal and societal costs of STDs are the greatest.