Cervical stenosis causing haematocervix and haematometra in a postmenopausal woman

English, Nicola; Harker, Ellen; Epee-Bekima, Mathias

doi:10.1136/bcr-2016-217161

Cited by 3 publications

(3 citation statements)

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“…A estenose do canal cervical uterino (ECCU), ou orifício exocervical estenótico ou estenose cervical uterina, diz respeito em literatura referência ao estreitamento do orifício cervical interno do útero, onde há a criação de um obstáculo, total ou parcial, da comunicação entre o canal vaginal e a superfície interna uterina, e vice-versa 1,2,3,4 .…”

Section: Introductionunclassified

Estenose cervical uterina em mulheres pós-menopausadas submetidas ao exame de vídeo-histeroscopia ambulatorial – prevalência e achados

Pires,

Murta,

Falcão Júnior

et al. 2023

Braz. J. Develop.

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Introdução: A estenose do canal cervical uterino (ECCU) é o estreitamento patológico do orifício cervical interno do útero, onde há a criação de um obstáculo da comunicação entre o canal vaginal e a superfície interna uterina. Trata-se de condição capaz de apresentar consequências clínicas significativas, como sangramento uterino anormal, infertilidade e dificuldade para o Exame de Vídeo-histeroscopia (EVH). Estima-se que sua incidência na população feminina geral seja cerca de 3,4%-4,7%, mas não é possível encontrar dados de prevalência da condição em populações específicas, como em mulheres na pós-menopausa (MPM). Estas apresentam maior predisposição à ECCU e, muitas vezes, são subdiagnosticadas. Objetivo: Analisar a prevalência de ECCU em pacientes pós-menopáusicas submetidas ao EVH, além dos achados clínicos e histeroscópicos correspondentes. Método: Estudo observacional, analítico e transversal, realizado a partir da análise de dados coletados em um Hospital Universitário em um período de 9 meses de 2022. Resultados: Contou-se com a coleta de dados de 283 pacientes, das quais cerca de 21,2% apresentaram a presença de ECCU. Ou seja, comparada à população feminina geral, a prevalência de ECCU é maior em MPM. Ademais, não houve associação significativa entre a presença de ECCU e variáveis como parto cesáreo, complicação gestacional, comorbidade, cirurgia uterina prévia, infertilidade e achados ao USTV. Conclusão: Constatou-se a prevalência de 21,2% de ECCU em 283 participantes. Destaca-se a importância de serem realizados mais estudos sobre o tema para manutenção do diagnóstico e tratamento precoces da ECCU.

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Section: Introductionunclassified

Estenose cervical uterina em mulheres pós-menopausadas submetidas ao exame de vídeo-histeroscopia ambulatorial – prevalência e achados

Pires,

Murta,

Falcão Júnior

et al. 2023

Braz. J. Develop.

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“…The complications inherent to conization include vaginal bleeding, cervical stenosis, amenorrhea, dysmenorrhea and deep dyspareunia [ 12 , 13 ]. Cervical stenosis is the most important complication due to the clinical repercussions, which may range from menstrual cramps to hematometra, infertility, and the impossibility of early detection of relapse and or recurrence of the premalignant lesion due to the difficulty of follow-up [ 12 , 14 – 17 ]. Studies show rates of cervical stenosis ranging from 3 to 25% after laser conization and from 1.3 to 19% after LEEP [ 12 , 14 , 18 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…The clinical studies evaluating anti–cervical stenosis measures have all been nonrandomized, and they have used temporary devices in an attempt to avoid this type of complication [ 22 , 23 ]. In addition, studies published to date have used several different types of devices without adequate standardization [ 17 , 24 , 25 ]. We propose the first randomized, prospective clinical trial evaluating the role of a new endocervical device called DUDA (Uterine Device to Dilate the Endocervical Canal) developed with characteristics proportional to the size of the cervical and endocervical canal to prevent cervical stenosis after LEEP in patients with high-grade squamous intraepithelial lesions (HSILs).…”

Section: Introductionmentioning

confidence: 99%

A randomized clinical trial of a new anti–cervical stenosis device after conization by loop electrosurgical excision

et al. 2021

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Background The complications inherent to conization include vaginal bleeding, cervical stenosis, amenorrhea, dysmenorrhea, and deep dyspareunia. Cervical stenosis is the most important complication due to the clinical repercussions. Studies show rates of cervical stenosis ranging from 1.3 to 19% after the Loop Electrosurgical Excision Procedure (LEEP). Objective Our primary outcome was to compare the role of a new endocervical device to prevent cervical stenosis after LEEP in patients with high-grade squamous intraepithelial lesions (HSILs). Methods A randomized clinical trial was performed including phases II and III for evaluation of a new device for cervical stenosis prevention. In Phase II, we included 25 patients who underwent LEEP and placement of the device to assess its toxicity and efficacy. In phase III, we compared two groups (with and without the use of an anti-stenosis device) to evaluate its efficacy and safety. Results From August 2015 to June 2018, 265 participants were randomized (Phase II: 25, Phase III: 120 with DUDA and 120 without DUDA). The toxicity during phase II was observed in only one patient (4%) with pain grade > 7. There were 7 cases of toxicity during Phase III, 2 in the DUDA group (1.8%), and 5 in the No DUDA group (4.5%). The complications rate was numerically higher in the No DUDA group (2.5x higher) than the DUDA group, but this difference did not reach statistical significance (p = 0.52). The rate of cervical stenosis in DUDA group was (4–7,3%), and in No DUDA group was (4.3–5.8%) (p = 0.5). We did not find a significant difference when comparing the evolution at 3, 6, and 12 months in terms of cervical patency and visualization of the squamocolumnar junction (SCJ) during colposcopy. The DUDA group exhibited 15% to 19% nonvisualization of the SCJ, whereas that rate ranged from 10 to 12% in the No DUDA group. Conclusions The rate of cervical stenosis was not different comparing the use of a new device, specifically produced to prevent cervical stenosis, compared to no use after LEEP procedure. This clinical trial opens up space for a discussion of the utility of using cervical stenosis devices after LEEP. Perhaps in another type of conization it can be evaluated to avoid cervical stenosis.

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Hysteroscopic approach to uterine cervical canal stenosis

Zizolfi¹,

Foreste²,

Cammarota³

et al. 2021

Minerva Obstet Gynecol

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Cervical stenosis causing haematocervix and haematometra in a postmenopausal woman

Cited by 3 publications

References 1 publication

Estenose cervical uterina em mulheres pós-menopausadas submetidas ao exame de vídeo-histeroscopia ambulatorial – prevalência e achados

Estenose cervical uterina em mulheres pós-menopausadas submetidas ao exame de vídeo-histeroscopia ambulatorial – prevalência e achados

A randomized clinical trial of a new anti–cervical stenosis device after conization by loop electrosurgical excision

Hysteroscopic approach to uterine cervical canal stenosis

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