Cervical Ectropion: Disease Profile
Woman's Diagnostic Cyber Disease Profile
cervical eversion, pseudoeversion secondary to DES adenosis
presence of endocervical glandular epithelium on the cervix surface (portio)
Is it common?
it is common in teenagers and may be seen in pregnancy, and in women on oral contraceptives Differentiating
features a transition zone from flat, squamous epithelium to raised, glandular epithelium can be seen along edges of eversion. There may be an increased, clear cervical discharge. The presence of the glandular epithelium differentiates eversion from erosion. A cervical erosion may appear reddened but the epithelium is denuded and mucous is not clear. Other features can be confused with chronic cervicitis (cervical erosion) but in that case the woman usually has a yellowish, mucous (mucopurulent) discharge Cause In teens it is common because the glandular epithelium has not fully receded under the chronic acidity of the vaginal fluids after menses start. In women whose mothers were exposed to diethylstilbesterol (DES) in utero, the glandular tissue stays on the outside of the cervix and even sometimes over onto the vagina as a developmental birth defect.
Cervical biopsy is usually not necessary since it can be recognized visually without magnification. Occasionally colposcopy visualization is needed.
Natural history untreated
gradually the glandular epithelium is replaced by flat, squamous epithelium under the acid effect of vaginal secretions. This process is called metaplasia and can sometimes result in small patchy areas of glandular epithelium on the face of the cervix or the metaplastic process can block off endocervical glands and result in mucous pockets called nabothian cysts. Goals of
therapy (Rx) do no harm, this is not a disease process but rather a common physical fnding variant 1st choice therapy explain the finding so that the woman knows about it and so that future examiners will not try to offer an unneeded treatment Other therapies used none
any destructive therapy to the cervix such as laser, cryosurgery, cautery or conization of the cervix Reason for Rx
choices this is a normal anatomical variation References Dunnihoo, DR (ed.), Fundamentals of Gynecology and Obstetrics, J.B. Lippincott, Philadelphia, 1990: 178. Other resources